If you have just been told you need a dental filling, you may already be wondering which type is the better choice.

White or silver? Composite or amalgam? Tooth-coloured or more traditional?

It is a reasonable question, and the answer depends on more than appearance.

A dental filling is used to repair a tooth affected by decay, wear, a crack or other minor damage. It replaces lost tooth structure and helps restore the tooth’s shape and function. However, filling materials have different properties, and not every material is suitable for every tooth.

At Alphington Dental Care, patients often ask about the differences between white and silver fillings when considering their tooth restoration options.

Some people are particularly concerned about appearance. Others want to understand strength, cost, longevity or how much natural tooth structure needs to be removed. Often, the aim is to find an appropriate balance between these considerations.

The Australian Dental Association explains that dentists can choose from several dental filling materials, including composite resin and dental amalgam, and that the most suitable material depends on factors such as the tooth’s location, bite and filling size.

Here is what separates white fillings from silver fillings and what to consider when discussing the options with your dentist.

What Are Silver Fillings?

Silver fillings are also known as dental amalgam fillings.

Amalgam has been used in dentistry for more than 150 years. It is made from a mixture of metals that includes mercury, silver, copper, tin and zinc.

Amalgam is a strong restorative material and has historically been used frequently in back teeth, where fillings may need to withstand considerable chewing pressure.

Back teeth do a lot of work. They grind food and absorb significant bite forces, so the properties of the filling material can be particularly important for larger restorations in these areas.

One obvious difference is appearance.

Amalgam fillings are silver-grey rather than tooth-coloured and can become darker with time. As a result, they may be noticeable when you laugh, speak or open your mouth.

For some patients, that is not a concern, particularly when the filling is on a less visible back tooth. For others, appearance is one of the main reasons they ask about tooth-coloured alternatives.

What Are White Fillings?

White fillings are generally made from composite resin.

Composite resin is a tooth-coloured material that can be selected to blend with the surrounding tooth. This makes it a common option when appearance is an important consideration.

Composite fillings can be used in both front and back teeth, depending on factors such as the size of the restoration, the tooth’s position and the forces placed on it. The Australian Dental Association notes that composite resin is bonded directly to the tooth surface and can be colour-matched to the tooth being restored.

One potential advantage of this bonding process is that, in some cases, less healthy tooth structure needs to be removed compared with preparing a tooth for an amalgam restoration.

That does not mean composite resin is automatically the right choice for every tooth.

Your dentist still needs to assess:

• How much tooth structure remains
• Where the filling will be placed
• The size and depth of the cavity
• Your bite
• Whether moisture can be adequately controlled during treatment
• Other individual dental factors

For many patients, one of the main attractions of composite resin is straightforward: it can provide a more natural-looking restoration because it blends with the surrounding tooth.

White Fillings vs Silver Fillings: Strength and Durability

Strength is an important consideration when comparing white and silver fillings.

Amalgam has a long history as a durable material, particularly for restorations exposed to significant chewing forces. Composite materials have also developed considerably and are now routinely used for a wide variety of restorations, including many back teeth.

However, there is no single lifespan or strength comparison that applies to every filling.

How a restoration performs can depend on:

• The size of the filling
• Where the tooth sits in the mouth
• How much natural tooth structure remains
• The amount of chewing pressure on the tooth
• Your bite
• Whether you grind or clench your teeth
• Your oral hygiene
• Your diet
• The condition of the surrounding tooth
• Regular dental reviews

A small composite filling in a front tooth is very different from a large restoration replacing a substantial portion of a molar.

The same applies to amalgam.

For this reason, neither material should automatically be described as the stronger or longer-lasting choice for every situation. The most appropriate filling material and its expected performance depend on the individual tooth and a professional dental assessment.

White Fillings vs Silver Fillings: Appearance

Appearance is often one of the biggest differences patients notice.

Composite resin is tooth-coloured. Your dentist can select a shade intended to blend with the surrounding tooth, making the restoration less noticeable.

This can be particularly appealing for:

• Front teeth
• Teeth visible when smiling
• Restorations close to the front of the mouth
• Patients who prefer not to have visible metallic fillings

Amalgam does not match the colour of natural teeth. Its silver-grey appearance is therefore more noticeable.

There is no right or wrong preference.

Some people place a high priority on having a tooth-coloured restoration. Others are comfortable with an amalgam filling in a part of the mouth that is rarely visible.

If appearance matters to you, mention it during your appointment. Your dentist can explain whether composite resin is clinically suitable for the tooth being treated.

White Fillings vs Silver Fillings: Tooth Preparation

White and silver fillings are placed differently.

How Amalgam Fillings Are Retained

Amalgam does not bond directly to tooth structure in the same way composite resin does.

