You brush, you floss and still, you got a cavity. Which means a trip to the dentist to get it filled. You’re not happy and you’re also worried about the material your dentist may use to fill the tooth. I can’t save you from the dentist’s chair, but I can give you some information about filling material. Well, Dr. Wyatt Traina will. He’s a prosthodontist at Prosthodontics Associates in Portland, Maine. Here’s what he has to say:

Dr. Wyatt Traina/tooth filling

Dr. Wyatt Traina

One of the most common dental procedures people experience is a filling. What happens during the procedure is the dentist removes the decayed part of the tooth and fills in the resulting empty space with some sort of filling material.

The recommended filling material has changed over time as material science has progressed. Developing it is difficult because it needs many properties — it has to be strong, easy to place, resistant to corrosion, safe, tooth colored and stable in saliva.

Our two main options in 2017 are amalgam (silver) or composite (white). Let’s take an in-depth look at both.

Amalgam fillings

Amalgam restorations are made of silver, mercury, and copper with trace amounts of other elements. The precise amount of each varies by manufacturer. The components are stored separately and then mixed together immediately prior to placement.

After mixing, the silver colored material becomes soft and easy to handle like very fine wet sand. Within a few hours, the material sets hard and it’s safe for the patient to chew. Amalgam has been used since the 1800s and for good reasons. It is strong, easy to place, resistant to corrosion, safe, and stable in saliva. The biggest disadvantage to amalgam is that it is silver in color and so not suitable for fillings in the front teeth.

There have also been concerns about its safety in recent years as people become more health conscious. The biggest safety concern is over one of the main ingredients — mercury. Chemistry is an interesting science in that the properties of a part of a compound can be vastly different than the properties of the compound. For instance, hydrogen and oxygen are both flammable gasses, but together they make water.

When mercury is combined with silver in dental amalgam, it is safe. Research has shown that while dental amalgams do leech some of their components into the body, the actual amount is hundreds of times less than what the World Health Organization says is enough to be toxic. Would I do an amalgam filling on myself or my family? Yes.

Composite resin fillings

Our other more popular filling material is composite resin. This material is a type of plastic that is bonded to the tooth. It is strong, resistant to corrosion, safe, tooth colored, and fairly stable.

The trouble with composite resin is that it is very vulnerable to saliva contamination when it is being placed. As a result, these are more difficult fillings to do than the amalgam fillings.

Studies and literature say that the composite fillings are as good as amalgam for the first five years, but anecdotally I don’t think they last as long as amalgam.

Either type of filling is an acceptable way to restore a decayed tooth. The most important thing you can do is talk with your dentist about the type of filling that’s most appropriate for you.


Do you have a tooth related question? Ask it in the comment box below or send me an email (Diane Atwood from Catching Health) and I’ll do my best to get you the answer. Nothing personal, please