Dr. Mike Malone’s Blog

Years ago, I let my former dentist talk me into white fillings, and have had cause to regret it ever since. My teeth became very sensitive, and over time I have had to have all those filling replaced by a different dentist. Two of the teeth my former dentist treated were my wisom teeth, and now the white filling material has completely worn away. The teeth where the fillings used to be look awful. They are yellow and ugly, and it makes me angry all over again that I let that dentist talk me into white fillings. Now my new dentist wants to use the same fillings to fix the problem! She says she does not even place silver fillings anymore.

Do I need to find ANOTHER new dentist? Why in world would she want to use something that clearly doesn’t work for me?

Edith in Tulsa, OK

Dear Edith,

The white fillings are not the problem. The technique your former dentist used to place them was the problem.

Many dentists have gone “mercury free”, meaning they no longer place silver amalgam fillings. Silver amalgam fillings are a source of ongoing controversy in the dental field, and more and more people in the general population are also aware of this controversy. Silver amalgam fillings are more than 50% mercury by weight, a known neuro-toxin. Recent studies are inconclusive about whether or not the small amount of mercury vapor released during chewing is harmful to the body, but many people are opting to err on the side of caution and just avoid them altogether. As an additional factor, properly placed white fillings are without question the better choice from an aesthetic standpoint.

Amalgam fillings require more of the tooth structure to be removed, and the material of the filling actually weakens your teeth. The only real advantage of amalgam fillings is that they are easier to place than white fillings, and the technique to place them is throughly covered in dental schools. Most dental schools do NOT require graduating dentists to know how to properly place a white composite filling.

If your new dentist only places white composite fillings, then chances are good that she is skilled at it. To put your mind at ease, ask her about her training for this kind of procedure. Placing white composite fillings requires strict adherence to the proper protocol. If your former dentist had followed this protocol, your teeth would not have been sensitive.

If you are satisfied that she has the proper training, then I think you can confidently go ahead with the white fillings in your wisdom teeth. The material of the filling bonds with your teeth to actually make the overall structure of your tooth stronger, and will serve to seal the tooth. White composite fillings also do not convey heat and cold the way amalgam fillings do, and so are more comfortable.

I have a back molar that needs to have a filling. I asked my dentist about getting a white filling, because it looks so much better than the ugly silver ones, but he did not seem to want to use a white filling in my back tooth.  What should I do? I hate the way the silver fillings look, and I heard something about them containing mercury.

–Addison from New Orleans

Dear Addison,

This is a tricky situation - you should always avoid pushing your dentist to do something he does not feel comfortable doing. Your dentist may be reluctant to put a white filling in your back molar because he is not confident in his ability to do the job properly. The placement of white composite fillings is not required training in dental schools, so a dentist must seek training above and beyond his dental school training to know how to effectively place a white composite filling, particularly in the back of the mouth.

That being said, if you are really sure you want a white filling, you will want to seek a dentist who is trained to place white composite fillings properly.

You are very right - white composite fillings are much more attractive than silver amalgam fillings. And you are also correct about the mercury - silver amalgam fillings are more than 40% mercury by weight, and whether or not that mercury is toxic to the body is a hotly debated subject in the world of dentistry. Some research seems to indicate that small amounts of mercury are released when chewing, but it has not been determined that the amount of mercury released is toxic. Many people choose to err on the side of caution and go with the white composite fillings.

Again, you should always avoid pushing your dentist into doing something he is not comfortable doing. This often has a less than satisfactory result. To locate a dentist in your area who is trained to place white composite fillings, check the referral list on mynewsmile.com.

For more information on white fillings, check out our website.