It is not uncommon for a patient to ask their dentist if they should have their silver fillings replaced. Amalgam/silver fillings just aren’t a popular choice with patients these days. Many people don’t want them and they want the amalgam fillings they already have out of their mouth. Here is a list of 4 common reasons I hear from patients and my thoughts on each.
1. They are causing toxic mercury poisoning/fibromyalgia/autism/cancer/radio signals in my brain. I’ve kept up with the research in my field, and to date there is no scientific evidence to support any of these claims. True, there is mercury in an amalgam filling, but the amount is not toxic and has never been demonstrated to pose any health risk to any patient. There is a lot of fanatic opinion and misinformation on the web regarding this matter, but there is no scientific basis to support the idea of replacing amalgam dental fillings because of any poisoning or health risk. If this is your only reason for considering having an amalgam filling replaced, it is a reason based on misinformation.
2. It’s ugly, you can see it when I smile. Cosmetics is a big reason many patients choose to have amalgam fillings replaced, especially if it is on a front tooth or shows when a patient smiles. Life is too short not to smile and laugh every day. If you’re not smiling or don’t show your teeth in photos because you’re self conscious about your silver fillings, having them replaced is probably a good idea for your overall happiness and wellness. Like with any dental treatment, there are risks, pros, cons, etc. and you should discuss those with your dentist.
3. The tooth hurts. Amalgam is a great dental restoration, but it doesn’t last forever, and in some situations it can cause cracks to form in the tooth. Bacteria can seep into these cracks and cause cavities to form under the filling. Leaks, cracks, bacteria, and cavities can all cause a tooth to hurt. If a tooth with a silver filling in it hurts, the possiblity exists that the filling needs to be adjusted or replaced. Consult with your dentist to determine what is going on with the tooth and what you’re options are.
4. I had a tooth with a silver filling that broke, will the others break? Should I just replace them all now? Teeth with large amalgam fillings are more prone to fracturing than teeth that don’t have large amalgam fillings. There are of course many risk factors but it is safe to say that the larger and wider the filling the greater chance there is for tooth fracture. To repair or replace or to monitor is a choice that is made on a tooth by tooth basis with your dentist. Some patients prefer to be proactive and replace any silver filling that is the slightest bit suspicous looking. Other patients prefer to take a wait and see approach and only act when the tooth breaks or is causing discomfort. Talk with your dentist and get on the same page philosophically about what you would like the plan to be.
In summary, silver/amalgam fillings are still a common dental filling material that we see in patients. They are just as safe as any other dental restorative material and concerns about toxicity or poisoning should not be factored in when evaluating replacement. There are several valid reasons for replacing them. There are also valid reasons for leaving them alone when they are not in the esthetic zone and they are functioning properly. Patients should make the decision together with a dentist they trust on when to replace their amalgam fillings.