Composite vs amalgam fillings — which is right for your tooth
Composite (white) fillings are now the gold standard for most cases. Amalgam (silver) still has niche uses but is being phased out. Here is the complete comparison.
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The basic difference
The two main types of dental fillings are:
- Composite (white/tooth-colored): Made of resin + ceramic particles. Bonded to the tooth. Mercury-free.
- Amalgam (silver): Made of silver, tin, copper, and mercury (about 50% mercury). Used since the 1830s.
At Eco Dental NY, we only use composite (white) fillings. No mercury. No amalgam. Modern materials, modern technique.
Side-by-side comparison
Composite (white) fillings
- Appearance: matches tooth color
- Cost: $200-500
- Lifespan: 7-15 years
- Mercury: none
- Tooth removal needed: minimal (only decayed structure)
- Bond strength: strong (chemically bonded)
- Insurance coverage: typically same as amalgam
Amalgam (silver) fillings
- Appearance: silver/dark gray
- Cost: $150-300
- Lifespan: 10-15+ years
- Mercury: ~50% of filling weight
- Tooth removal needed: more (mechanical retention)
- Bond strength: mechanical only (not chemically bonded)
- Insurance coverage: covered at same rate
The mercury question
Amalgam fillings contain about 50% elemental mercury bound into the silver-copper-tin alloy. The FDA states that amalgam is safe for most patients, but some considerations:
- Small amounts of mercury vapor are released over time, especially when chewing or grinding
- Long-term cumulative exposure is debated in dental research
- Pregnant women, breastfeeding mothers, and young children are advised against amalgam
- Many countries (Norway, Sweden, Denmark) have banned amalgam
- The U.S. is gradually moving away — amalgam use has dropped 70%+ in 20 years
For Brooklyn patients, composite is virtually always the better choice. We use only composite at Eco Dental NY.
When amalgam might still have an edge
In specific cases, amalgam is still considered:
- Very large fillings in back teeth where the bite force exceeds composite’s strength
- Patients who can’t keep the tooth dry during placement (composite bonding requires dry tooth)
- Very specific medical/budget situations
But honestly: modern composite materials are now strong enough for almost any case. The vast majority of practices have moved to composite-only.
Should I replace my old amalgam fillings?
The straightforward answer: not unless they’re failing.
Replacement criteria:
- Replace if: filling is broken, leaking, has decay underneath, or causing recurring sensitivity
- Replace if: you want a complete cosmetic upgrade and money isn’t a constraint
- Don’t replace if: it’s intact, functioning, and not causing problems — even if it’s 30 years old
Removing healthy amalgam fillings creates more drilling, more cost, and brief mercury vapor exposure. Not worth it unless there’s a reason.
Frequently asked questions
Are composite fillings as durable as amalgam?
Modern composite (post-2010) is comparable. 7-15 year lifespan for composite vs 10-15+ for amalgam. The bonding to tooth actually improves with composite — less chance of decay underneath.
Why are composite fillings more expensive?
The material costs more, the technique is more time-intensive (etching, bonding, layering, light-curing), and the dentist’s skill matters more. Net: usually $50-100 more than amalgam.
Do composite fillings stain?
Less than natural teeth. Resin can pick up some color from coffee, wine, smoking over many years. Polishing can refresh appearance. After 7-15 years, replacement is often easiest.
Can composite fillings get cavities?
Yes — at the margins where filling meets tooth, bacteria can cause new decay. Proper hygiene + cleanings every 6 months prevent this. Good news: composite bonds tighter than amalgam to the tooth.
What if I have a large cavity?
If composite filling would be more than 50-60% of the tooth surface, we recommend a crown or onlay instead. Stronger long-term solution. Free consultation to evaluate.
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