I can usually count on one hand the number of silver fillings that I do in a year. Most of my patients do not want silver fillings because they would prefer a filling that matches the color of their teeth. Silver fillings are considered unaesthetic. But do they last longer?
One of the frustrating things dentists deal with on a daily basis are fillings and crowns that do not last as long as expected or hoped. Sometimes it is the result of a patient not brushing and flossing regularly and eating lots of cavity-causing foods and they get a cavity next to their filling or crown. But sometimes it is because the material itself has not held up as expected.
I often see silver fillings that are over 30 years old. They don't look very pretty but they are still serving the patient well. I sometimes see white fillings that are less than 5 years old that need to be replaced. I rarely see silver fillings that are that new that need to be replaced.
So what's the difference? And if you don't mind a less aesthetic filling should you consider a silver filling? White fillings are more technique sensitive. There are dozens of additional steps to place a white filling compared to a silver filling. One of the most critical steps is to make sure that the tooth is kept dry during the placement of the filling. That's why we use a dental dam or isolite to keep things dry. If the tooth is contaminated with any saliva during the placement of the filling, it will not last very long.
There is always a gap or space between a filling and the tooth. It is not big enough to see or feel, but it is big enough for bacteria to enter and cause cavities next to and under the filling. Silver fillings are self-sealing. White fillings are only sealed if careful attention is taken with each of the many steps required especially keeping the tooth dry.
I'm not trying to make a case for silver fillings. But, it is important to understand that white fillings are more complicated. That's why they cost a little more. Also if you have silver fillings that you are considering replacing, you need to make sure that it is done extremely well, otherwise you could end up with fillings that might not last as long.
Finally, its important to understand that there are two types of white fillings: Composite resin and porcelain or ceramic. If you have a larger filling, you should ask your dentist about using porcelain or ceramic rather than composite resin. It will wear better and last longer.
Article by Jonathan Campbell, DDS. Dr. Campbell is a dentist in Salt Lake City. He practices at Legacy Dental. He offers both silver and white fillings and together you can decide on the best option for taking care of whatever cavities you might have.