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Silver Fillings (Amalgams)
Advantages of silver fillings:
- Durability — silver fillings last at least 10 to 15 years and usually outlasts composite (tooth-colored) fillings.
- Strength — can withstand chewing forces
- Expense — is less expensive than composite fillings
Disadvantages of silver fillings:
- Poor aesthetics — silver fillings don’t match the color of natural teeth.
- Destruction of more tooth structure — healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling.
- Discoloration — amalgam fillings can create a grayish hue to the surrounding tooth structure.
- Cracks and fractures — although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack or fracture, amalgam material — in comparison with other filling materials — may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks andfractures.
- Allergic reactions — a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations.
Advantages of composites:
- Aesthetics — the shade/color of the composite fillings can be closely matched to the color of existing teeth. Composites are particularly well suited for use in front teeth or visible parts of teeth.
- Bonding to tooth structure — composite fillings actually chemically bond to tooth structure, providing further support.
- Versatility — in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.
- Tooth-sparing preparation — sometimes less tooth structure needs to be removed compared with amalgam fillings when removing decay and preparing for the filling.
- Disadvantages of composites:
- Lack of durability — composite fillings wear out sooner than amalgam fillings (lasting at least five years compared with at least 10 to 15 for amalgams); in addition, they may not last as long as amalgam fillings under the pressure of chewing and particularly if used for large cavities.
- Increased chair time — because of the process to apply the composite material, these fillings can take up to 20 minutes longer than amalgam fillings to place.
- Additional visits — if composites are used for inlays or onlays, more than one office visit may be required.
- Chipping — depending on location, composite materials can chip off the tooth.
- Expense — composite fillings can cost up to twice the cost of amalgam fillings