Many teeth are still being filled with the silver-coloured amalgam fillings because they are long- lasting and less expensive than some other options. Presently, there is a heated debate among dentists about the choice of fillings for the teeth.
Some patients are quick to opt for the composite resin filling simply because it is a white filling and will better match the natural tooth colour. However, because the resin is composed of plastic and glass mixture, it probably won’t last as long as other fillings for the teeth. There also seems to be a problem with deep-fillings when a composite is used. They can create insensitivity and even pain that can lead to more intense dental efforts to reverse–and that can possibly lead to nerve damage. Dentists will tell you that when it comes to longevity and cost-effectiveness, amalgam fillings are hard to beat. But many dentists no longer recommend amalgam fillings and are even replacing them with composite fillings because of the materials in amalgam fillings. An amalgam filling is an alloy of mercury (50%), silver, copper, tin and sometimes zinc. On the other hand, there is no denying that amalgams are more readily visible-often appearing as black dots among the teeth.
Because of the fear of mercury in amalgams, several European countries, as well as several United States dental schools, have refused to accept dental amalgam as an alternative dental filling material. In many cases, dentists have recommended the removal and replacement of silver amalgam in a patient’s mouth with crowns, inlays, or composite fillings. This overlooks the fact that mercury vapours are also released when the amalgam filling is removed. And, often, this extensive “correction” of otherwise good fillings and healthy teeth causes the patient to experience more pain and problems. Moreover, In the United States, official studies by the Food and Drug Administration (FDA) and the National Institute of Health (NIH) have stated that “current data is insufficient to support an association between mercury release from amalgams and the various complaints that have been attributed to this restorative material.” The American Dental Association (ADA) has joined the FDA in positing that amalgam is a safe restorative material, and any dentist who recommends removing amalgams due to health concerns from mercury is deemed unethical and could lose their license.
Dentists are quick to point out that besides there being even a hint of mercury getting into the bloodstream, the materials in amalgams shrink and degrade over time exposing the cavity. On the other hand, they contend the materials in composites are primarily adhesives, stick to the inside of the teeth and will not shrink over time. Another important reason for choosing composite fillings IS they are more aesthetically pleasing. They match the other teeth better and are, therefore, worth the extra cost and the few extra minutes. Because of this, they are the way most teeth are being filled today and are recommended by so many dentists.