Is it advisable to replace old amalgam (silver) fillings with white composite ones? I recently changed dentists and my new dentist advised doing this at a cost of about $3600. I haven’t had any problems with the existing fillings that I am aware of.
Alex in Boston
It depends. If your older amalgam fillings are “leaky fillings,” meaning that they have deteriorated with age and there are now gaps between the filling and the tooth that can allow bacteria to seep in and cause tooth decay under the filling. This can lead to serious problems. However, a dentist should not recommend replacing a filling unless there is a problem. There is no reason to replace an amalgam filling just because it is amalgam. Some patients choose to do this for cosmetic reasons or because they are concerned about the level of mercury in the fillings. But this should be a choice of the patient, never something the dentist tries to get them to do if the filling is intact. For the record, there have never been any documented health effects related to mercury in amalgam fillings. (Learn more about white composite versus amalgam (silver) fillings.)