Silver-colored vs tooth-colored fillings

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The chewing surfaces of your back teeth are more likely to
develop cavities than other tooth surfaces. 1 It is important that dentists remove the decay and fix these teeth as
soon as possible to keep them strong. In fact, if the tooth is not
treated, it can become so damaged that it needs to be removed.
In many cases, dentists can fill the tooth with silver-colored or tooth-colored fillings depending on your needs, the size of the cavity, and the type of filling you would like.
USE OF SILVER-COLORED VS TOOTH-COLORED FILLINGS The American Dental Association Science and Research Institute looked at information about insurance claims to get an idea of how often silver-colored and tooth-colored fillings are used in back teeth.2
They looked at claims information generated by private
insurers across all 50 states, Puerto Rico, and the US Virgin
Islands. They collected information on how often the insurers
paid for each type of filling using the following factors
n Treatment dates from 2017 through 2019
n Patients aged from 0 through 55 years
n Male or female
n Living in a city or in the country
n Race and Hispanic or Latino ethnicity
From 2017 through 2019, 33% of the study group had a filling placed in a back tooth. Tooth-colored fillings were used more often than silver-colored fillings. Only 5% of people had a silver-colored filling placed in a back tooth compared with 28% of people who received a tooth-colored one.
Although tooth-colored fillings were more common in every age group, the oldest people (aged 35-55 years) had the lowest number of silver-colored fillings placed per year. Men also were more likely than women to have silver-colored fillings. People who lived in the country had more silver-colored fillings than people who lived in the city.
In areas where more people were classified as non-Hispanic Black citizens, more silver-colored fillings were placed. Silvercolored fillings were used less often among communities made up of people classified as White, Hispanic or Latino, and Asian.
Each filling type has positive traits and negative traits. Some of
those are compared in the Table.3-5
Although both types of filling materials have positive and
negative points, either is useful for fillings in the back teeth.

  • The numbers in this table come from a review of several studies that found that
tooth-colored fillings were twice as likely to develop new cavities at the
edges than silver-colored fillings.† American Dental Association Health
Policy Institute.3 ‡ Bohaty and colleagues.4 § Sometimes new tooth decay or
cavities develop around the edge of the filling and the filling needs to be
replaced.{ Worthington and colleagues.5
    These materials differ in cost, longevity, and appearance, which may be important in your decision making. n
    Prepared by Anita M. Mark, senior scientific content specialist, ADA Science and Research Institute, Chicago, IL.
    Disclosure. Ms. Mark did not report any disclosures.
    Copyright ª 2023 American Dental Association. Unlike other portions of JADA, the print and online versions of this page may be reproduced as a handout for patients without reprint permission from ADA Publishing. Any other use, copying, or distribution of this material, whether in printed or electronic form, including the copying and posting of this material on a website, is prohibited without prior written consent of ADA Publishing.
    “For the Patient” provides general information on dental treatments. It is designed to prompt discussion between dentist and patient about treatment options and does not substitute for the dentist’s professional assessment based on the individual patient’s needs and desires.
    You can find more information for patients at ADAcatalog.org or at MouthHealthy.org.
  1. Griffin SO, Wei L, Gooch BF, Weno K, Espinoza L. Vital signs: dental sealant use and untreated tooth decay among U.S. school-aged children. MMWR Morb Mortal Wkly Rep. 2016;65(41):1141-1145.
  2. Estrich C, Eldridge LA, Lipman RD, Araujo MWB. Posterior dental restoration material choices in privately insured people in the United States, 2017 through 2019. JADA. 2023;154(5):393-402.
  3. Survey of dental fees. American Dental Association Health Policy Institute. Accessed February 21, 2023. https://www.ada.org/resources/practice/practice-management/finances/ survey-of-dental-fees
  4. Bohaty BS, Ye Q, Misra A, Sene F, Spencer P. Posterior composite restoration update: focus on factors influencing form and function. Clin Cosmet Investig Dent. 2013;5: 33-42.
  5. Worthington HV, Khangura S, Seal K, et al. Direct composite resin fillings versus amalgam fillings for permanent posterior teeth. Cochrane Database Syst Rev. 2021;8: CD005620.

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