Tooth Fillings

Dental amalgam or resin composite fillings?

 Which type of filling to choose

Thanks to technological advances, dentists and patients today have several choices when it comes to selecting materials to fill cavities. Among the choices are natural tooth-colored materials such as resin-based composite fillings and more traditional dental fillings such as those made of metal amalgam. The advent of new materials for fillings has been beneficial, especially in terms of aesthetics, but does not eliminate the appropriateness of traditional dental materials that are stronger, more durable and less expensive. These materials are best in situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.

What is dental amalgam?

Most people recognize dental amalgams as silver fillings. Dental amalgam is a mixture of mercury, silver, tin and copper. Mercury, which makes up about 50 percent of the compound, is necessary to bind the metals together to provide a strong, hard, durable filling. After years of research, mercury continues to be the only element that will bind these metals together in such a way that it can be easily manipulated to fill a cavity.

Dentists often prefer dental amalgam because it is easier to work with than other alternatives. Many dentists consider amalgam stronger than the resin-based composite, and therefore use amalgam for back teeth fillings. Many patients prefer dental amalgam for the same reasons, plus its cost-effectiveness and ability to fill cavities quickly. It is estimated that more than 1 billion amalgam fillings are placed annually.

What are resin composite fillings?

Resin composite fillings are made of ceramic and plastic compounds. Because resins mimic the appearance of natural teeth, these fillings have been used in front teeth for years. When they first appeared, however, resin compounds weren’t strong enough to be used in back teeth, where high-pressure grinding and chewing require greater durability.

In the past 10 years, technology has improved enough to allow the use of resin material in posterior or back teeth. Still, many dental plans including Delta Dental don’t cover resin fillings in teeth that aren’t visible in a smile, and many dentists choose not to use resins for one or more of these reasons:

  • With more durable resin material available for only a decade, resins haven’t stood the test of time in teeth where grinding and chewing result in heavy wear; by contrast, the durability of amalgam fillings is well documented — the average life span of amalgams is 8 to 10 years, but many last 20 years or more.
  • Amalgam is one of the best filling materials when dentists need to place fillings in areas of the mouth that are difficult to keep dry, such as molars (back teeth) or cavities below the gumline. Resin fillings need a specific environment in which to be placed; for example, the prepared tooth must be completely dry when the resin material is being applied and cured. Clinical experience has consistently shown that amalgam is, for a great many situations, still the most reliable filling material for long-term, low-maintenance function.
  • Resin costs more than amalgam, which can make the cost of the service higher than for a comparable amalgam filling.

For these reasons, the majority of dental health carriers pay for coverage of resin fillings in teeth that are visible in a patient’s smile. For example, virtually all of Delta Dental’s plans cover resin fillings on the teeth where their cosmetic benefit is critical: the six front teeth (incisors and cuspids) and on the facial (cheek side) surfaces of the next two teeth (bicuspids).

ADA and FDA recommendations for fillings

Dental amalgam has a 150-year proven track record of as one of the safest, most durable and least expensive materials used to a fill a cavity. Ongoing scientific studies conducted over the past 100 years continue to show that amalgam is not harmful.

Much of the concern over the safety of amalgams arises from the use of mercury as a bonding agent. But when mercury is combined with other materials in dental amalgam, its chemical nature changes, rendering it harmless. The amount of mercury released in the mouth under the pressure of chewing and grinding is extremely small and no cause for alarm. In fact, it is less than what patients are exposed to in food, air and water, and less than what gets released in patients who opt to have an existing amalgam filling removed.

The American Dental Association (ADA) maintains that dental amalgam remains a safe, affordable and durable cavity filling choice for dental patients. In addition, the U.S. Food and Drug Administration (FDA) does not recommend the removal of amalgam fillings from patients who have them because this could cause more harm to the tooth structure and pose other health risks to the patient.

Deciding which type of filling to use is best made by our patient and Dr. Lee, taking into account the size and location of the cavity, patient history, cosmetic concerns and cost. Ask Dr. Lee to discuss all of the choices available for dental fillings to help you decide which alternative is right for you.

What is Dental Amalgam (Silver Fillings)? Academy of General Dentistry.What is a Composite Resin (White Fillings)? Academy of General Dentistry.Questions and Answers on Dental Amalgam. U.S. Food and Drug Administration Consumer Information.

Last updated: March 2012

This oral health information is intended for educational purposes only. You may always consult Dr. Lee for any questions concerning your oral health.

