The short answer: yes, you can replace old silver (amalgam) fillings with tooth-colored composite, and many patients choose to. It is not always necessary, though. A healthy, well-sealed silver filling can be left alone. Replacement makes the most sense when a filling is cracked, worn, leaking, causing sensitivity, or when you want a more natural look. At your exam we show you the filling on X-rays and a photo, and explain whether to replace it now or keep watching it.
"Should I get my old metal fillings taken out?" comes up often at De Anza Smiles, especially from patients who had them placed years ago. Here is how Dr. Insiya Saboowala talks it through.
What silver (amalgam) fillings are
Silver fillings, called dental amalgam, are a mix of metals that dentists have used for more than a century. They are strong and long-lasting, which is why so many people still have them in their back teeth. Over time, though, they can darken, the tooth around them can stain gray, and the metal expands and contracts with hot and cold in a way that can stress the tooth.
Why patients replace them
There are a few good reasons to replace an old amalgam filling:
- Cracks or wear: an old filling can crack, wear down or pull away from the tooth, leaving a gap where decay can start
- Leaking or new decay: if we see decay under or around the filling on an X-ray, it needs to come out and be replaced
- Sensitivity: some patients feel sharp sensitivity to cold or pressure around a large metal filling
- Appearance: metal shows when you laugh or talk, and the tooth can look gray; a tooth-colored filling blends in
- A large old filling: when the metal takes up most of the tooth, a tooth-colored filling or a crown protects what is left better
What tooth-colored fillings are
A tooth-colored filling is made of composite resin, a tooth-shaded material that bonds directly to the tooth. We match it to the shade of your enamel, so once it is placed it is hard to see. Because it bonds to the tooth, we can often keep more of your natural tooth than metal fillings required. Tooth-colored fillings are part of our everyday general dentistry, and they are also used in cosmetic dentistry for front teeth.
What replacing a filling involves
- Numbing: the area is numbed so you are comfortable the whole time
- Removing the old filling: we gently remove the amalgam with suction and water to keep the area clean and clear the old material away
- Cleaning the tooth: we remove any decay and check the tooth underneath
- Placing the composite: the tooth-colored material is bonded in, shaped and hardened with a curing light
- Shaping and polishing: we adjust your bite and polish so it feels like your own tooth
Most single fillings are done in one visit. If an old filling has hidden a lot of decay or a crack, we will talk with you about whether the tooth needs a crown or root canal instead, and explain the options before anything is done.
Is amalgam removal safe? Dental amalgam is considered safe for most people, and there is no need to rush to replace healthy fillings. When you do choose to replace one, we remove it carefully using high-volume suction and water to limit exposure, and dispose of the old material properly. If you are pregnant or have a specific medical concern, tell us and we will plan around it.
When it is fine to wait
If an old silver filling is intact, sealed and not causing problems, replacing it just because it is metal is usually not necessary. Taking out a good filling means removing a little more tooth, so we only recommend it when there is a reason. At your checkup we keep an eye on every old filling and let you know if one starts to crack, leak or wear.
What affects the cost
The cost of replacing a filling depends on how many teeth are involved, the size of each filling, and whether a tooth needs more than a filling to protect it. Most PPO dental plans help cover composite fillings. We review your benefits with you and give you the cost up front before we start, with CareCredit available if it helps.
Replacing fillings in Cupertino
If your old silver fillings are worn, sensitive or you just want a more natural smile, book an exam with Dr. Saboowala at our office on Pacifica Drive. We will show you what we see and give you a clear plan. Call (408) 255-1700 or request an appointment.