Amalgam Restoration

Dental Amalgam is a commonly used dental filling that has been used for over 150 years. It is a mixture of small amount of mercury with at least one other metal. Amalgam has many advantages over other restorative material, such as low cost, strength, durability, and bacteriostatic effects. 

Amalgam is used in dentistry for a number of reasons. It is relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity than other direct restorative materials, such as composite. On average, most amalgam restorations serve for 10 to 12 years, whereas resin-based composites serve for about half that time. However, with recent improvements in composite material science and a better understanding of the technique-sensitivity of placement, it should be noted that this difference is decreasing.

There are circumstances in which composite restoration serves better than amalgam; when amalgam is not indicated, or when a more conservative preparation would be beneficial, composite is the recommended restorative material. These situations would include small occlusal restorations, in which amalgam would require the removal of a more sound tooth structure, as well as in “enamel sites beyond the height of contour.”

The Australian Dental Association and American Dental Association Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.

Frequently asked questions

What are amalgam fillings and when are they used?
Amalgam fillings (also called silver fillings) are made from a blend of metals including mercury, silver and tin. They are known for strength and durability and are sometimes used for large rear tooth cavities when cost or access to aesthetics isn’t the priority.

Are amalgam fillings safe and durable?
Yes. The Australian Dental Association and other credible health bodies consider amalgam fillings safe for most people. They are highly durable and can last many years, although dental cracks may occur over time because metal expands and contracts differently to tooth structure.

Do I need to replace old amalgam fillings?
Replacement is only recommended if fillings are worn, fractured, leaking or decay is present underneath. Replacing intact amalgams purely for cosmetic reasons may remove healthy tooth structure and is generally unnecessary.