Dental Amalgams, or what is commonly known as silver fillings have been around for a very long time. I am going to be the first to admit, there have been numerous controversies regarding the mercury levels in such fillings. Based on sound research, it is currently understood that amalgam fillings are not harmful. The scope and research are beyond the scope of our discussion today. I am a beneficiary of amalgams.
These restorations are strong and they can last for quite a long time. I have seen such restorations last numerous decades. In fact, the two such restorations in my mouth have lasted over 30 years, without issues.
Amalgams are malleable. Meaning, I could carve it and shape it into a tooth. Amalgam fillings are wedged into teeth; they do not bind or glue to tooth structure. Thus, they often may require a larger prep.
To summarize, I usually place amalgam fillings in areas hard to reach, back teeth, where moisture control is difficult and where esthetics is not the primary concern. Having said that, there is not a right or wrong location for an amalgam. Your doctor and you will discuss the pros and cons of any such restoration.
A composite restoration, commonly known as a white filling is an esthetic tooth-colored restoration. It is a polymer. For it to harden, many small individual chemical units join through the use of light energy.
The beauty of a composite, besides aesthetics, is its ability to bond to teeth. Therefore, it is suitable for even restoring the smallest cavities and/or fractures.
Composites are suitable on all teeth. They do require good moisture control in their placement.
Over time, composites may discolor through staining.
I have seen composites last decades. But like any restoration, they are susceptible to poor oral hygiene.
As always, the placement of a composite is both art and science. Your doctor and you will discuss the pros and cons of any such restoration.