18-07-2023

Amalgam removal: Should you remove your silver filings?

Amalgam was once a popular choice for fillings. If you had a cavity thirty years ago or longer, chances are your dentist used amalgam or a silver filling to repair your tooth. While amalgam is a safe material, today some patients are opting to have their old fillings replaced.

Why replace amalgam fillings?

Amalgam often gets a bad rap because of the materials it contains. Amalgam is around 50% mercury with the rest of the material made up of metals including silver, tin and copper. A dental filling that contains mercury may sound unsafe but organisations like MedSafe have found there is no evidence of adverse health effects on patients with amalgam fillings. The amount of mercury used in amalgam is very small and isn’t absorbed easily by the body.

So, if there’s nothing wrong with having an amalgam filling, why get them replaced? For most patients, it comes down to personal preference.

Aesthetic reasons

Silver fillings stand out against the white enamel of our teeth. If you have an amalgam filling, it’s probably visible each time you open your mouth. Amalgam fillings start off looking silver but will darken over time. Today, dentists often opt for fillings made from materials that will blend in with the colour of your tooth enamel. Ceramic, porcelain and glass ionomer fillings are inconspicuous and make it impossible to tell whether you have any fillings at all.

If you don’t like the way your amalgam fillings look, you can consider replacing them with another more subtle material.

The filling is starting to break or crack

The main reasons a dentist will recommend amalgam removal and filling replacement is because the health of your tooth is at risk. Amalgam fillings can last a long time – decades in fact. While they are durable, they do have a downside. Amalgam can expand and contract with exposure to temperature. Over time, this can lead to cracks forming in your tooth, or in the filing itself.

If your amalgam filling is cracked or starts to break around the edge, your tooth is no longer effectively sealed. This can lead to bacteria and decay getting into the tooth and causing secondary damage. Replacing the filling with a new material will seal your tooth and prevent this from happening.

Are there downsides to getting amalgam removal?

There are some things you should consider before getting amalgam removal. When a filling is cut out, some of the tooth structure is cut away with it. Amalgam fillings already require more tooth structure to be cut away than composite fillings. If you choose to have your amalgam fillings removed for personal preference, it’s worth noting that you might be removing more structure during than necessary, especially as the health of your tooth will likely stay the same.

What’s the procedure for getting amalgam removal?

All dentists are trained in amalgam removal. At Gentle Dental, we’ll start with a consultation and can alleviate any questions or concerns you have about keeping your fillings or about the procedure itself.

During the procedure, we’ll keep you comfortable with pain relief, so you won’t feel a thing. We’ll also use protection measures to isolate your teeth and prevent the inhalation or swallowing of amalgam as it’s removed. We also pipe in oxygen during the removal and use a high-powered suction to remove amalgam slurry or vapors to minimise any exposure to the material.

What material should my amalgam fillings be replaced with?

Choosing what material your silver fillings are replaced with is up to you and your dentist. Your dentist may make recommendations, depending on how much of the tooth structure was removed. Common materials to replace a silver filling include composite and porcelain. Either way, your filling will be replaced with a non-metal option and one that blends in with the enamel of your teeth.

How do I look after my new filling?

If you’re opting to keep your amalgam filling for now, make sure you schedule annual checkups so that your dentist can monitor your filling as it ages. Overall, you can look after your new filling with good oral hygiene practices:

  • Brush twice a day
  • Floss every day
  • Schedule regular dental appointments
  • Limit processed food and sugars

If you are thinking of getting amalgam removal the best thing to do is come in for a consultation at one of our Wellington, Lower Hutt or Upper Hutt locations. Our friendly dentists can talk through the procedure with you and help you decide whether amalgam removal is right for you. Book your appointment now.