The Silver Bullet
Q: Yesterday I saw my dentist. In his examination, he said that my bite was causing a lot of wear on my fillings and that a bunch of them would have to be replaced. That was a surprise because seven or eight years ago I had all my silver fillings taken out and white ones put in. He said that for a strong bite like mine, the white fillings don’t last very long by comparison to silver fillings. I told him if I’d known that, I would have stayed with the silver ones. My wife had replaced hers, they looked good and it seemed easy enough, so I had it done too. Now he says I’ve worn the teeth so badly that I need crowns on some of them. I’m frustrated because I don’t feel any pain and I can’t feel any problems. If white fillings don’t last, why put them in? My wife said it was because of the mercury that she had hers replaced – is that a factor? My health was good when I had silver fillings – what’s so bad about them? In any case, now I’m looking at crowns and onlays, whatever they are. Is there a good material that will last like my silver fillings? Should I go back to silver?
A: Silver amalgam fillings have come under public scrutiny and pressure for over 150 years. It has survived because it has a history of durability and relatively low cost compared to gold or porcelain, or a combination of these two. In the early eighties, great pressure was brought to bear to the point that white fillings are today a consumer driven material. Yes, there was pressure from inside the profession for white fillings, but consumers have voted with their pocketbooks for white fillings in lieu of black fillings.
For over 35 years, manufacturers have tried to find a white filling material that would match silver amalgam for longevity. We are still not there. Having said that, it is folks like yourself that have the most problem in wearing white fillings out – others with a less forceful bite have white fillings that have lasted 15 or more years and are still providing good service.
In the past 10 years, several products have come to the profession that have great promise in durability – but they are as expensive as crowns or gold fillings and are used as such.
When you wear out fillings in the back teeth, you inevitably wear your front teeth. Get a good analysis – have your dentist carefully scrutinize each tooth. Have him talk to you about the best materials that will last for decades. I’ve seen gold fillings that were 60 years old. If that makes you think of rappers, have him explain the new materials and the proper bite dynamics that will give you decades of trouble free service.