Should I Remove my Metal Fillings?

teeth with one tooth having metal in it
If you’re considering replacing your metal fillings, or if your dentist has recommended it, there are some things you should know.

Many of our patients ask us if they should remove all of their old metal fillings and replace them with a newer material.  That question is a bit like opening a can of worms.  The reason it has a complex answer is because of the variety of opinions on the safety of dental amalgam.  It is very common for old metal fillings to need replacement.  What is interesting is the difference between why patients want to remove them and why dentists recommend removal.

Most Common Reasons People Consider Replacing Metal Fillings

If you are asking yourself or your dentist this question, that means you have already considered removing the metal fillings.  It also means you probably have a good reason for considering this removal.  In a discussion about removing old metal fillings, it is important for your dentist to understand why you are considering it.

Cosmetic Concerns

Teeth with black-looking metal on them
Amalgam fillings typically appear dark silver or black in color.

By far, the most common reason patients request removal of their old metal fillings is because they do not like their appearance.  For many people, their back teeth are visible when they speak or laugh.  Amalgam fillings typically appear dark silver or black in color.  In some cases, the tooth around the filling becomes grey or bluish in color over time.

The discoloration does tend to get worse as time progress, so many of our patients request removal of these dark-colored dental fillings simply to improve the appearance of their teeth.

Fear of Mercury

Another common reason our patients request the removal of dental amalgam fillings is they receive information stating that their fillings are not safe.  This is a very controversial issue in dentistry.  Unfortunately, the plethora of information available on the internet does not do anything to make the issue much clearer.  If you want to find evidence supporting the belief that the mercury in dental amalgam fillings is completely safe, you will find it.  If you look for information supporting the belief that the mercury in dental amalgams is poisonous, you will find that, too.

The American Dental Association and the Food & Drug Administration both deem dental amalgam safe for continued use.  The World Health Organization classifies it as a non-essential mercury-containing product that requires safe handling, use and disposal as it is eventually phased out of use.

Assumption that the Fillings Need Replacement

A much smaller number of people ask if their fillings need replacement simply because they have been present for decades.  The assumption is that after many years of use with the wear and tear of chewing, the fillings break down and require replacement.  This type of concern for the durability of dental restorations is appropriate and is generally an indication of responsible oral health care.

Most Common Reasons Dentists Recommend Replacing Metal Fillings

Perhaps you were not considering replacing your old metal fillings, and your dentist recommended that you do so.  There are several good reasons for replacing your amalgam fillings.  These are generalities.  You can ask your dentist for the reason your specific fillings need replacement.

New Cavities

By far, the most common reason old dental fillings require replacement is the development of new cavities underneath the old fillings.  Many people mistakenly assume that once the dentist removes a cavity and places a filling, the tooth can no longer get a cavity.  Nothing could be farther from the truth.  A tooth with a filling actually has a higher risk of getting a cavity than a tooth without a filling.

Plaque and bacteria have a tendency to collect at the edge of any dental work, like fillings and crowns.  If you do not clean these edges well, eventually a new cavity forms.  In order to get to the cavity to remove it, the dentist has to remove the old metal filling in its entirety.

Fracture of the Filling or Tooth

It is very common for old metal fillings to crack, and it is also common for the remaining tooth structure around an old metal filling to crack.  These cracks are entry points for bacteria into the tooth, and they require restoration in order to prevent future dental problems (like cavities or progression of the crack).

If the tooth itself is cracked, a filling may not be the best replacement option.  Cracked teeth often require full coverage with a dental crown.

Significant Wear and Tear

teeth with metal on side of tooth instead of fully on top, like metal got partially scraped off
“Open margins” allow for bacteria, plaque, and eventually, cavities to develop.

Some people are just really hard on their teeth.  Chronic teeth grinding or clenching can take its toll on both the teeth and the dental work.  Over time, the fillings may break down, causing small gaps to open between the filling and tooth.  These gaps, called “open margins”, allow bacteria and plaque buildup, which can also lead to cavities.

What is the Replacement for Metal Fillings?

We use tooth-colored composite resin fillings for every new restoration, whether we remove metal fillings or not.  Composite is a better cosmetic option and is metal-free.  It also bonds to tooth structure, allowing us to perform more conservative dentistry and preserve more of your natural tooth.

Interested in Filling Replacement?

Call today to schedule a consultation with our dentists.  We will evaluate all of your existing dental work and inform you of any concerns we see.