One of the toughest decisions to make at the dental office is when you’re given a choice between a silver and white filling. The daunting ambience, little facts and a few minutes given to make the decision does not help! As the clock ticks, most people decide to go with the dentist’s decision since s/he knows best. In this article, I’d like to break it down to you, so next time you visit a dentist you’re equipped with enough knowledge to ask the right questions and choose what’s best for you.
As dentists and patients, some of the things we consider while providing and receiving dental restorations respectively are: aesthetics, durability, cost and safety. While both silver (Amalgam) and White (Resin Based Composite) materials have evolved over time in their own modes, each has its unique advantages and disadvantages.
Once upon a time gold crowned teeth and glistening smiles were a symbol of wealth, prestige and beauty. That is now considered a historical era as Present-day superstars and celebrities dictate aesthetics for us today. Thus, as we follow their trend, given a choice we prefer dazzling smiles with incredibly white teeth. Consequently, when it comes to front fillings and teeth exposed while smiling, dentists and patients unanimously opt for natural tooth-colored restorations any day. As for the back teeth, silver and white materials are being chosen equally to maximally exploit the advantages of each material at distinct circumstances.
When comparing the durability of white verses silver fillings, not in the very distant past the silver fillings proved to be twice as strong as white ones but due to a dramatic enhancement in both materials, recent studies show comparable survival rates. One study checked and compared a 12-year survival rate of both and concluded comparable performance. However the catch-22 for white restorations is that it’s very technique sensitive, it takes more surgery time and requires the area being treated to be extremely dry to be as resilient as silver fillings, which are more forgiving of technique. Therefore, a silver filling would be a better option for a tooth placed far back in the mouth that cannot be kept dry of saliva or the mouth cannot stay open for long enough to perform a first-rate white filling, since no one will see it there and it’s existence will soon be forgotten.
Regarding the cost factor, silver fillings are more economical as compared to white ones and may be a good option for patients for whom the aesthetics is not much of a concern or budget is more of a concern. We can’t all look like celebrities right?
Lastly, a lot of controversy exists around the safety of silver amalgam, which has recently led to its decrease in use worldwide. This has led to the emergence of government bans, amalgam-free clinics, and anti-amalgam international conventions. The debate among professionals has also caused a hullabaloo among the public who are half informed of the situation.
Take home message: Next time you need a filling in your back teeth, ask yourself if you’d like to go with beauty (white filling) at an extra cost, time and the inconvenience of keeping your mouth open for longer or durability and less inconvenience at the expense of aesthetics which will likely not be noticeable i.e. silver filling.
Look out for my next blog, as I will decrypt the aspect of safety of silver fillings: “Are Silver fillings safe?” The debate continues…..