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23 November, 2009

Home > Fact sheets by category > Diseases and conditions > Teeth > Treatments > Dental fillings.

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Dental fillings

Dental fillings are used to restore worn or damaged teeth and treat tooth decay. Dental amalgam is a strong, inexpensive material that is commonly used for filling teeth, especially the molars (back teeth). In recent years, alternative tooth-coloured filling materials have also become more common and affordable.

Improvements in dental health mean the need for fillings generally is on the decline. Correct cleaning of your teeth and a healthy diet can help to eliminate dental decay and avoid the need for fillings. Regular dental check-ups will make sure any problems are identified and treated early.

Filling materials
Dental fillings are used to restore teeth and treat tooth decay, especially in the molar (back) teeth. These teeth do most of the heavy chewing of the food we eat, so wear and tear is inevitable. The dentist uses a drill and other tools to remove the decay. The hole is cleaned and dried, and then sealed with a filling material. Types of filling material include:

Dental amalgam
Tooth-coloured fillings.

Other forms of tooth restoration, such as gold or ceramic crowns, are an expensive alternative to amalgam and tooth-coloured filling materials.

Dental amalgam
Dental amalgam (often called ‘silver fillings’) is an inexpensive and highly durable material commonly used for filling teeth, especially those that are subject to a lot of wear and tear such as molars. Modern dental amalgam is a metal alloy that is generally made up of mercury, silver and tin, with small amounts of copper and zinc. It is pliable when first mixed and can be moulded into a tooth cavity, reducing the amount of natural tooth that needs to be removed in order to fit the filling.

Cosmetic filling materials
Tooth-coloured (white) fillings have been used in front teeth for cosmetic reasons for many years. Recent improvements in filling materials for back teeth mean these are now more affordable and widely used as an alternative to dental amalgam as well. While they may look better, these fillings have not been in use long enough to test how durable they are in the longer term compared with amalgam but current results are promising.

Mercury in dental amalgam
Concerns have been raised about the use of dental amalgam because it contains mercury. While high levels of mercury are harmful to human health, the metal alloy in modern dental amalgam has low mercury content. Repeated international reviews of the scientific evidence have been unable to link the use of dental amalgam directly with ill health.

The current advice from the National Health and Medical Research Council of Australia is that, for most people, these low levels of mercury exposure will not affect their general health. There is also no clinical evidence to support any connection between amalgam fillings and cancer.

Some European countries, such as Sweden, have been trying to phase out the use of amalgam dental fillings for environmental reasons. Although mercury occurs naturally in the environment, incorrect disposal of materials like dental amalgam can add to mercury levels in the environment that concentrate in the food chain.

Situations when amalgam use should be avoided
People who are advised to avoid getting new amalgam fillings or having existing ones removed or replaced (where possible) include:

Pregnant women – mercury may cross the placenta and enter the bloodstream of the foetus.
Women who are breastfeeding – mercury may be passed to the baby through breast milk.
Children – growing and developing teeth are more sensitive to the effects of any chemical substances in the environment, including mercury.
People with kidney disease – high levels of mercury exposure can affect the kidneys, so exposure to mercury should be minimised for people with kidney disease.

While there is currently no scientific evidence directly linking amalgam with either ill health or birth defects, these recommendations have been made for precautionary reasons.

Replacing amalgam fillings
Deciding to have your amalgam fillings replaced is your choice and should be made in consultation with your dentist. If you are considering having them replaced, it is important you consider the following:

Replacement can be expensive.
Replacing your filling often causes more of the natural tooth to be lost.
Mercury levels rise in the body immediately after an amalgam filling is replaced, due to handling of the amalgam.
During replacement of your amalgam filling, exposure to mercury can be reduced by using a rubber shielding device called a ‘dental dam’.
Extra suction during the removal of a filling can also reduce exposure to mercury.
Dentists can cut away the amalgam filling rather than drilling it out, which can also help reduce mercury exposure.

Where to get help

Your dentist
Your dental therapist
Community dental agencies
Your community health centre
Royal Children’s Hospital Tel. (03) 9345 5344, 9am–5pm, Monday to Friday. After hours Tel. (03) 9345 5522
Dental Health Services Victoria Information Line Tel. (03) 9341 1000, 8.30am–5pm, Monday to Friday

Things to remember

Modern dental amalgam is a strong, inexpensive metal alloy commonly used to restore teeth and treat tooth decay.
Dental amalgam has low mercury content and is considered safe for most people.
Alternative tooth-coloured filling materials are also available. Discuss your treatment choices with your dentist.

You might also be interested in:
Dental care - common conditions - 0 to 5 years.

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