Replacing Old Amalgam Fillings: Is It Necessary?

Many patients have silver amalgam fillings from childhood and wonder if they should have them removed. Some worry about mercury content, while others simply hate the look of 'metal mouth.'

While replacing them is a personal choice, dentists generally follow the rule: 'If it ain't broke, don't fix it.' However, there are valid reasons to make the switch.

Metal expands and contracts with heat and cold. Over decades, this movement acts like a wedge, creating microscopic cracks in the tooth structure surrounding the filling. If your dentist sees these fractures, replacing the filling with bonded composite can save the tooth from breaking.

Old fillings can pull away from the tooth edges, creating gaps where bacteria can enter. This leads to decay underneath the filling. If this happens, the filling *must* be replaced.

It is perfectly valid to replace fillings simply because you want a white smile. Composite fillings blend invisibly with your teeth. Just be aware that every time a filling is replaced, a tiny bit more tooth structure is removed.

The FDA and ADA consider amalgam fillings safe for adults and children over 6. However, if you have a metal allergy or prefer a mercury-free option, composite is the standard choice.