I spend quite a bit of time everyday talking about the differences of white and silver fillings. I thought it might be an interesting blog topic.
The first difference is the cost which I talked about in the “Things to know about your Dental Insurance” blog. You can read about why in that blog, but basically the white filling costs a little more than the silver.
Another difference is cosmetics. White fillings blend into the tooth, so usually it is very hard for the untrained eye to tell that a filling has been done. Silver fillings are, well, silver.
When I take checkup x-rays, the silver in the metal fillings create a little halo effect. So, when I look to see if there are any problems under existing fillings, the problem has to be larger for me to be able to detect it under silver fillings than under white fillings.
Conservation of healthy natural tooth structure is super important! When I am doing a white filling, I remove the decayed tooth structure and when I get to healthy tooth, I stop drilling and bond the white filling in. When I am doing a silver filling I remove the decayed tooth structure and then I have to drill in some retention features, these are required to make the silver filling stay in the tooth and not fall out. A silver filling isn’t bonded into the tooth but rather anchored. In the x-ray shown below there are 4 fillings, 2 on the upper and 2 on the lower. The decayed tooth structure was equal in size. You can see the difference in size between the top and bottom. The bottom is the white and the upper is the silver. White fillings are more conservative than silver.
These are the major differences between white and silver fillings in my eyes. There are instances in which one material is clearly a better choice than the other and if that is the case I try to educate the patient on why and guide them to the longer lasting, better material. There is a trace amount of mercury in silver fillings, but there is no science indicating this to be detrimental to the patients health. I work with amalgam (silver filling material) every day and feel it to be safe. I would not recommend white over silver fillings for this reason alone. My job as your dentist is to inform and educate you of the condition in your mouth and advise treatment when indicated. As long as either a silver or white filling will work to fix the cavity, I let the patient direct me to which material they prefer.