SILVER FILLINGS There has been a lot of debate around the risks and benefits of silver fillings, especially over the fact that the amalgams (silver fillings) still contain some elemental mercury. The amount of studies conducted over the years on silver fillings would have one think that all the questions regarding its use in the oral cavity would be answered by now. Guess again. It is un-ethical for a dentist to remove an amalgam that is intact and serviceable, unless a patient specifically requests that specific service knowing that its removal also has some risks. Many old amalgam restorations can last for several years. If the tooth or the filling is cracked and if there is leakage with decay associated with an old amalgam, then it is wise to remove it and restore the tooth again. Choice of materials today is much different than it was only a few years ago. Some insurance companies have a much higher co-pay if the patient chooses something other than amalgams, but the costs should not be the only consideration when it comes to “ideal treatment” for your specific tooth. Other insurance companies will cover composites at a higher level than others. The insurance industry seems to be in a state of flux at this time in this area. The look and feel of your teeth and mouth is a personal choice. Large silver fillings have a tendency to make the tooth appear gray and even darker over time than the rest of your teeth. Also when choosing the color of the restoration you should ask yourself if you are happy with the current color of your teeth, if not then before your choose a restoration you may want to consider a color change before a colored restoration is placed. There are simple inexpensive bleaching techniques that can lighten your teeth quickly and easily. Silver fillings can last a long time and they usually can be done in one visit. They may be a little more sensitive to hot and cold initially due to an increase in thermal conduction. In rare cases some people may actually be allergic to the amalgams. If you are concerned about the presence of Mercury in your mouth then please talk to your dentist about those concerns. Together you can decide what would be in your long term best interest. The FDA has an advisory posted on their web-site at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgams/default.htm and the American Dental Association also has information on filling choices at http://www.ada.org/public/topics/fillings.asp