Your dentist says you need a filling. Then they give you a choice: white or silver. Suddenly you're being asked to make a clinical decision with no background and a lot of conflicting opinions online.

It doesn't need to be complicated. Here's what the science actually says — without the misinformation from both sides.

Dental amalgam — the silver filling material — is an alloy of mercury, silver, tin, and copper. It has been used in dentistry for over 150 years. The mercury is bound in the alloy; it is not in a free form that your body absorbs in any significant quantity.

Amalgam is extremely durable, relatively inexpensive, and sets quickly. For back teeth where biting forces are highest, it remains a clinically sound choice. It lasts longer than most patients realise — 10 to 15 years is typical.

The NHS still uses amalgam. The British Dental Association considers it a safe, effective material. Its phase-down is driven by environmental mercury concerns — not health risks to patients.

White fillings are made from composite resin — a mixture of plastic (acrylic) and fine glass particles. The material is placed in the cavity while soft and hardened with a blue light.

Composite can be colour-matched to your natural tooth. It bonds directly to the tooth structure, which can help reinforce a weakened tooth. And it contains no mercury — which is why many patients prefer it on principle.

The main limitation is durability under heavy bite forces. In large fillings in back teeth, composite wears faster than amalgam. It is also more technique-sensitive — the cavity must be kept completely dry during placement, which is not always easy in the back of the mouth.

For small to medium fillings in back teeth, composite and amalgam perform similarly over 5 to 10 years. For large fillings under heavy bite pressure, amalgam still has a durability advantage that composite has not fully matched.

For front teeth, composite is the clear choice — amalgam would look grotesque and would not bond to the tooth in the same way.

The idea that white fillings are universally stronger or better is not supported by the evidence. They are a different material with different strengths and different limitations.

This is a common frustration — and it's worth addressing honestly.

White fillings fail more often than amalgam when placed in back teeth. The most common reasons are:

• The cavity was too large for composite to handle the bite forces
• The tooth was not kept completely dry during placement — moisture contaminates the bond
• The filling was placed over an old amalgam base without proper preparation
• The bite was not adjusted correctly after placement

A well-placed composite filling in an appropriate cavity should not fall out. If yours has fallen out repeatedly, the issue may be the technique or the case selection — not the material itself.

You will find loud claims online that amalgam is toxic and should never be used. These claims are not supported by mainstream dental research.

Mercury exposure from dental amalgam is extremely low — well below the levels associated with any known health effect. Major health organisations worldwide — including the WHO, the FDA, and Public Health England — have repeatedly found amalgam safe for general use.

Removing intact amalgam fillings releases more mercury during the removal process than leaving them in place. If your amalgam fillings are intact and functioning, there is no clinical reason to replace them.

That said — if you have concerns, discuss them with your dentist. Your comfort and confidence in your treatment matters too.

The best filling material depends on where the cavity is, how large it is, and your specific circumstances. Your dentist should explain their recommendation and the reasoning behind it.

At Meads Village Dental Practice, we use both materials and choose based on clinical evidence, not habit or cost pressure. If you have questions about your existing fillings or want to discuss options, we're happy to talk it through.

Call 01323 723757 or book at www.meadsdental.com