For over 150 years standard fillings have been made out of a silvery-grey material called ‘amalgam’. This is still one of the strongest and longest-lasting materials available for fillings. However, many people find it unattractive and some are concerned about possible health risks.

White fillings are now becoming a popular alternative to amalgam fillings. The new dental materials mean it is much easier to find a perfect match for the shade of a particular tooth. In most cases, it is quite impossible to see that the tooth even has a filling.

In some cases, the cavity that needs filling is quite large, but the surrounding tooth is healthy. A composite filling may not be strong enough, but it would seem pointless to remove more of the healthy tooth in order to make a crown. In these cases an inlay may be the answer.

The dentist can make an inlay by preparing the cavity in much the same way as they would for a filling. But instead of putting in a filling, the dentist takes an impression of the tooth. The impression is then sent to the laboratory where the technician makes an ‘inlay’ using porcelain, resin-material or gold. The dentist then bonds this into place.

Yes, though we generally recommend that fillings of any kind be replaced only when this is clinically necessary: for example, where decay occurs beneath or around an existing filling or a filling breaks. Sometimes, when the existing fillings are very large, a composite filling may not be an option - a porcelain inlay may be required. Please discuss this with our dentist.

Here is a list of the pros and cons of white composite fillings versus silver amalgam fillings. There are several important differences between the two types, it's not just a matter of appearance.

Given the opportunity to make a fully informed choice, the vast majority of today's dental patients will choose the white fillings. There are several reasons for this: In the view of many, the mercury in amalgam is viewed as potentially toxic. (Traditional dentists like to use the term "silver fillings," but they have more mercury in them than silver.) Also, the feeling is that the white composite represents a more advanced technology. Additionally, composite is more aesthetic. For all these reasons, the public is demanding white. And, with today's technology, composite fillings can easily withstand the stress required to serve in a back tooth.

They are generally less expensive. Composite fillings, if they are done correctly, take about 60% longer, require special expertise and expensive materials, and are more difficult to place, and so they cost considerably more than silver

General dentists can place amalgam without extra training. Composite requires the use of special bonding technology that many dentists are uncomfortable with.

The proper placement of a white filling requires that the site for the filling be kept totally isolated from saliva while it is being placed. In the very back of the mouth, on some patients, it is difficult to keep the tooth isolated for the duration of the procedure. This can also be uncomfortable for some patients. A silver amalgam filling does not require this strict isolation of the tooth.

The filling by itself is a stronger material, although it weakens the tooth.

Silver fillings have a longer history of use than mercury-free fillings, thus some feel that they are more tried and tested.

Since they bond to the tooth, composite fillings restore most of the original strength of the tooth. Silver weakens the teeth, making them more susceptible to breaking. Since broken teeth are very expensive to restore, composites can save a lot of expense over the long run.

Composite fillings restore the natural appearance of the tooth.

Teeth restored with white fillings are less sensitive to hot and cold than teeth restored with amalgam, if correct techniques are used.

Composites are mercury-free. Mercury in the fillings is viewed by some as being toxic.

Composites require less removal of tooth structure. Especially with new cavities, the size of the hole made for the filling can be dramatically smaller with composites.