Should You Replace Silver Fillings with White Fillings? A London Dentist’s Guide
South Ken MD Team
If you have ever caught a glimpse of a dark silver filling when laughing or talking, you may have wondered whether it can be replaced with something less noticeable. Perhaps you have read conflicting information online about amalgam safety. Or maybe your filling is simply starting to show its age.
Replacing silver fillings with white composite is one of the most common questions patients ask. The short answer is: it depends. Not every silver filling needs to be replaced, and the decision should always be guided by a thorough clinical assessment rather than cosmetic preference alone.
In this guide, we explain the differences between silver and white fillings, when replacement may be appropriate, what the process involves, and what to realistically expect.
Quick Answer: Should You Replace Silver Fillings?
In most cases, silver (amalgam) fillings do not need to be replaced if they are intact and the surrounding tooth is healthy. Replacement is usually considered if there is decay, cracking, leakage, or if a patient prefers a tooth-coloured alternative after discussing the risks and benefits. A dental examination is required to determine suitability.
Signs a Silver Filling May Need Review
- Cracks in the tooth around the filling
- Dark lines or gaps at the edges
- Food trapping or roughness
- Persistent sensitivity
- Visible deterioration
What Are Silver (Amalgam) Fillings?
Silver fillings — more accurately called amalgam fillings — are made from a blend of metals including silver, tin, copper, and mercury. They have been used in dentistry for over 150 years and remain one of the most extensively studied restorative materials available.
Amalgam fillings are known for their durability, particularly in the back teeth where bite forces are greatest. Many amalgam restorations last 15–25 years or more, making them a reliable option for large cavities in high-stress areas.
However, their metallic appearance is a significant drawback for patients who prefer discreet restorations. Over time, amalgam can also cause surrounding tooth structure to develop a greyish tint. Despite these cosmetic limitations, a well-placed amalgam filling that is intact and symptom-free does not automatically require replacement.
What Are White (Composite) Fillings?
White fillings are made from a resin-based composite material that can be precisely shade-matched to your natural tooth colour. Unlike amalgam, composite bonds adhesively to the tooth structure, which can allow for a more conservative preparation — meaning less healthy tooth needs to be removed.
Modern composite materials have improved significantly in strength and wear resistance, making them suitable for both front and back teeth in many situations. Our white fillings in London are placed using layered techniques and cured with a special light, achieving a natural, seamless result.
It is worth noting that composite placement is more technique-sensitive than amalgam. The tooth must be kept dry during bonding, and the material is applied in incremental layers. The suitability of a white filling depends on the size, location, and condition of the cavity being treated.
7 Reasons Patients Consider Replacing Silver Fillings
Patients choose to explore amalgam replacement for a variety of reasons — some clinical, some cosmetic:
Visible Metal When Smiling
Silver fillings in premolars or upper molars can be visible when laughing, yawning, or in photographs. Many patients find this aesthetically undesirable.
Cosmetic Preference
Some patients simply prefer the idea of tooth-coloured restorations throughout their mouth, even if the existing fillings are clinically sound.
Marginal Staining
Over time, the junction between an amalgam filling and the tooth can develop dark lines or discolouration that may be cosmetically noticeable.
Decay Beneath the Filling
Recurrent decay can develop around or underneath old fillings. If a filling needs to be removed to treat new decay, replacing it with composite may be preferred.
Tooth Fractures
Large amalgam fillings do not bond to the tooth. Over many years, the remaining tooth structure can weaken and crack, sometimes requiring the filling to be replaced with a bonded restoration.
Bite Discomfort
Changes in bite alignment or wear patterns can sometimes cause discomfort around old fillings. Reassessment may identify a need for replacement.
Smile Enhancement Planning
Patients considering cosmetic dental work may wish to address visible silver fillings as part of a broader treatment plan.
Important to Note
Replacing a silver filling is not always clinically necessary. If the filling is intact, the tooth is healthy, and there are no symptoms, monitoring may be the most appropriate approach. Removing a sound filling carries its own risks, including loss of healthy tooth structure.
Wondering whether your silver fillings should be replaced? Our dental team can assess your restorations and discuss the most suitable options for your situation.
Book a Dental AssessmentWhen Replacement May Be Appropriate — And When Monitoring Is Better
The decision to replace a silver filling should be made on a case-by-case basis following a thorough assessment. Here is a general guide:
Replacement May Be Discussed If:
There is recurrent decay around or beneath the filling. The restoration is fractured or visibly deteriorating. Margins are failing, allowing bacteria or food to enter. The tooth structure is compromised or at risk of fracture.
Monitoring May Be Suitable If:
The filling is stable with no signs of wear or damage. There are no symptoms such as sensitivity or discomfort. Dental imaging shows no decay beneath or around the restoration. The tooth structure remains sound.
