Amalgam fillings, commonly known as silver fillings, have been used in dentistry for decades because they are strong and long-lasting. However, like all dental restorations, they can develop problems over time and may eventually require repair or replacement.
At Dural Dental Practice, we assess existing fillings carefully to determine whether they are still healthy and functioning well.
Common Problems with Amalgam Fillings
Recurrent Decay
Decay can form around the edges of old amalgam fillings when gaps develop over time. This is called recurrent or secondary caries.
Tooth Fracture
Large amalgam fillings can place stress on the remaining tooth structure. As the tooth ages, this may increase the risk of cracks or fractures.
Post-Operative Sensitivity
Some patients experience sensitivity to heat, cold, or pressure after a filling is placed. Occasionally, older fillings may also become sensitive due to leakage or wear.
Open Contact Points
Worn or poorly shaped fillings can create spaces between teeth that trap food and plaque, contributing to gum irritation and decay.
Galvanic Shock
A rare condition in which different metals in the mouth create a small electrical current, causing a sudden, sharp sensation.
Mercury and Allergy Concerns
Dental amalgam contains mercury combined with other metals. While research supports its safety for most patients, some people prefer metal-free alternatives for aesthetic or personal reasons. Allergic reactions are uncommon.
Amalgam Tattoo
Small particles of amalgam can sometimes become embedded in the gums or soft tissues, causing a harmless blue-grey stain.
Tarnish, Corrosion and Marginal Breakdown
Over time, amalgam fillings may darken, corrode, or develop worn edges known as “ditching.” These areas can collect plaque and increase the risk of further decay.
Modern Alternatives to Amalgam Fillings
Today, several restorative options are available, depending on the size, location, and condition of the tooth.
Composite Resin Fillings
Composite fillings are tooth-coloured restorations that bond directly to the tooth structure. They are popular for their natural appearance and conservative preparation.
Ceramic or Porcelain Inlays and Onlays
Porcelain restorations are highly aesthetic and durable. They are often recommended for larger restorations where additional strength is needed.
Gold Inlays and Onlays
Gold restorations are extremely durable and biocompatible. Although less commonly chosen today for cosmetic reasons, they remain one of the longest-lasting restorative options in dentistry.
Crowns
When a tooth has a very large filling or a significant risk of fracture, a crown may provide better long-term protection by covering the entire tooth.
Glass Ionomer Restorations
These materials release fluoride and may be useful in certain situations, particularly for patients at high risk of dental decay.
When Should Fillings Be Replaced?
Not every amalgam filling needs replacement. Many continue to function well for years without problems. Replacement is usually recommended when there is:
- Recurrent decay
- Cracking or fracture
- Significant wear
- Pain or sensitivity
- Poor function or food trapping
At Dural Dental Practice, we tailor treatment recommendations to each patient and discuss the most appropriate restorative options to help maintain long-term oral health and function.
