WHITE Fillings vs SILVER Fillings:
Since the advent of White fillings some 30 odd years ago there has been a strong argument about which one is better white or the silver amalgam. There has been lots of arguments and counter arguments showing one of them as the ONE than the other, but in this whole debate sometimes the patient is left confused as to decide on what restoration to go with. By writing this blog I want to assist the patients to make an informed choice.
As a dentist my views on this topic are directly related to my daily practice and experience. Before the white fillings were discovered amalgam fillings were doing great in terms of stability and performance, but after the discovery of white fillings there were specific research conducted to show the disadvantages of silver amalgam fillings especially to show the harmful effects of mercury on the patient’s health. Silver fillings were indirectly related to mental health disorders such as Alzheimer and Dementia. This, when it was reiterated in some of the magazines and by many dentists that it became a reason of fear in many patients and then most of them never wanted to have a silver filling done and at the same time many wanted them to be replaced.
Now the big question : Are silver fillings this harmful?
Well the answer is this :
Till date there has not been any one conclusive research which links mercury in the silver filling directly to any of the mental health disorders. So the chances of mercury in the silver filling causing any harm to the patient is not yet established. If I relate my own experience, I see a lot of geriatric patients in my Mt Brydges office who have had silver fillings for more than 40-50 years. Most of them are hale and hearty and quite a few of them will put even a young person to shame with their sharp wit and observation. But at the same time White fillings cannot boast of such success as its history is not that old.
Do we do silver fillings at Future Dental?
No we don’t. And one of the biggest reason of not doing them is because of low esthetics. None of the patients young or old want silver fillings in their mouth any more. They have all moved to more esthetic white fillings. The other important reason of not doing them is the environmental waste that the silver filling creates with mercury. Although all our offices uses high grade mercury separators, but we still refrain from using them. Also with the advancement of white fillings, the new ones which we use have very good strength and less reports of leakage and sensitivity.
So it is good to change silver fillings to white ones?
We at Future Dental do not change the silver filling unless or until it is a failing restoration. I have previously worked in offices that suggested the patients to change silver fillings to a white one, but I have always refrained from doing it as I believe the disadvantages weigh in far more than advantages. As this blog is intended for general public I do not want to get into the technical details but I will say one thing that I have seen many complications on the teeth where the silver filling should not have been changed in the first place as far as patient losing the tooth. This is not said to create fear in your heart but only to help you make an informed choice. So next time your dentist asks you to change your silver filling, ask him or her about the complications and risks and then make your informed and empowered choice. If it is a failing restoration then there cannot be much choice but replacing a good restoration can have some lasting repercussions.
Ideology of Future Dental.
- We only use White fillings for almost all our restorations.
- We do not recommend to change your existing silver filling unless or until there is clinical and x ray evidence of a failing restoration
- We do change the silver fillings if the patient is troubled by the esthetics but only after making the patient aware of its risks and complications and helping him/her make an informed choice.
- We do recommend crowns for large white or sliver fillings to have a long term stability. We have observed many cases of fractured teeth on a large fillings and hence have come to this conclusion.
- We do help patients with all types of complications occurred at our or any other office.
- Last but not the least we always insist our patients to become more proactive in using preventive measures like regular cleaning and fluoride treatment to help prevent or early detection of any dental problems, saving them time and effort.
Dr. Shreyank Patel (DDS)