Many people think that modern dentistry only dictates using white fillings. I feel there is a place in good patient care for both a traditional amalgam (silver) filling and the composite (white/plastic) filling. For me, it’s all about the size and location of where the filling is to be placed. Having observed the longevity of both types of fillings in back molar teeth for over 20 years, I believe the larger than average molar silver fillings last longer than white ones. This observation comes from seeing more than 8,000 patients in this community who have come to me with fillings from other dentist in their back teeth that have needed replacement.
Dental benefits for Medicaid recipients only pay for silver fillings. This is because fees for white fillings are much more than for silver fillings. Both the American Medical Association and the American Dental Association have currently and for many decades published sound scientifically-based studies showing that amalgam (silver) fillings are very acceptable and poses no health risks to the public.
I like white fillings because they are cosmetically superior to silver fillings. If a patients requests that I replace all of their silver fillings with white ones for cosmetic reasons I understand. Remember though that every time you drill on a tooth you run the risk of nerve damage. I advise patients to replace the silver filling with whites ones as either they have more decay in that tooth or if the filling or tooth breaks.
A dentist must be able to totally control moisture to place a white filling. If the location is well below the gum like under the edge of a failing crown, or a large area in a back molar than a silver filling is better. Talk over the options with your dentist the next time you need a filling.