Are Silver or White Fillings Better for Kids?

By Yahia Khan, 30.01.2025

Understanding Dental Fillings

What Are Dental Fillings?

Dental fillings are materials used to restore the function and structure of a tooth damaged by decay. When cavities form, they leave holes in the enamel that can weaken the tooth and lead to further complications if untreated. Dental Fillings help seal these spaces, restoring the tooth's integrity and preventing bacteria from entering.

Why Are Fillings Necessary?

Children are particularly prone to cavities due to their developing oral hygiene habits, dietary choices, and thinner enamel compared to adults. Filling cavities promptly is essential to protect the tooth from further decay, pain, and potential infections. Pediatric dentists aim to provide fillings that not only restore functionality but also maintain the natural look of your child’s smile.

Common Materials Used in Fillings

Silver Fillings (Amalgam)

Silver fillings, also known as amalgam fillings, are made from a combination of metals, including silver, tin, copper, and mercury. This type of filling has been used for over a century and is known for its durability and cost-effectiveness.

Advantages of Silver Fillings:

• Durability: Highly resistant to wear and can last 10-15 years or more.
• Strength: Ideal for molars where chewing forces are the greatest.
• Affordability: Generally less expensive than white fillings.

Drawbacks of Silver Fillings:

• Aesthetics: Silver fillings are noticeable and may not match the natural color of teeth.
• Potential for Cracks: Metal expands and contracts with temperature changes, which can stress the tooth over time.
• Mercury Concerns: Though deemed safe by the FDA, some parents worry about the presence of mercury in amalgam fillings.

White Fillings (Composite)

White fillings are made from a composite resin material that blends seamlessly with natural tooth color, offering a more aesthetic alternative to silver fillings.

Advantages of White Fillings:

• Aesthetics: Virtually invisible, making them ideal for visible teeth.
• Bonding Strength: Adheres directly to the tooth structure, requiring less removal of healthy enamel.
• Versatility: Suitable for both front and back teeth.

Drawbacks of White Fillings:

• Cost: Typically more expensive than silver fillings.
• Durability: May wear down faster, especially on molars.
• Time-Consuming: The process for placing composite fillings is longer and requires more precision.

Factors Influencing Filling Choices

1. Durability

Durability is a significant factor when choosing fillings for children. Silver fillings are stronger and longer-lasting, making them suitable for molars that endure heavy chewing. On the other hand, white fillings may require more frequent replacement, particularly for children who grind their teeth.

2. Aesthetics

White fillings are often preferred for visible teeth because they blend seamlessly with natural tooth enamel. If your child is self-conscious about their smile, particularly as they grow older, white fillings can be a better option.

3. Cost

For families on a budget, silver fillings are often a more affordable choice. However, some insurance plans may cover composite fillings, especially if they are deemed medically necessary for visible teeth.

4. Age of the Child

Younger children with primary teeth may benefit from silver fillings due to their cost and durability. Since these teeth will eventually fall out, the aesthetic considerations of white fillings may not be as important.

5. Allergies or Sensitivities

If your child has a known allergy to any materials used in amalgam or composite fillings, your pediatric dentist will recommend a suitable alternative.

Pros and Cons of Silver (Amalgam) Fillings

Pros of Silver (Amalgam) Fillings

1. High Durability and Strength

Silver fillings are renowned for their exceptional durability, often lasting 10-15 years or more. They can withstand the heavy chewing forces typically exerted on molars, making them an excellent choice for back teeth where cavities frequently occur.

2. Cost-Effective Option

Compared to composite (white) fillings, silver fillings are more budget-friendly. This affordability makes them a practical choice for families managing dental care costs, especially for younger children with primary teeth that will eventually fall out.

3. Ideal for Molars and Areas Requiring Strong Bite Pressure

Because of their strength, silver fillings are particularly suitable for molars and other areas where strong bite pressure is common. These teeth are essential for grinding food, and the durability of silver fillings ensures they remain intact over time.

Cons of Silver (Amalgam) Fillings

1. Noticeable Metallic Appearance

One of the primary drawbacks of silver fillings is their noticeable metallic look, which does not blend with natural tooth enamel. For parents and children concerned about aesthetics, especially for visible front teeth, this may be a significant disadvantage.

2. Potential Concerns About Mercury Content

Amalgam fillings contain a small amount of mercury, which has raised concerns among some parents. However, the American Dental Association (ADA) and the Food and Drug Administration (FDA) have deemed amalgam fillings safe for use in children and adults. The mercury is bound within the filling material, making it stable and unlikely to pose health risks. Educating families about these facts can help dispel common misconceptions.

3. Limited Use for Visible Front Teeth

Due to their metallic appearance, silver fillings are rarely used for visible front teeth. Composite fillings are typically preferred in these cases to maintain the natural look of a child’s smile.

Pros and Cons of White (Composite) Fillings

Pros of White (Composite) Fillings

1. Natural Tooth-Like Appearance

White fillings are made of composite resin, which closely matches the natural color of teeth. This makes them ideal for restoring teeth in visible areas, such as the front teeth, where aesthetics are a priority. For children, a natural-looking smile can help boost their confidence.

2. Bonds to the Tooth Structure

Composite fillings chemically bond to the tooth, providing a strong and secure fit. This bonding process allows the dentist to preserve more of the natural tooth structure compared to silver fillings, as less drilling is required. Maintaining the integrity of the tooth is especially important for young patients with developing teeth.

3. Suitable for Visible Teeth and Aesthetic Purposes

The aesthetic appeal of composite fillings makes them a preferred choice for teeth that are easily seen when your child smiles or talks. These fillings help maintain a bright and natural-looking smile, which is an important consideration for both parents and children.

Cons of White (Composite) Fillings

1. Higher Cost Compared to Silver Fillings

Composite fillings are generally more expensive than silver fillings. The higher cost reflects the advanced materials and additional time required for their placement. While some dental insurance plans may cover composite fillings for visible teeth, the expense can still be a consideration for families.

2. May Not Be as Durable in Areas with High Bite Force

While composite fillings are durable, they may not withstand heavy chewing forces as effectively as silver fillings. For molars and other teeth subjected to strong bite pressure, white fillings may wear down or require replacement sooner than amalgam fillings.

3. Requires More Time and Skill to Place

The process of placing composite fillings is more complex and time-consuming than silver fillings. Dentists must carefully layer the material and use specialized equipment to cure and bond the filling. This requires a higher level of skill and precision, which can add to the overall cost and appointment duration.

What Does a Pediatric Dentist Recommend?

A pediatric dentist focuses on providing individualized care, recognizing that every child’s dental situation is different. Their recommendation for silver (amalgam) or white (composite) fillings will depend on several factors, such as:

• The Location of the Cavity: Cavities in molars may require durable silver fillings, while cavities in visible teeth are better suited for aesthetic white fillings.
• The Child’s Age: Younger children with primary teeth may benefit from silver fillings due to their affordability and durability.
• Oral Hygiene Habits: A child’s ability to maintain good oral hygiene can influence the longevity of the chosen filling material.

This patient-focused approach ensures that the recommended treatment aligns with the child’s current and future dental needs.