Is it necessary to replace silver fillings that are not bothering me?

 

Absolutely not. I kind of like the "If it's not broke, don't fix it" attitude. But I will try and explain further. There are many dentists who are urging patients to replace all the silver fillings in their mouth without a reasonable explanation why. There is a lot of controversy and literature that suggests the harmful effects of silver fillings can cause multiple health problems. More specifically, critics state the small amounts of mercury in the silver restorations can be potentially harmful leading to neuropathies.

 

Neuropathies are nonspecific disorders that can affect the nervous system and brain which alter things such as vision, memory, sense of smell and taste, etc. While mercury has been shown to demonstrate potentially harmful effects if exposed in large amounts, there is not enough conclusive evidence to deter dentists from still routinely placing silver fillings. If in doubt, you can consult the American Dental Association and the FDA as they still support the use of silver fillings as an acceptable restoration in dentistry.

 

So why should silver fillings be replaced?

 

Silver fillings should be replaced if they develop cavities around them. If the silver fillings(amalgams) chip, fracture, break, or develop symptoms such as cold/biting sensitivity, then it is acceptable to replace the fillings. In these cases, a tooth colored filling (aka "composite") would typically be used to restore the tooth back to function.

 

Is there any harm in replacing my silver fillings if they don't bother me?

 

Depending on the size of the filling and location, there is always a chance of sensitivity developing following replacement of the filling as with any other filling. This should be discussed at detail with your dentist prior to replacements. If the filling is more than 50% of the tooth, then a crown may be necessary to restore the tooth back to function as well as recreating an esthetic appearance.

 

If silver fillings are safe then why do you not do them on a regular basis?

 

Two simple reasons:

 

1. There are environmental hazards associated with disposing of silver filling material in the garbage. This is one of the few dental materials that has specific instructions for disposal requiring special filters/traps as well as pickup services that is not only expensive but time consuming.

 

2. Most patients simply do not want them! Less than 5% of the general public prefer silver fillings or the tooth colored kind. It becomes a supply and demand issue where there is no demand.

 

What happens if I whiten my teeth following my white fillings being placed?

 

Tooth colored fillings, much like crowns, dentures, bridges and veneers will not respond to teeth whitening like natural teeth. It is for this reason that tooth colored fillings that will be placed on the front teeth will typically follow teeth whitening so that the fillings will not have to be redone. Back teeth have less issues with esthetics simply because of their position, therefore not as critical.

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