One of the biggest controversy in dentistry today deals with the choice of using an amalgam (silver) or a white filling for cavities.
Over the past few years the popularity of white filling materials have increased tremendously. The white filling material is a composite material is composed of an oligomer with an inorganic filler such as silicon dioxide. It is tooth colored so it blends in with your tooth and it can also be used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.
With recent advances in technology of composite resins, the sensitivity to cold has been drastically reduced. Originally the white filling materials were not strong enough for use on the back teeth but with the newer technology they can withstand the forces of chewing and can now be used on all of the teeth in the mouth. The newer composites also come in more shades and therefore they can be better blended in with the existing tooth.
The dental amalgam filling material has been used for 150 years and has a good track record. Recently there has been a controversy dealing with the safety of the filling material. Dental amalgam is a mixture of mercury, silver, tin and copper. Mercury, which makes up about 50 percent of the compound, is used to bind the metals together and to provide a strong, hard, durable filling. While extremely toxic, when the mercury is combined with other materials in dental amalgam its chemical nature changes, so it can’t be released into your mouth in significant amounts.
Both types of filling materials are suitable to use, the white filling material is more difficult to place and more time consuming, therefore usually costs more than the amalgam filling.
With today's trends to want more cosmetic pleasing materials, the use of the white filling material will definitely be on the increase.
While the FDA maintains that amalgam fillings are within current safety limits, there is still a major controversy about the safety of the toxic metals used to make up the amalgam.