If you grew up with a mouth full of silver fillings, you already know the drill — literally. For decades, silver amalgam was the default material dentists reached for anytime a cavity needed filling. But walk into Auslander Dental in Gambrills today, and you’ll find something different: tooth-colored composite resin has become the standard of care, and more patients than ever are asking to have their old metal fillings replaced entirely.

So what changed? Is composite really better, or is this just a cosmetic upgrade? In this guide, we’ll break down exactly how composite fillings and silver amalgam compare — durability, safety, appearance, cost, and long-term oral health — so you can understand why the shift happened and whether replacing your old fillings makes sense for you.

What Are Silver Amalgam Fillings?

Silver amalgam is a metal alloy made primarily of mercury, silver, tin, and copper. It’s been used in dentistry for over 150 years because it’s inexpensive, easy to place, and extremely durable under heavy chewing forces. If you have fillings from the 1980s, 90s, or early 2000s that are still holding up, there’s a good chance they’re amalgam.

The tradeoffs, though, have become harder to ignore:

  • Appearance — the dark gray/silver color stands out against natural teeth, especially in visible areas of the mouth
  • Tooth structure loss — amalgam requires a larger cavity preparation because it doesn’t bond to the tooth; the filling has to be mechanically retained
  • Expansion and contraction — amalgam expands and contracts with temperature changes more than natural tooth enamel, which can eventually lead to microfractures
  • Mercury content — while the ADA and FDA consider amalgam safe for most adults, many patients today prefer to avoid mercury-containing materials altogether

What Are Composite Fillings?

Composite fillings are made from a tooth-colored resin — a blend of fine glass or quartz particles suspended in a plastic matrix. Unlike amalgam, composite is applied in soft layers and hardened with a curing light, which allows it to bond directly to the tooth structure.

That bonding process is the real game-changer. Because composite chemically adheres to enamel and dentin, your dentist can preserve significantly more of your natural tooth during the procedure — there’s no need to carve out extra healthy structure just to “lock” the filling in place mechanically.

Composite vs. Amalgam: Side-by-Side Comparison

Factor Composite Fillings Silver Amalgam
Appearance Matches natural tooth color, virtually invisible Dark gray/silver, visible when smiling or talking
Tooth structure removed Minimal — bonds directly to tooth More extensive — requires mechanical retention
Mercury content None Contains mercury (approx. 50% of the alloy)
Placement time Slightly longer (layered and cured) Faster, single placement
Durability 7–10+ years with good care 10–15 years, though prone to cracking over time
Sensitivity to temperature Expands/contracts similarly to natural teeth Expands/contracts more, can stress tooth structure
Cost Slightly higher upfront Lower upfront cost
Repairability Can often be repaired without full replacement Usually requires full replacement

Why Gambrills Patients Are Making the Switch

1. Nobody wants a visible metal filling

This is the most obvious driver. Whether it’s a molar that shows when you laugh or a front tooth that took a chip, patients simply prefer fillings that blend in rather than stand out. Composite makes that possible in a single visit.

2. Preserving healthy tooth structure matters long-term

Every time a tooth is drilled, some structural strength is lost. Because composite doesn’t require the same aggressive shaping that amalgam does, more of your natural, healthy tooth stays intact — which can mean fewer complications (like the need for a crown) down the road.

3. Concerns about mercury exposure

While major health organizations maintain that amalgam is safe for the general population, a growing number of patients — especially those who are pregnant, have autoimmune conditions, or are simply cautious by nature — prefer a mercury-free option. Composite gives them that peace of mind without sacrificing durability.

4. Fewer temperature-related complaints

Patients with amalgam fillings sometimes report heightened sensitivity to hot or cold, particularly as the filling ages and the seal around it weakens. Composite’s expansion rate is much closer to that of natural enamel, which tends to reduce this issue.

5. Better long-term value

Amalgam is cheaper at the moment of placement, but it often can’t be repaired — only replaced. Composite fillings, on the other hand, can frequently be touched up or partially repaired, which can save money over the life of the restoration.

Should You Replace Existing Amalgam Fillings?

This is one of the most common questions we hear at Auslander Dental, and the honest answer is: it depends. If your amalgam fillings are intact, symptom-free, and show no signs of cracking or leakage, there’s typically no urgent medical need to replace them just because composite exists.

That said, replacement is often worth considering if:

  • The filling is cracked, chipped, or visibly worn at the edges
  • You notice new sensitivity to hot, cold, or pressure
  • There’s dark staining spreading into the surrounding tooth (a sign of decay underneath)
  • You simply want a more natural-looking smile

The best way to know for sure is a proper evaluation. Every mouth is different, which is why we recommend a full exam before deciding on any restorative work. If you’re not currently a patient of record, our Why Us page walks through what makes our approach to restorative dentistry different from a typical high-volume practice.

What to Expect When Getting a Composite Filling

Step What Happens
1. Numbing Local anesthetic is applied so the area is completely numb
2. Decay removal Any decayed tissue is carefully removed, preserving as much healthy tooth as possible
3. Bonding prep The tooth surface is conditioned so the composite resin can bond securely
4. Layering & curing Composite is applied in thin layers, each hardened with a curing light
5. Shaping & polishing The filling is shaped to match your natural bite and polished for a smooth, tooth-like finish

Most composite fillings — including replacements of old amalgam — are completed in a single visit, and you can typically eat and drink normally once the numbness wears off.

What If You Have a Dental Emergency Involving an Old Filling?

A cracked or dislodged filling can happen without warning — often mid-meal, on a weekend, or right before an important event. If you’re dealing with a broken filling, sudden sensitivity, or a piece of a tooth that’s come loose, don’t wait it out. Exposed tooth structure is vulnerable to further decay and infection the longer it goes untreated. Visit our Emergency Care page to see how quickly we can get you in, or call us directly at 301-517-7335.

Frequently Asked Questions

Are composite fillings as strong as amalgam?

Modern composite materials have improved significantly and hold up well for most bite forces, including molars. For very large restorations or patients with heavy grinding habits, your dentist may recommend a crown instead of a filling regardless of material.

Is it safe to have old amalgam fillings removed?

Yes, when performed by a trained dental team using proper protective measures. Removal itself briefly aerosolizes small amounts of mercury vapor, which is why it should always be done in a professional dental setting — never attempted or rushed.

Does insurance cover composite fillings?

Many PPO plans cover composite fillings at the same rate as amalgam for back teeth, though some plans only reimburse at the amalgam rate and require you to pay the difference. Our front desk can verify your specific benefits before treatment.

How long do composite fillings last?

With good oral hygiene and regular checkups, composite fillings typically last 7 to 10 years or more, and many last significantly longer.

Will my composite filling match my tooth color exactly?

Yes. Composite resin is available in a wide range of shades, and your dentist selects the closest match to your natural tooth color before placement, so the result blends in seamlessly.

Ready to Talk About Your Fillings?

Whether you have a new cavity that needs treatment or old amalgam fillings you’d like evaluated, our team can walk you through the best option for your specific teeth and budget. Learn more about the procedure on our Composite Tooth-Colored Fillings page, or contact us to schedule a visit. You can also reach our Gambrills office directly at 301-517-7335.