Interesting statistic from the US this week. It appears that the American Dental Association has reported that American dentists are becoming increasingly satisfied with amalgam (silver) fillings. This may seem counter – intuitive considering that the US is considered the birth place of cosmetic dentistry. The truth I think is though that the limitations of the composite (white) fillings are becoming apparent. The two problems with these plastic fillings remain that they wear out much more quickly than the silver fillings and that they shrink while setting and gaps can open between the filling and the tooth causing them to fail. On average they only last half as long as the silver fillings. How well they perform is related to their size, which is why I always try to make the limitations known to patients before providing them. Even with this knowledge though a surprisingly high proportion of patients still want the white fillings. Really though if it has to be white it should be inlays or crowns, with the exception of small white fillings. Sadly patients with a mouth full of large white fillings are looking at years of maintenance and replacements..
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