Silver to White Fillings
When swapping silver fillings is worthwhile, what goes in their place, how we take them out safely and what it costs.
Is It Possible to Replace My Silver Amalgam Fillings with White Ones?
Yes. Silver amalgam fillings can be taken out and replaced with tooth-coloured composite or, where the old filling is large, a bonded ceramic onlay. An intact amalgam filling isn't a health risk, so most people change them because of how they look, or because one has worn, cracked or started to leak. Each filling is removed carefully with the tooth numbed, normally in a single visit. At Peninsula Dentists on Greenwich Peninsula, a white filling on a back tooth starts at £118 and a ceramic onlay at £650, and dental plan members pay 10% less.
Swapping Silver Fillings for Tooth-Coloured Ones
It's entirely possible. Amalgam, the grey metal used in fillings for generations, can be drilled out and replaced with materials that blend in with your own enamel. Which material we choose comes down to the size of the old filling. Small and medium ones are usually replaced with composite, a tooth-coloured resin bonded straight onto the tooth and sculpted at the same appointment. When the existing filling is big, or has left the surrounding walls thin, a ceramic onlay designed from a digital scan is stronger and lasts longer.
Amalgam is a durable, proven material that has served patients well. When people ask us to replace it, the reason is nearly always cosmetic, particularly on teeth that show when they smile or laugh, or because an old filling is beginning to break down.
Should Sound Fillings Come Out?
Health on its own isn't a reason to remove them. Current UK guidance considers intact amalgam fillings safe, and every time a filling is replaced the cavity has to be cleaned out and reshaped, which costs you a little more natural tooth. Amalgam is no longer placed in children under 15, or during pregnancy or breastfeeding, except where a dentist judges it clinically necessary; but an existing amalgam filling in good condition can stay where it is.
The usual triggers for replacement are appearance, or a filling that is wearing, cracking or leaking. Warning signs include a grey shadow or a fine crack in the enamel around it, food packing into the area, twinges from cold or sugary food, or a sharp spot your tongue won't leave alone. At every dental examination we assess each filling and let you know whether any need work.
Ready to Lose the Silver?
Book a dental examination and we'll assess every filling and explain what each one needs.
Your Options and What They Cost
| Option | Suits | Fee |
|---|---|---|
| Composite (white) filling | Small and medium cavities | From £118 on a back tooth |
| Ceramic onlay | Large old fillings, or teeth with weak walls | From £650 |
| Ceramic crown | Teeth that are heavily restored or cracked | From £650 |
These are guide fees from our current list, and yours are confirmed in a written plan before treatment begins. Members of our dental plans receive 10% off.2 Composite fees go up with each extra surface of the tooth the filling covers, so a filling spanning two or three sides of a molar is priced above a one-surface repair. Where several big fillings call for onlays and the total reaches £1,500 or more, you can pay monthly through Chrysalis Finance, subject to status. See our guide to fillings, onlays and crowns for how we decide.
How the Appointment Works
A composite replacement is normally done in one appointment; an onlay takes two.
- First we assess each filling, taking X-rays where helpful, to judge its depth and look for decay beneath it
- We numb the tooth with local anaesthetic
- The amalgam is drilled out gently with high-volume suction running throughout and, where suitable, a rubber dam: a thin protective sheet stretched around the tooth so that particles stay out of your mouth
- We clean the cavity and treat any decay we find underneath
- For composite, we bond the new material in, shape it to your bite and polish it, so the tooth is complete when you leave
- For an onlay, we scan the tooth with our iTero Element instead of taking a putty impression, fit a temporary, and bond the finished ceramic onlay at the second visit
Expect the numbness to last two hours or so, and be careful with hot drinks and chewing until it wears off.
Should You Replace Every Filling at Once?
Rarely. Our usual approach is to deal with the fillings that are failing, or the ones that show most, and monitor the others. Taking out a healthy filling ahead of time brings no benefit and sacrifices a little tooth, so good timing beats speed.
If you want several replaced for cosmetic reasons, we can group them into one or two longer appointments, generally working on one side per visit and leaving the other free for eating. Planning to whiten too? Then do that first. Composite won't change colour with bleaching, so we'd lighten your teeth with our Boutique home whitening at £350, allow a couple of weeks for the shade to stabilise, before shading the new fillings to suit your brighter smile.
How Strong Are White Fillings?
Today's composites are tough, and because they bond to the tooth they help reinforce it. In small and medium cavities on back teeth they give many years of reliable service. They are less forgiving to place than amalgam: the tooth must stay completely dry during bonding, something a rubber dam helps us achieve, and the material is laid down in thin layers, each set with a curing light. Placed with that care, composite seals the tooth very effectively.
Where a back tooth has a very large filling, a ceramic onlay generally outlasts composite. It is made in the laboratory to an exact fit, covers the chewing surface and stops the remaining walls from splitting. We match the material to each individual tooth rather than using one approach throughout. If you grind, a custom night guard from £135 protects new fillings and the teeth around them.
Caring for Your New Fillings
Look after white fillings just as you would your natural teeth. Brush morning and night with a fluoride toothpaste, clean between your teeth every day and attend your dental examinations so we can keep an eye on the margins. Over time composite can take up stains from coffee, tea, red wine and tobacco; a polish during your hygiene visit with Stefanie Goodall keeps it bright.
A freshly placed filling can be a little sensitive to cold for several days, and this normally fades without any treatment. If your bite feels high, or the sensitivity is still there after two weeks, come back and let us look. Adjusting the bite takes just a few minutes and very often fixes it.
Questions
This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.