Amalgam vs. Composite: The Unending Debate Over Dental Fillings

When you need a cavity filled, the dentist is essentially offering you a choice between two very different philosophies: the old guard and the modern contender. Amalgam (the silver filling) is known for its incredible longevity and durability. It’s cheap, it’s tough, and it’s been successfully used for over a century. However, it requires removing more healthy tooth structure to place, it’s aesthetically jarring, and it carries the baggage of a long-standing controversy over its mercury content.

On the flip side, Composite (the tooth-colored filling) is the aesthetically superior choice; it bonds directly to the tooth, requiring less drilling and virtually disappearing into your smile. The central issue remains the delicate balance of cost, safety, and longevity. While Composite fillings are favored by patients and are undeniably attractive, they are more expensive, more technique-sensitive to place, and, historically, haven’t been quite as durable as the rock-solid Amalgam, especially in high-stress areas.

Today, modern composites are rapidly closing the longevity gap, but the debate persists: are we choosing the proven, tough, but controversial material, or the beautiful, conservative option that may require earlier replacement?

MBH/PS

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In recent years, private clinics have not been recommending dental amalgams, especially due to their health hazards and disposal issues.

Nowadays, patients are concerned about aesthetics and don’t prefer amalgam fillings. High-quality composites are now available with increased strength and longevity, thereby replacing amalgam restoration.

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I would prefer composite fillings over amalgam fillings as they are aesthetically pleasing and conservative tooth preparation.

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