Composite vs. Amalgam Fillings

If you need to have a cavity filled, you may be wondering what the best materials option is. Dentistry has evolved over the years and uses many different, modern and aesthetically-pleasing options for dental fillings, so patients may naturally want to explore their options when getting a filling. Overall, there are two main types of fillings available when you need a cavity filled: composite fillings and amalgam fillings. In this blog, we’ll look at composite vs amalgam fillings and explain why Dr. McCormick chooses not to use amalgam fillings in his practice. 

Composite Fillings

Composite fillings are made of a combination of ceramic and safe plastic resin material. The advantages of composite fillings are many, which is why they’ve become increasingly popular with both dentists and patients. Composite fillings have a huge advantage in terms of aesthetics, as dentists have a wide range of colors and shades to choose from, resulting in a filling that is unnoticeable when you speak or smile. They adhere easily to the surface of your tooth, giving the filling a strong bond to the rest of your natural tooth. 

Composite fillings are also favored because they require less removal of the natural tooth structure around the cavity, which keeps them smaller and more of your tooth intact. They can be bonded to the tooth directly, so that Dr. McCormick can make a more conservative repair to the tooth.

Amalgam Fillings

You may be more familiar with amalgam fillings if it’s been a long time since you had a filling done, but they’ve received a lot of coverage in the media, and not always in a positive light. Amalgam fillings have been around for 150 years and haven’t changed much. They’re sometimes called silver fillings because of their silvery metal color, although there may not be actual silver in them. These fillings are made with an alloy, or amalgam, of metals, including silver, tin and copper, as well as liquid mercury, which is a sticking point for many health-conscious people, as mercury is toxic to the body in all forms. According to the FDA, “Dental amalgam contains elemental mercury. It releases low levels of mercury in the form of a vapor that can be inhaled and absorbed by the lungs. High levels of mercury vapor exposure are associated with adverse effects in the brain and the kidneys.”

The highest risk for mercury exposure to patients come when an amalgam filling is being placed into the tooth. It’s created by mixing the mercury with a mixture of powdered metals, and filling the cavity with it, which does release a low level of mercury, so dentists who use amalgam fillings need to be careful to mix the filling in a safe environment. Once placed, the filling mixture hardens quickly into a solid state to create the filling. This type of filling is very long-lasting and strong, and for a long time, this was the most common and most affordable method of filling cavities, so most people over the age of 40 do have one or more amalgam fillings. 

The FDA has deemed amalgam fillings to be safe for patients over the age of 6, as they generally only release mercury when being placed or removed and aren’t believed to degrade over time. However, many patients who have amalgam fillings are naturally concerned about the toxicity of the material. Others feel they have a sensitivity or allergy to the materials used in amalgam fillings. 

For the safety of our patients and team, our office is mercury-free and we do not place amalgam fillings. We do, however, offer a service to safely remove existing amalgam fillings, with strict protocols to avoid exposing our patients or team to mercury vapor during the process.

Composite vs Amalgam Fillings

When looking at composite vs amalgam fillings, composite fillings have a clear advantage over amalgam fillings, as they do not include toxic mercury, eliminating the risk of putting the patient or our dental team at risk of mercury exposure. For these reasons, our office chooses not to place amalgam fillings. 

Composite fillings are very durable and are excellent in small and medium-sized fillings, but are slightly less breakage-resistant than an amalgam filling. For that reason, some other dentists may still choose to use amalgam fillings when a large filling is needed, or in a tooth that withstands heavy chewing pressure, like a molar.  For situations when a composite filling is not advised, we will offer other metal-free options for your treatment.

Other considerations with composite fillings are that they can stain and discolor, similar to a natural tooth, but it is important in any case to keep up good dental hygiene and keep your teeth clean and healthy. It also ta