Replacing Silver Fillings
When swapping amalgam for tooth-coloured fillings makes sense and when it doesn't, the materials that take its place, and what to expect from the appointment and the fees.
Can I Have My Old Silver Fillings Changed to White Ones in Lanark?
Yes. At Lanark Smile Studios we take out old amalgam and put in a tooth-coloured composite filling instead, or fit a ceramic onlay when the filling is large and the tooth needs strengthening. A silver filling that's intact poses no health risk, so most people change theirs because they're visible when smiling or have begun to crack or leak. White fillings on back teeth are from £118, a ceramic onlay is £750, and dental plan members save 10%.
Should You Replace Them?
It depends. Amalgam, a silver-grey blend of mercury, silver, tin and copper, has been used in back teeth for more than a century, and it is hard-wearing. UK health advice says amalgam fillings in good repair are safe and don't need removing. Each replacement makes the cavity a little larger, so changing a sound filling means losing a small amount of healthy tooth.
Sound reasons for replacing a filling include:
- It's visible when you smile or laugh and you'd rather it wasn't
- It has cracked, or a dark line or gap has appeared around its margin
- An X-ray shows decay starting under or next to it
- The surrounding tooth is cracked or has lost a piece
- It traps food, feels rough to your tongue, or the tooth has turned sensitive
At your dental examination we'll go through your fillings one by one and give you a straight answer on which are failing, which are sound, and which you might want to change purely for looks.
Is Amalgam Safe?
Amalgam gives off very small amounts of mercury vapour, mainly while it is being placed or drilled out. UK health guidance says the levels from intact fillings are too low to do harm. Since 2018, as a precaution, dentists have avoided it for under-15s and for anyone pregnant or breastfeeding, other than where a strong clinical reason exists.
If you have a specific health concern, or a confirmed allergy to one of the metals, let your dentist know. We'll discuss it with you and won't push you in either direction. During pregnancy we'd usually recommend leaving sound amalgam in place until after the birth and until you've stopped breastfeeding, because drilling it out is when exposure peaks.
Ready to Lose the Silver Fillings?
Book a dental examination and we'll assess each filling and say which ones are worth changing.
What Goes in Its Place
Which material we recommend depends on the size of the old filling and how much tooth surrounds it.
- Composite (a white filling). Suits small to medium fillings. A tooth-coloured resin that bonds to the tooth and is shaped in the chair at a single appointment
- Ceramic onlay. Suits large fillings, or teeth whose walls have become thin. Made from a scan of the tooth and bonded in place at a second appointment. It covers the cusps and guards the tooth against splitting
- Ceramic crown. Suits teeth that are mostly filling or have cracked. It covers the entire tooth
Unlike amalgam, composite bonds to the tooth, so less healthy tooth needs drilling away to keep it secure. For large fillings in back teeth, a ceramic onlay is the most durable choice. Our filling, onlay or crown guide explains how we make that call.
Fees
| Replacement | Typically for | Fee | Members pay |
|---|---|---|---|
| White filling, back tooth, 1 surface | A small filling confined to the chewing surface of a molar | £118 | £106 |
| White filling, back tooth, 2 surfaces | One that also runs down between neighbouring teeth | £145 | £130 |
| White filling, back tooth, 3 surfaces | A filling that covers several sides of the tooth | £165 | £149 |
| Ceramic onlay | A big filling with thin walls around it | £750 | £675 |
| Ceramic crown, back tooth, from | A tooth that is heavily filled or cracked | £675 | £608 |
You'll have every fee in writing before treatment starts. 1 The NHS doesn't cover replacing a sound filling just to change its colour, so that's done privately. If you're an NHS patient with us, a failing filling can be replaced on the NHS.
Removing the Old Filling
- An X-ray shows us how deep the old filling sits and whether there's decay underneath
- We apply numbing gel, then numb the tooth with local anaesthetic
- Where it's suitable, a rubber dam is placed over the tooth to isolate it from the rest of the mouth, keeping it dry and stopping fragments falling into your mouth
- We drill the amalgam out with care, using powerful suction the whole time to collect particles and vapour
- Any decay beneath is removed and the cavity is prepared for the new material
- Composite is built up in layers, each set hard with a curing light, then shaped to your bite. For an onlay, we take a digital scan with our iTero scanner instead and fit a temporary to protect the tooth until your next visit
One filling generally takes between 30 and 60 minutes. The numbness lasts two to three hours, so hold off on hot drinks and chewing until it wears off.
Replacing Several Fillings
We usually begin with fillings that are failing, move on to the most visible ones, and leave healthy fillings in the back molars until they need work. Replacing them all at once has no health benefit, and many people are content to change only the ones that show.
If you'd like several changed for appearance, we can combine them into a few longer appointments, doing the left side and the right side on different days so you always have one side to chew on. Planning to whiten too? Do that first. Composite is matched to the shade of your teeth on the day and won't lighten later, so we'd use our home whitening kit, £350, allow the shade two weeks to settle, then match your new fillings to it.
How Long White Fillings Last
Today's composite is strong enough for most fillings in back teeth and lasts for many years in small and medium cavities. It's more demanding to place than amalgam, as it has to be kept completely free of moisture during bonding, and that's partly why we use a rubber dam. Where a filling is very large, a ceramic onlay generally outlives composite: it's made in a laboratory, doesn't shrink while it sets and covers the cusps.
Look after your new white fillings as you would your natural teeth, with fluoride toothpaste twice a day and cleaning between your teeth every day. Composite can stain slightly from tea, coffee, red wine and smoking, and a polish at your hygiene appointment removes it. A tooth may be a little sensitive to cold for about a week. Soreness on biting usually means the filling is a touch high, which a quick adjustment fixes. If you grind your teeth, a night guard, £210, protects the new fillings.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.