Should I replace silver fillings?

Q: Should I have my old silver fillings replaced with the new tooth colored fillings?

A: I like to tell my patients that there are three major flaws with silver fillings. First they are ugly. Second, they are not typically bonded to the tooth and they expand and contract with temperature, thus allowing teeth to fracture. And third, they are just plain ugly(yes, I know i said that twice). It may not seem obvious, but there are some risks you need to be aware of it you want them replaced for no other reason besides being ugly. Any time you do any dental work on a tooth you are putting the tooth at risk for potential future problems. For example, because the fillings block out everything on an x-ray, your dentist may not be able to see what is going on under the filling… and you could end up needing more treatment than originally anticipated. Sometimes a filling or replacement turns into a crown, an onlay, or root canal as well. It is also possible (although not common) that dental “insurance” companies may not cover replacement of silver fillings for tooth-colored material. They may call it “cosmetic” and you’ll be stuck with the full bill. Some people are also concerned about the mercury in these filings. Be aware that they are most “toxic” when they are newly placed, and then when they are drilled out. If there is an obvious defect or need to replace a silver filling, I always recommend replacing them with a material that looks like a tooth. Between composites and porcelain, we have great material choices to make your teeth look great.