Instead, the tooth is prepared in a shape that mechanically holds the filling in position. Because of this, placing an amalgam filling can require the removal of additional tooth structure to create adequate retention.

How Composite Fillings Bond to Teeth

Composite resin uses an adhesive bonding process.

The material is bonded to the prepared tooth surface, which can allow dentists to preserve more natural tooth structure in some situations.

Preserving healthy tooth structure is generally desirable, but the amount of preparation required is ultimately determined by the condition of the tooth.

For example, if a tooth has extensive decay or an old, damaged restoration, sufficient tooth structure still needs to be removed to treat the affected area appropriately.

In cases where too much tooth structure has been lost for a straightforward filling, your dentist may discuss other restorative options. These can include digital crowns or other dental restorations where clinically appropriate.

White Fillings vs Silver Fillings: Cost

Cost is another practical consideration.

Composite fillings can require several clinical steps. The tooth generally needs to be carefully isolated from moisture, and the composite may be placed and cured in increments before being shaped, adjusted and polished.

This can affect treatment time and cost.

However, filling fees depend on more than the material alone.

Factors can include:

• The size of the restoration
• Which tooth needs treatment
• How many surfaces of the tooth are affected
• The complexity of the procedure
• Whether an existing filling needs to be removed
• Whether other dental treatment is required

A small restoration on one tooth may therefore cost differently from a large restoration on another.

Rather than assuming one filling material will always cost more than another, ask your dentist about the treatment recommended for your particular tooth and any associated fees before proceeding.

Are Silver Amalgam Fillings Still Used in Australia?

Yes, dental amalgam can still be used in Australia in appropriate clinical circumstances, although its use has become much less common.

The Australian Dental Association states that, under current requirements, dental amalgam can continue to be used when a dental practitioner considers it clinically necessary for an individual patient. Current Australian requirements also restrict dental amalgam to approved capsulated forms rather than bulk mercury.

The ADA recommends minimising amalgam use in children, pregnant or breastfeeding women and people with kidney disease.

Composite resin is now frequently chosen, particularly where a tooth-coloured restoration is preferred.

If you already have an older amalgam filling that is functioning well, it does not automatically need to be replaced simply because it is silver.

The Australian Dental Association advises that there is no need to remove and replace a healthy amalgam restoration without a sound reason. Removing a filling also removes some additional tooth structure, so replacement should be considered carefully. You can read more in the ADA’s guidance on whether amalgam fillings should be removed.

Possible reasons for assessing an existing filling include:

• Decay developing around it
• Cracking or fracture
• A loose or damaged restoration
• Persistent pain or sensitivity
• Changes to the tooth
• A cosmetic concern you would like to discuss

Whether replacement is appropriate depends on the individual tooth.

Do Silver Fillings Contain Mercury?

Yes.

Dental amalgam contains mercury combined with other metals such as silver, copper, tin and zinc.

Understandably, some patients have questions about this.

Healthdirect states that amalgam is considered safe and effective for most people, while the Australian Dental Association considers approved dental amalgam a safe and acceptable restorative option when clinically indicated and used in accordance with current regulations.

There are circumstances where a different material may be preferred, including for some children, during pregnancy or breastfeeding, or for people with kidney disease. Your dentist can discuss this with you based on your medical and dental history.

If you have concerns about an existing amalgam filling, it is better to discuss them with your dentist rather than having a healthy filling removed automatically.

So, Which Filling Is Better?

There is no single answer that applies to every patient or every tooth.

White composite fillings and silver amalgam fillings have different characteristics.

A composite filling may appeal if:

• A tooth-coloured appearance is important
• The restoration is in a visible area
• Adhesive bonding is appropriate for the tooth
• Your dentist considers composite suitable for the size and position of the cavity

Amalgam may still be considered in selected clinical situations where its properties make it appropriate.

The more useful question is not simply, “Which filling is better?”

It is:

What restoration is most appropriate for this tooth?

A dentist needs to consider the location and size of the cavity, remaining tooth structure, bite, appearance preferences and other clinical factors before recommending a material.

Healthdirect similarly advises that dental professionals choose filling materials according to the individual tooth and patient rather than treating one material as universally suitable. You can find additional information in Healthdirect’s guide to dental fillings.

What If a Filling Is Not Enough?

Sometimes a tooth has lost too much structure for a conventional filling to be the most appropriate restoration.

For example, a tooth may have:

• A very large existing filling
• Significant decay
• A substantial fracture
• Extensive wear
• Too little remaining tooth structure to predictably support another filling

In these circumstances, a dentist may discuss another restorative option, such as a dental crown, depending on what the examination shows.

Alphington Dental Care provides information about digital crowns, bridges and veneers for patients who want to understand how these restorations differ from conventional fillings.

A larger restoration is not automatically required simply because a tooth has had a filling before. The decision depends on how much healthy tooth remains, where damage is located and how the tooth functions within your bite.