If you are unsure about the condition of your fillings, arranging a private dentist appointment allows your dentist to examine each restoration and provide personalised advice.
What Happens During Amalgam-to-Composite Replacement?
The process of replacing a silver filling with a white composite restoration is straightforward and typically completed in a single appointment:
Assessment
Your dentist examines the tooth clinically and may take X-rays to evaluate the filling and underlying tooth structure.
Local Anaesthetic
The area is numbed with local anaesthetic to ensure comfort. For very small restorations, anaesthetic may not always be required.
Amalgam Removal
The old filling is carefully removed using a dental handpiece. Appropriate protocols are followed to minimise debris.
Isolation
The tooth is isolated to keep it dry during bonding, which is essential for a strong, durable composite restoration.
Layering and Curing
Composite resin is applied in thin layers, each hardened with a curing light. This builds up the restoration gradually for optimal strength and aesthetics.
Bite Check
Your bite is checked and adjusted to ensure comfort and correct alignment.
Polishing
The filling is shaped and polished to a smooth, natural finish that blends with the surrounding tooth.
"“Most patients are pleasantly surprised by how straightforward the replacement process is. Some mild sensitivity may occur for a few days after treatment, but this typically settles quickly.”"
Are White Fillings as Strong as Silver?
This is one of the most common questions patients ask, and the answer depends on several factors:
- For small to moderate cavities, modern composite materials perform well under normal biting forces
- For very large restorations, particularly in back teeth under heavy bite pressure, an onlay or crown may be more appropriate than a direct filling
- Composite fillings bond to the tooth, which can help support remaining tooth structure — unlike amalgam, which relies on mechanical retention
- No filling material lasts forever — both amalgam and composite will eventually need review or replacement
- Longevity varies depending on the size of the filling, the patient’s bite, oral hygiene habits, and whether they grind their teeth
Your dentist will advise on the most suitable material based on the specific demands of each tooth. In some cases, an indirect restoration such as an inlay, onlay, or crown may provide a more predictable long-term result than a direct filling.
Cost Factors in London
The cost of replacing a silver filling with a white composite varies depending on several factors:
- The size and complexity of the existing filling
- The location of the tooth (back teeth may require more complex techniques)
- The number of fillings being replaced in the same visit
- Whether additional restorative support (such as a build-up or crown) is needed
White composite fillings are generally more technique-sensitive and time-consuming to place than amalgam, which can be reflected in the fee. Your dentist can provide a clear estimate following an assessment, so there are no surprises.
How to Help a White Filling Last Longer
While no filling lasts indefinitely, there are practical steps you can take to maximise the lifespan of your white composite restorations. Our general dentistry services include ongoing monitoring and preventive care to help your restorations stay in good condition:
- Maintain consistent oral hygiene — brush twice daily with fluoride toothpaste and clean between teeth daily
- Avoid biting hard objects such as ice, pen lids, or packaging
- If you grind your teeth (bruxism), discuss a night guard with your dentist
- Attend regular dental reviews so any early signs of wear or deterioration can be identified
- Limit staining foods and drinks (tea, coffee, red wine) where possible, or rinse with water after consuming them
With proper care and regular monitoring, white composite fillings can provide an excellent aesthetic and functional result for many years.
Frequently Asked Questions
Is it safe to keep silver fillings?
Silver (amalgam) fillings have been used safely for over 150 years. While they do contain mercury as part of a stable metal alloy, major dental and health organisations — including the British Dental Association and the NHS — consider them safe for most patients. If your filling is intact and the tooth is healthy, there is generally no clinical reason to remove it.
Does replacing silver fillings hurt?
The procedure is carried out under local anaesthetic, so you should not feel pain during treatment. Some patients experience mild sensitivity or tenderness for a few days afterwards, which typically resolves on its own. Your dentist will discuss comfort management before starting.
How long do white fillings last?
The lifespan of a white filling varies depending on its size, location, the patient’s oral hygiene, and bite forces. Small to medium composite fillings can last 7–15 years or more with good care. Larger restorations in high-stress areas may have a shorter lifespan and could eventually require upgrading to an onlay or crown.
Can any silver filling be replaced?
Not every silver filling is suitable for direct composite replacement. Very large amalgam fillings, or teeth with significant structural damage, may require an onlay, crown, or other indirect restoration instead. Your dentist will assess each tooth individually and recommend the most appropriate option.
Do white fillings stain?
White composite fillings can pick up surface staining over time, particularly from tea, coffee, red wine, and tobacco. Regular dental hygiene visits and professional polishing can help maintain their appearance. Your dentist can also replace or repair the surface layer if significant discolouration develops.
This article is for general information. Treatment suitability varies and requires a clinical assessment.
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