Capital Family Dentistry

5 out of 5 stars based on 25 Dental Fillings reviews.

Our Latest Patient Testimonial

As always, everyone was kind,compassionate, and the dental procedures gentle.

- William C

5 out of 5 stars on

Our Latest Patient Testimonial

First time I went to new Dr and found him gentle and skilled at his work. He replaced some old fillings and they look beautiful

- Joan B

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Our Latest Patient Testimonial

I have been a long time customer of CFD. With the change of Doctors recently, I was wondering how or if the service would change. What was always great care, has only increased. The technology up-grades within the office, has only reinforced a sense of determination to enhance the patient experience, WELL DONE. As I was writing this accolade, Dr. Lee just called me, wondering how I was doing after a procedure I had this morning. What wonderful customer care!!!

- John B

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Our Latest Patient Testimonial

Excellent. Very gentle. Kept me informed every step. Gave frequent swallow breaks. Painless. I will return.

- Bob M

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Our Latest Patient Testimonial

An excellent job of replacing a chip and a sliver of my incisor that broke off when I was eating. My tooth looks better than it did before my mishap. The whole procedure took little more than a half hour. I went anticipating the possibility that I needed a crown, so was very pleasantly surprised.

- Marty L

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Our Latest Patient Testimonial

I am a self-admitted dental chicken... not an easy customer. My first visit was due to serious pain in a broken tooth. The staff could not have been any nicer or gentle... they won me over with their quick care, complete explanation of the procedure needed and assistance with my insurance. I have since returned for cleanings and fillings and was completely comfortable with my care. My only hesitation of recommending this group of professionals is that they may become so popular that I couldn't get in on a moments notice... they are that good. And they deserve the high ratings.

- Donna M

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The staff and Doctors are amazing. They are very friendly and caring. Drs. Ingram and Lee have a very gentle technique and are so compassionate. My experiences there are always better than I expected, compared to past dental experiences. Thank you Thank you everyone at Capital Family Dentistry!

- Kathryn S

5 out of 5 stars on

Our Latest Patient Testimonial

Thanks for squeezing me in today!!

- Kathy K

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I'm a lifer. Always the best service and care

- Tanner T

5 out of 5 stars on

Our Latest Patient Testimonial

I'm a nervous dental patient, and the staff and Dr. Lee helped me to feel very calm and comfortable. My fillings were pain free, even though I struggle with getting numb enough. I was really impressed that Dr. Lee called later in the day to follow up and check on how I was feeling.

- Nora W

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Our Latest Patient Testimonial

I have been coming to Capital Family Dentistry for years and have been thoroughly pleased with the staff and the work that I have had done. I would highly recommend them.

- Deborah F

5 out of 5 stars on

Our Latest Patient Testimonial

Dr. Lee and his staff were very encouraging and helped calm my fears. He was the first dentist to ever tell me that I did great.

- Melissa L

5 out of 5 stars on

Our Latest Patient Testimonial

Great and friendly group. Always positive and caring. Thank you.

- Buong L

5 out of 5 stars on

Our Latest Patient Testimonial

Dr. Lee is a true professional. He is a caring and compassionate dentist that has excellent skills. He was the right choice by Dr. Ingram to take over this business. I would highly recommend him to any new patients.

- Patrick L

5 out of 5 stars on

Our Latest Patient Testimonial

Everyone is so caring and considerate! I felt so comfortable! Very professional, kind, down to earth. Exactly what I needed! Such a relief to be in good hands and feel trusting!

- Liz E

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Our Latest Patient Testimonial

Like most folks I don't like going to the dentist, but I found Doctor Lee to be to be tremendously gifted. Thank you and your staff for your excellent care.

- Randy J

5 out of 5 stars on

Our Latest Patient Testimonial

The visit was fine. The staff and Doctor were very concerned that "all was going well" during my fillings.

- Alena W

5 out of 5 stars on

Our Latest Patient Testimonial

The staff acted in a professional manner. My questions prior to treatment were answered clearly and completely. Overall, the office has a relaxed, and friendly atmosphere. Filling perfectly matches the tooth color. Thank you!

- Diane M

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Our Latest Patient Testimonial

While a routine visit for a filling, I was surprised to get a call from the doctor to check on me to make sure I was not having any problems or to call if I did experience a problem. Great client care.

- Kenneth K

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Great service ,great people

- Michael M

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