I absolutely love this dentist office! Every Dentist and dental hygienist I’ve ever been treated by, have been wonderful! I recently went to have a second opinion on a tooth with sensitivity, and Dr. Andrew’s was fantastic! She used a desensitizing resin to help with the issue. Thank you to all the Staff for being so kind and caring!
World Laughter Day falls on the first Sunday in May, but the question behind it comes up all year: do you hold back a laugh because of a dark filling? If old silver fillings make you self-conscious, it is natural to wonder whether to swap them for tooth-colored ones. Here is how the two compare and when replacement makes sense.
Amalgam vs composite fillings: the basics
Silver (amalgam) fillings are a mix of metals, including silver, tin, copper and mercury bound into a stable alloy. They have been used for well over a century, are strong, and hold up well in back teeth that take heavy chewing forces.
Composite (tooth-colored) fillings are made of resin with fine glass or ceramic particles. They are shaded to match your tooth and bonded directly to it.
| Silver (amalgam) | Tooth-colored (composite) | |
|---|---|---|
| Look | Silver, can darken over time | Matches the tooth |
| Tooth removed to place it | More, to hold the filling mechanically | Usually less, because it bonds |
| Durability | Very durable in large back-tooth fillings | Durable; large back-tooth fillings may wear sooner |
| Placement | Tolerates some moisture | Needs a dry tooth; takes a little longer |
| Contains mercury | Yes, bound in the alloy | No |
Are silver fillings safe?
The American Dental Association considers amalgam a safe, durable material. In 2020 the U.S. Food and Drug Administration recommended that certain higher-risk groups avoid new amalgam fillings when an alternative is appropriate. These groups include people who are pregnant, planning pregnancy or nursing, children under 6, and people with certain kidney or neurological conditions or a mercury allergy.
The FDA also said it does not recommend removing silver fillings that are in good condition, because drilling out a sound filling removes healthy tooth and briefly increases exposure to mercury vapor. If you have concerns about your own fillings, talk to your dentist.
Should I replace my silver fillings?
Replacement makes sense when a filling has a problem, such as:
- A crack or chip in the filling or the tooth around it
- Decay under or beside the filling, often found on X-rays
- A loose filling or leaking edge where food or stains get in
- A tooth that is cracking around a large old filling, which may need a crown instead (see crowns and bridges)
If a silver filling is intact and you simply do not like how it looks, replacement for appearance is your choice to make with your dentist. Ask how much tooth would be removed, whether a composite filling or a crown would last better in that spot, and what your plan covers.
What are the downsides of composite fillings?
Composite is not perfect. Very large fillings in back molars can wear or chip sooner than amalgam. The tooth must be kept completely dry while it is placed, so the appointment can take a little longer. Some people notice temporary sensitivity afterwards. For a very large cavity, a crown may protect the tooth better than any filling.
How long do fillings last?
It depends on the size and location of the filling, your bite, grinding and your cavity risk. Many fillings of either type last for years, and some last decades. Regular exams catch a failing filling early, while it is still a simple repair.
What happens when you replace a filling?
For most people, replacing a filling is a routine visit. The tooth is numbed, the old filling and any decay are removed, and the new tooth-colored filling is bonded in layers and hardened with a light. Many replacements are finished in one appointment. Learn more on our tooth fillings page. For a small chip or a dark spot on a front tooth, tooth bonding uses the same tooth-colored material.
Start with a check of your current fillings
The $239 new patient visit at Kona Coast Dental Care includes digital X-rays, a full exam and a cleaning, so your dentist can see which old fillings are sound and which need attention. See the new patient visit. The practice is in-network with HDS, HMSA and HMAA, accepts more than 140 plans including Delta Dental and MetLife, and offers CareCredit financing.
Frequently asked questions
Do any dentists still use amalgam fillings?
Yes, some dentists still place amalgam in certain situations, though tooth-colored composite is now widely used. Ask your dentist which material they recommend for your tooth and why.
What is the healthiest filling to get?
The best filling is the one that fits your tooth, your bite and your health history. Talk to your dentist, especially if you are in one of the FDA's higher-risk groups.
Will insurance pay to replace silver fillings?
Plans usually help when a filling is broken or has decay under it. Replacement for appearance alone is often not covered. Check your own plan.
Does replacing a filling hurt?
The tooth is numbed first, so most people feel pressure rather than pain. Sedation is available at the practice for patients with dental anxiety.
Book a visit
Call 808-329-8067 or book online. Kona Coast Dental Care, 75-5591 Palani Rd, Suite 202, Kailua-Kona. Open Monday, Tuesday, Friday 7–4; Wednesday, Thursday 7–7; Saturday 8–4.
Reviewed by the dentists at Kona Coast Dental Care · November 5, 2026