Silver to White Fillings
When it's worth changing amalgam for tooth-coloured fillings, when it isn't, what goes in their place, and what the appointment and fees look like.
Can I Get My Silver Fillings Replaced with White Ones in Hamilton?
Yes. At Hamilton Smile Studios we replace old amalgam fillings with tooth-coloured composite, or with a ceramic onlay where the filling is large and the tooth needs bracing. An intact silver filling isn't a health risk, so most people swap them because they show when they smile, or because they've started to crack or leak. White fillings on back teeth start at £118, a ceramic onlay is £750, and plan members get 10% off.
Is It Worth Replacing Them?
Sometimes, but not always. Amalgam, the silver-grey mix of mercury, silver, tin and copper, has been filling back teeth for well over a hundred years, and it's tough. UK health advice is that amalgam fillings in good condition are safe and don't need taking out. Every time a filling is replaced, the cavity gets slightly bigger, so swapping a sound one costs you a little healthy tooth.
The good reasons to replace one are:
- It shows when you laugh or smile, and you'd prefer it didn't
- It's cracked, or there's a dark line or gap at its edge
- There's decay starting underneath or beside it on the X-ray
- The tooth around it has a crack, or a piece has broken off
- It's catching food, feels rough, or the tooth has become sensitive
We'll look at each of your fillings at your examination and tell you honestly which ones are failing, which are fine, and which you might simply want to change for appearance.
Health Concerns About Amalgam
Amalgam releases tiny amounts of mercury vapour, mostly when it's placed or drilled out. UK health guidance is that the amounts from intact fillings are too small to cause harm. Since 2018 it hasn't been used for children under 15 or for pregnant or breastfeeding women unless there's a strong clinical reason, as a precaution.
If you have a particular health worry, or a diagnosed allergy to one of the metals, tell your dentist. We'll talk it through without pushing you either way. If you're pregnant, we'd normally suggest waiting until after the baby is born and you've finished breastfeeding before removing any sound amalgam, since drilling it out is when exposure is highest.
Want Rid of Your Silver Fillings?
Book an examination and we'll check every filling and tell you which are worth replacing.
What Replaces a Silver Filling
The right replacement depends on how big the old filling is and how much tooth is around it.
- Composite (white filling). For small and medium fillings. Tooth-coloured resin bonded to the tooth and shaped there and then, in one visit
- Ceramic onlay. For large fillings, or where the walls of the tooth have thinned. Made from a scan of the tooth, then bonded on at a second visit. It caps the cusps and protects the tooth from splitting
- Ceramic crown. For teeth that are mostly filling already, or are cracked. Covers the whole tooth
Composite bonds to the tooth, which amalgam doesn't, so less sound tooth has to be cut away to hold it in place. Ceramic onlays are the hardest-wearing option for big back-tooth fillings. Our guide to choosing between a filling, onlay or crown goes into how we decide.
Costs
| Replacement | Usually suits | Fee | Plan member |
|---|---|---|---|
| White filling, back tooth, 1 surface | A small filling on the top of a molar | £118 | £106 |
| White filling, back tooth, 2 surfaces | A filling that runs down between two teeth | £145 | £130 |
| White filling, back tooth, 3 surfaces | A filling wrapping over several sides | £165 | £149 |
| Ceramic onlay | A large filling with thin walls around it | £750 | £675 |
| Ceramic crown, back tooth, from | A heavily filled or cracked tooth | £675 | £608 |
Every fee is confirmed in writing before we start. 1 On the NHS, replacing a filling that's sound just to change its colour isn't covered, so that's private treatment. A failing filling can be replaced on the NHS if you're on our NHS list.
How the Old Filling Comes Out
- We X-ray the tooth to see how deep the old filling goes and check for decay beneath it
- The tooth is numbed with local anaesthetic after a numbing gel
- Where suitable, we stretch a rubber dam over the tooth to wall it off from the rest of your mouth. It keeps the area dry and stops fragments going into your mouth
- The amalgam is drilled out carefully, with high-volume suction running throughout to catch particles and vapour
- Any decay underneath is cleaned out and the cavity shaped for the new material
- Composite goes in layer by layer, each one hardened with a curing light, before being carved to fit your bite. If you're having an onlay instead, we take a digital scan on our iTero Lumina and protect the tooth with a temporary until the fitting appointment
A single filling usually takes 30 to 60 minutes. You'll stay numb for two or three hours, so avoid hot drinks and chewing until the feeling is back.
One at a Time or All Together?
We'd usually start with any fillings that are failing, then the ones that show most, and leave sound fillings in the back molars until they need attention. There's no health benefit to replacing everything at once, and plenty of people are happy to change only what's visible.
If you want several done for appearance, we can group them into a couple of longer visits, working on the left and right sides at separate visits so there's always a comfortable side to eat on. If you're planning whitening as well, do that first. Composite is matched to your current shade and won't lighten afterwards, so we'd whiten with our home whitening kit, £350, let the colour settle for two weeks, then match the new fillings to it.
Strength and Lifespan
Modern composite is strong enough for most back-tooth fillings and lasts many years in small and medium cavities. It's fussier to place than amalgam, because it has to be kept completely dry while it bonds, which is one reason we use a rubber dam. For the biggest fillings, a ceramic onlay generally outlasts composite, because it's made in a laboratory, doesn't shrink as it sets and covers the cusps.
To keep new white fillings in good shape, treat them like the rest of your teeth: fluoride toothpaste morning and night, plus daily cleaning between teeth. Composite can pick up a little stain from coffee, tea, red wine and smoking, which a polish at your hygiene appointment lifts. A tooth may be mildly sensitive to cold for a week or so. If it aches when you bite, the filling may be slightly high, and a five-minute adjustment fixes it. If you grind, a night guard, £210, protects your new work.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.