I have two fillings that I want taken out and replaced with white fillings, both because of how they look and because of the mercury. I’ve been trying to lead a more healthy lifestyle, and a lot of the holistic magazines I read now mention removal of silver (mercury) fillings as part of reducing your “toxic load”.

Anyway, my dentist said that maybe those teeth won’t look very good when we are done, because the silver fillings might have stained my teeth? They are molars, but are visible when I laugh or talk.

Is this right? What makes the stain? That kind of freaks me out, because what if the toxins are now soaked into my teeth. I am also kind of worried about how strong these teeth will be after the procedure. About seventy percent of the teeth are filling, and my dentist said that the material in the composite is not as strong as the silver filling material (he will never call it mercury). Are these teeth going to be at risk for breaking or cracking?

Maggie in Colorado Springs

Dear Maggie,

Over the years our practice has removed many amalgam fillings and replaced them with white fillings, and we have never seen a case where they did not look significantly better. It is true that the amalgam fillings can cause some discoloration in your teeth, but it is usually very minimal, and in back teeth or molars should be barely noticeable.

The real issue at hand is that it sounds like your dentist is not comfortable with this procedure, and is kind of trying to talk you out of it. Putting white composite fillings in the back teeth is very different and more challenging than placing amalgam fillings, and if your dentist has not had training in this procedure, he may not be comfortable doing it. Most dental schools do not teach placement of composite fillings, so unless your dentist has pursued training beyond dental school, he may not be comfortable doing them, especially in the back of the mouth.

One point that should be made very clear: it is ALWAYS a bad idea to push a dentist out of his or her comfort zone. If you get the feeling that your dentist is not comfortable with a procedure you want, then it is best to seek the services of a different dentist.

One other thing–you state that more than half of the teeth in question are fillings, and in that case, we would strongly suggest porcelain crowns rather than fillings. For smaller fillings, replacing amalgam fillings with white composite fillings actually yields a stronger end result, because the composite bonds to the tooth. But removing and replacing fillings that large may well result in the cracking you are worrying about. Porcelain crowns are the safer option.

This blog post is provided as a courtesy of the dental office of Dr. Malone, Lafayette Louisiana cosmetic dentist.