Should You Replace Old Silver Fillings with Resin? Expert Insights

Is it necessary to replace silver amalgam fillings with composite resin?

Hello, doctor.
A few days ago, I visited a dentist recommended by a friend for a teeth cleaning.
During the examination, the dentist suggested that I replace the amalgam fillings I received 15-20 years ago with composite resin.
However, I feel that my teeth are fine at the moment.
After researching online, I am concerned that replacing them might lead to increased sensitivity or the need for root canal treatment.
Will replacing them with resin harm my teeth? Will it require making larger cavities? On the other hand, if I don't replace them, could the mercury in the amalgam harm my body? I often experience mouth ulcers and have poor memory, and I wonder if this is related to the amalgam fillings I had in the past.
I also read online that some people suggest waiting until new cavities develop before replacing the filling material.
Is this correct? Thank you, doctor.

hohoho, 30~39 year old female. Ask Date: 2016/05/27

Dr. Huang Zhicheng reply Dentistry

Hello, the article by Dr.
Zhang Yanxiang from the Chinese Society of Operative Dentistry in 2014 may provide you with the best advice regarding silver amalgam.
The article points out that some studies have already confirmed that the amount of mercury released from silver amalgam is negligible compared to the amount of mercury absorbed by the human body from food and the environment on a daily basis.
The Chinese Society of Operative Dentistry does not support an immediate and complete ban on silver amalgam, and it does not recommend the removal of existing silver amalgam fillings in non-emergency situations (such as recurrent caries or aesthetic considerations).
Wishing you peace and health.
Sincerely, Huang Zhicheng, Director of Dentistry, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/05/27

More Info

When considering whether to replace old silver fillings (amalgam) with resin composite fillings, there are several factors to take into account, including the condition of the existing fillings, the potential risks and benefits of replacement, and your overall dental health.

1. Condition of Existing Fillings: If your silver fillings are intact, without cracks or decay around them, there may not be an immediate need to replace them. Silver fillings are known for their durability and can last many years, often 10-15 years or more. If they are functioning well and not causing any discomfort, it might be prudent to leave them as is.

2. Risks of Replacement: Replacing silver fillings with resin can involve some risks. The process of removing amalgam can potentially expose the tooth to further damage, especially if the filling is deeply seated. There is also a risk of increased sensitivity post-replacement, as resin fillings can sometimes be less tolerant to temperature changes compared to amalgam. Additionally, if the tooth structure is compromised during the removal process, it may necessitate a larger cavity preparation, which could lead to a higher risk of needing a root canal in the future.

3. Health Concerns Regarding Mercury: One of the primary concerns with silver fillings is the mercury content. While studies have shown that the amount of mercury released from amalgam fillings is generally low and not harmful to most individuals, some people prefer to avoid mercury altogether. However, the link between amalgam fillings and health issues like memory problems or mouth sores is not conclusively established in scientific literature. If you have specific health concerns, it is advisable to discuss them with your dentist or a healthcare provider.

4. Timing of Replacement: Some dental professionals recommend waiting until a filling is failing or until new cavities develop before replacing old fillings. This approach can minimize unnecessary dental work and preserve tooth structure. If you are experiencing issues like sensitivity or pain, it would be wise to consult your dentist to evaluate the condition of your fillings and determine if replacement is necessary.

5. Benefits of Resin Fillings: Resin composite fillings can be aesthetically pleasing as they can be matched to the color of your natural teeth. They also bond well to the tooth structure, which can provide additional support. However, they may not be as durable as amalgam in high-pressure areas, such as molars.

In conclusion, the decision to replace old silver fillings with resin should be made after careful consideration of the current condition of your fillings, your dental health, and your personal preferences regarding materials. It is essential to have an open discussion with your dentist about your concerns, the potential risks and benefits of replacement, and the best course of action for your specific situation. If you feel comfortable with your current fillings and they are not causing any issues, it may be best to leave them in place until a problem arises.

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