White Fillings

Although most of our patients go out of their way to request white fillings for back teeth, occasionally we get questions about why we use them instead of the old standard silver fillings.

In most cases, white fillings are a better restoration than silver fillings for the following reasons:

• White fillings bond to tooth structure thereby adding strength to the tooth. Silver fillings simply fill a hole and don’t add ant strength.
• The tooth preparation (drilling) for a white filling can be more conservative. They are bonded to the tooth. Once the decay is removed, very little additional preparation is needed. Silver fillings are not bonded, and therefore need undercuts, slots, grooves, and/or pins to stay in place.
• The most obvious advantage is appearance. White fillings are mostly invisible; they blend with the tooth. Silver fillings become black as they age, can stain the tooth, and create a grey shadow visible through the sides of the tooth.

White fillings do have certain challenges. First, they are more difficult to place. The technique is more involved and takes longer, which is why the fees are higher. They also require a dry environment while they are being placed. If the tooth can’t be kept dry for the time it takes to complete the filling, then an alternative must be used.

Insurance plans handle white fillings in one of two ways. Many plans cover white fillings at the same percentage as any other filling. This is more common since white fillings are becoming standard in many dental practices. Some plans, however, still cover only silver fillings. The insurance benefit for white fillings is reduced to the amount that would be the benefit if a silver filling were placed. That leaves a higher out of pocket expense for the patient. We can usually estimate, in advance, what the insurance benefit will be.