What About Tooth Sensitivity Before or After a Filling?

Sensitivity can also influence the discussion.

Before treatment, a tooth may react to cold, sweet foods, biting or brushing because of decay, a crack, exposed dentine or another dental issue.

Some temporary sensitivity can also occur after a filling. Healthdirect notes that a tooth may feel sensitive for a short period following dental filling treatment.

How a tooth feels afterwards can depend on factors such as:

• The depth and size of the cavity
• The condition of the tooth
• The filling material
• Your bite
• How close the restoration is to sensitive internal tooth structures

If you already have sensitivity, tell your dentist what triggers it.

For example, mention whether you experience discomfort with:

• Cold drinks
• Hot foods or drinks
• Sweet foods
• Biting
• Brushing
• Pressure on one particular tooth

These details can help your dentist investigate the cause and determine whether a filling is likely to be appropriate.

If pain or sensitivity after treatment is persistent, worsening or concerning, contact your dentist for an assessment rather than assuming it is normal.

Talking Through Your Options With a Dentist

You do not need to decide between white and silver fillings before your appointment.

A dentist can assess the affected tooth and explain the available options in the context of your individual oral health.

For example, Dr Claire Wilson can assess factors such as the size and position of the cavity, how much healthy tooth structure remains, your bite and your preferences before discussing suitable restorative options.

The conversation may include:

• Where the filling will be positioned
• How visible the tooth is
• How much chewing pressure it receives
• How large the restoration needs to be
• How much healthy tooth remains
• Whether you have sensitivity
• Whether you grind or clench
• Your preference regarding appearance
• Costs and maintenance considerations
• Whether a filling or another restoration is more appropriate

This is more useful than choosing a material based solely on a general comparison.

White and silver fillings are not one-size-fits-all alternatives. The recommended filling material, suitability of treatment, expected longevity and results depend on the individual tooth, your oral health and a professional dental assessment.

If you have been told you may need a filling, you can learn more about dental fillings and tooth restoration at Alphington Dental Care.

To discuss your options, contact Alphington Dental Care or book a dental appointment online for an individual assessment.

FAQs

Are White Fillings as Strong as Silver Fillings?

Composite resin can be suitable for many front and back teeth, but neither material is automatically the strongest option in every situation.

Durability depends on factors such as the restoration’s size, location, remaining tooth structure, bite forces, grinding habits and ongoing oral care.

Your dentist can assess the tooth and recommend an appropriate material.

Do Silver Fillings Contain Mercury?

Yes. Dental amalgam contains mercury combined with metals including silver, copper, tin and zinc.

Current Australian Dental Association guidance considers approved dental amalgam a safe and acceptable restorative material when clinically indicated and used in accordance with current regulations. Certain patient groups may be advised to minimise its use, so individual circumstances should be discussed with a dentist.

Should I Replace My Silver Fillings With White Fillings?

Not automatically.

If an amalgam filling is healthy and functioning properly, the Australian Dental Association advises that it does not need to be removed simply because it contains amalgam. Removing an existing filling also removes additional tooth structure.

Replacement may be discussed if there is decay, cracking, damage, discomfort or another clinical or cosmetic reason. Your dentist can assess the individual tooth before recommending treatment.

Do White Fillings Cost More Than Silver Fillings?

Costs vary.

Composite restorations can involve more clinical steps, but the total fee also depends on the tooth, size of the cavity, number of surfaces involved and complexity of treatment.

Ask your dentist for information about your specific treatment and costs before proceeding.

Which Filling Is Better for Back Teeth?

There is no single material that is best for every back tooth.

Composite resin can be used for many posterior restorations, while amalgam may still be considered in selected circumstances. Factors such as filling size, remaining tooth structure, bite forces and the ability to adequately isolate the tooth can influence the recommendation.

Which Filling Looks More Natural?

Composite resin generally provides the more natural-looking result because its shade can be selected to match the surrounding tooth.

This is one reason composite fillings are commonly considered for visible teeth.

Can a White Filling Replace an Old Silver Filling?

Sometimes, but suitability needs to be assessed first.

Your dentist needs to evaluate the existing restoration, the amount of healthy tooth underneath and around it, any cracks or decay, and whether the remaining tooth can support a new composite filling.

For larger restorations, a filling may not always be the most appropriate replacement, and another restorative option may need to be considered.

How Do I Choose Between White and Silver Fillings?

The best approach is to discuss the individual tooth with your dentist.

Factors worth considering include:

• The tooth’s position
• The size of the restoration
• Remaining healthy tooth structure
• Your bite
• Appearance
• Existing sensitivity
• Cost
• Your medical and dental history

Your dentist can explain the advantages, limitations and suitability of the available materials before you make a treatment decision.