There has been a debate between the dental profession, health agencies and the public over the appropriate use of silver-mercury and plastic, tooth-colored fillings.
The reality is that both materials have strengths and weaknesses and the choice between the two is one that should be made on a case-by-case, or tooth-by-tooth, basis.
If economy and longevity of the filling are of primary concern and the tooth is in the back of the mouth, the silver filling may be the best choice.
If appearance or the need to strengthen the remaining tooth structure is most important, the plastic materials may be appropriate.
Make an informed choice
If the patient has a true mercury allergy, the choice is clear. However, this allergy is very rare. Claims have been made suggesting that mercury in silver fillings is a health risk, although no recognized health agency has accepted this opinion. There are many compounds found in the plastic materials and there are no assurances that some individuals will not experience an allergic reaction to one of these compounds.
The decision should be made as an informed choice between the dentist and the patient. It is important for the patient, as a good consumer, to know what is causing their dental health problems and, as a result, understand what they may do to limit their future disease. It is equally important for the patient to understand both the limitations of a treatment and other options that may be available.
While this controversy has probably attracted more attention than it deserves, it has brought out a couple of issues that often get lost in the debate between silver-mercury and plastic fillings.
First: It is important to remember that the best filling of all is one that is never needed. Preventing dental diseases is far more appropriate than trying to repair the damage after the fact. Once a tooth is affected by decay, it cannot heal and will forever be at risk for more problems. Even the best silver and plastic fillings have life expectancies which, according to some studies, may only average 11 years.
Discuss the options
Second: there are other filling materials that are usually superior to either mercury-silver or plastic. Gold restorations are noted for their length of service and, although initially more expensive, may very well be less costly in the long run. Newer processes are also available using tooth-colored materials that are processed in a laboratory and are stronger than the regular plastics. These, too, may be somewhat more expensive at first, but more economical over a lifetime.
As a good consumer, it is valuable to discuss these options with your dentist, thereby ensuring the best value for your health care purchase. Your dentist is the expert when it comes to recommending and providing dental treatment ... but the patient is the expert when it comes to decisions affecting personal health.