Amalgam was a very common material to be use for fillings in the past. These are the black metal fillings that are unsightly and contain mercury. The use of this material is decreasing, because of the desires of people to have white fillings, worry of mercury and advancements in the technology of white fillings.
The properties of white fillings in the past decade has improved dramatically, especially with ceramics. The last time I used amalgam was in 2012.
There are a couple of situations warranting to change the amalgam fillings to a white filling.
- There is decay associated with the filling
- The filing has broken
- The filling is loose
- There is a crack in the tooth
- You are unhappy with the appearance
In my experience, cracked teeth are a major problem with amalgam filled teeth. Nearly all the cracked teeth I see have an amalgam filling. Cracked teeth often require a crown to fix and sometimes a root canal as well. If I had any teeth with an amalgam filling, I would have it changed to a white filling ASAP.
One of the concerns with replacing fillings is that more tooth needs to be removed. This is certainly true, but if done with care, the amount is minimal. Being such a different colour to the tooth, it is very clear when to stop drilling. The material also does not stick to the tooth, so if the filling is cut strategically, it can just be flicked out in sections.
In conclusion, there is minimal risk and much potential gain in changing a black amalgam filling to a white one. The only situation where I would advise against replacement is when the filling is very close to the nerve.
This is only general advice so discuss with your dentist before making any decisions.