When it comes to dental care, one of the most common procedures carried out in practices across the UK is the filling of cavities. Over the years, patients have become more informed and concerned not just about aesthetics but also about safety and long-term health implications. Among the materials used for dental fillings, amalgam and composite are the most common. But which one is safer? In this article, we will explore the differences between amalgam and composite fillings, with a special focus on safety, durability, and patient preference. If you're searching for a reliable dentist in Richmond, understanding these options is vital before your next visit.

What Are Amalgam Fillings?

Dental amalgam is a mixture of metals including silver, mercury, tin, and copper. It has been used in dentistry for over 150 years and is well-known for its strength and longevity. Because of its durability, amalgam is often used in molars, where the pressure from chewing is greatest.

Advantages of Amalgam Fillings

• Durability: Can last 10 to 15 years or more
• Cost-effective: Generally less expensive than composite
• Less technique-sensitive: Easier for dentists to place, especially in difficult areas

Concerns About Amalgam Fillings

• Mercury Content: One of the primary concerns is the mercury content in amalgam. Mercury is a known toxin, and while the amount used in dental fillings is considered safe by many health authorities, it remains a point of contention.
• Aesthetics: Amalgam is silver-coloured and becomes darker over time, making it less desirable for visible teeth.
• Potential Allergic Reactions: Rare, but possible reactions to the metals in amalgam can occur.

In the UK, the use of amalgam has decreased significantly due to both patient preference and evolving regulations. For example, since 2018, EU regulations (still applicable in the UK) have limited the use of amalgam in children under 15, pregnant women, and breastfeeding mothers.

What Are Composite Fillings?

Composite fillings are made of a tooth-coloured resin material, which makes them a popular choice for visible teeth. These fillings are chemically bonded to the tooth, which can help support the remaining tooth structure.

Advantages of Composite Fillings

• Aesthetically Pleasing: Matches the natural colour of teeth
• Less Invasive: Requires less removal of tooth structure
• Mercury-Free: Eliminates concerns related to mercury exposure

Concerns About Composite Fillings

• Durability: Typically last 5 to 10 years, less than amalgam
• Cost: Usually more expensive than amalgam
• Technique-Sensitive: Requires a dry field during application, which can be challenging

While composite fillings may not last as long as amalgam, improvements in material science have significantly increased their durability in recent years. Many patients opt for composite due to its aesthetic advantages and mercury-free composition.

Safety Considerations: Mercury vs Resin

The safety debate often centres around the mercury in amalgam and the resin in composites.

Mercury in Amalgam

The British Dental Association (BDA) and other health authorities, including the World Health Organization (WHO), have deemed amalgam safe for use in most patients. However, mercury exposure can accumulate over time, and some studies suggest that individuals with multiple amalgam fillings may have higher mercury levels in their bodies.

In contrast, countries like Norway and Sweden have banned amalgam due to environmental and health concerns, prompting UK patients to reconsider their options.

Chemicals in Composite Fillings

Composite resins contain substances like bisphenol A (BPA), which has raised concerns due to its potential hormone-disrupting properties. However, most studies suggest that the amount of BPA exposure from dental composites is minimal and not considered harmful.

Thus, when it comes to safety, both materials present minor risks. The decision often comes down to individual health circumstances, preferences, and discussions with your dentist.

Environmental Impact

Beyond personal health, there is also the broader issue of environmental impact. Mercury from amalgam can enter the environment through waste disposal, prompting dental practices in the UK to use amalgam separators and adhere to strict waste management protocols.

Composite resins, while safer for the environment in terms of mercury, are still plastics that may contribute to microplastic pollution. Neither option is perfect, but amalgam poses a higher environmental risk.

Which Is the Safer Option?

There is no one-size-fits-all answer. Amalgam is strong, durable, and time-tested but contains mercury. Composite is aesthetically superior and mercury-free but may not last as long and can be more costly.

From a health and safety standpoint, composite fillings are generally regarded as the safer option, especially for those concerned about mercury exposure. However, amalgam may still be suitable for individuals who prioritise durability and are not in high-risk groups like pregnant women or children.

Conclusion

Choosing between amalgam and composite fillings involves multiple factors: safety, aesthetics, durability, cost, and environmental considerations. While amalgam remains a viable option for some, the shift towards composite fillings reflects modern preferences for materials that blend with natural teeth and avoid mercury exposure.

For personalised advice, consult with a trusted dentist who can assess your specific needs and recommend the most suitable filling material. Ultimately, the safest option is one that aligns with your health priorities, lifestyle, and the professional guidance of your dental care provider.