Recently there has been a lot of discussion about silver amalgam fillings.  There are pros and cons to these fillings.  You should educate yourself on these advantages and disadvantages because the difference is not just a matter of appearance.  Once you have the education you can make an informed decision and rest assured that you have the best fillings.

Dental schools, as a rule, do not fully train dentists for placing the newer composite types of fillings. Unfortunately, dentists have to pursue additional post-graduate continuing education to become proficient in composite bonding technology.  Hence, you may not have a dentist that is capable of doing both the silver and white composite fillings.  Decide which type of filling makes you and your expense account comfortable and go with your decision and not just with what your dentist is able to do.

The advantages of the Silver Amalgam fillings are:
1.  The silver fillings are generally less expensive.  Composite fillings can take about 60% longer to install.  Additionally, they require special expertise and expensive materials, and are more difficult to place, and so they cost considerably more than silver.  Additionally, dental insurance companies will generally not pick up this extra added cost.  The insurance companies generally will only pay for the lowest cost to fix the tooth which is the silver amalgam filling. 

2.  General dentists can place amalgam without extra training because this is taught in dental school.  Composite fillings require the use of special bonding technology that many dentists may not be trained on.  Dental schools often don't teach this technique because it is not on the exams and dental schools teach to the exams.

3.  Placing a silver filling is faster and can be a lot easier and comfortable than a composite filling.  The proper placement of a white composite filling requires that the site for the filling be kept totally isolated from saliva while it is being placed.  In the very back of the mouth, on some patients, it is difficult to keep the tooth isolated for the duration of the procedure. This can also be uncomfortable for some patients. A silver amalgam filling does not require this strict isolation of the tooth.

4.  The filling by itself is a stronger material, although it weakens the tooth.  Additionally, silver fillings have a longer history of use than mercury-free fillings, thus you may feel that they are more tried and tested.

The disadvantages of silver amalgam fillings:
1.  The silver amalgam filling is stronger but does not bond to the tooth like a composite filling.  Hence, silver weakens the teeth, making them more susceptible to breaking. Since broken teeth are very expensive to restore, composites can save a lot of expense over the long run. 

2.  Composite fillings restore the natural appearance of the tooth where the silver filling can easily be seen.

3.  Teeth restored with white composite fillings are less sensitive to hot and cold than teeth restored with amalgam, if correct techniques are used.

4.  Mercury in the fillings is viewed by some as being toxic.

5.  Silver amalgam fillings require more of the tooth structure removal than composites. Especially with new cavities, the size of the hole made for the filling can be dramatically smaller with composites. 

In summary, the largest advantage of a silver amalgam filling is that it is less expensive than the newer composite fillings.  However, there is an ongoing debate about the possible health issues of the mercury in the filling.  No one at this point has proven these health concerns, but many countries are banning the use of the mercury filling.  You must decide for yourself which filling will fit your situation best.