When you have a tooth filled or bonded at a Cosmetic Dentist office such as Brookside Dental, only non-metal, tooth colored materials are used to accomplish this type of naturally appearing tooth colored restoration. These tooth colored fillings are called composite restorations. Historically, two types of metal, Silver amalgam and Gold, have been used to restore decayed areas of teeth. Posterior metallic crowns, onlays, and inlays are generally made with gold alloy. However, the majority of metal fillings have been silver amalgam fillings, which are an alloy of silver, mercury and other metals. The dark metallic amalgam fillings in teeth are often referred to as silver fillings by patients and have been used in dentistry for over a hundred years. Metal fillings are used on posterior teeth but not on anterior teeth for obvious aesthetic reasons. Many dentists use silver fillings today, because they are less expensive than tooth colored fillings. This is the only advantage that metal fillings have when compared to composite or tooth colored fillings. Much of this cost savings has been driven historically by insurance companies that do not want to pay the higher price commanded by composite fillings. This attitude is changing and some insurance companies are paying the same percentage for both types of fillings, because consumers and their employers are demanding the higher quality composite fillings. Additionally, people want to look younger and more beautiful. Insurance payments are typically 80% of the fees for fillings that are submitted by dentists.

Tooth colored fillings have long been the standard when working on the front or anterior teeth. Quality dentistry has always been associated with beautiful anterior tooth colored fillings. More recently, there are several reasons for the shift toward posterior fillings that are tooth colored. The most obvious reason is that they look esthetically better than silver fillings. Silver amalgam fillings simply don’t look natural. The quality of these tooth colored materials used for fillings has become increasingly better each year with many scientific advances that maintain the color, resist fracture, and give natural translucent appearance. Quite honestly, amalgam is not aesthetically pleasing even in the lower posterior teeth which are exposed to view much of the time when talking. Patients should be informed of the discolored appearance that can occur to their teeth, particularly when the amalgam fillings are located in the more anterior and readily visible parts of the mouth. A major drawback to amalgam fillings is that preparation for the filling requires back cutting the tooth much like a pyramid so that when the metal hardens it will have good retention. This retention back cutting is required, because the metal does not actually bond to the tooth structure–it simply fills the cavity space and sits next to the normal tooth structure. The back cut areas of the tooth are thin, weak areas, which fracture easily. Amalgam filled teeth are highly susceptible to having cusps that fracture off. Posterior teeth with fractured cups require the placement of a more expensive crown on the tooth to preserve normal architecture and function. Bellevue Cosmetic Dentists, Dr Cynthia Pauley and Dr Patricia Pauley, only use tooth colored composite material to restore teeth, both posterior and anterior.


  • Composite resin tooth colored fillings look natural with a translucent tooth-like appearance and can be mixed to match any color of the tooth by your dentist.
  • Since “back-cutting” is not required, less of the natural tooth structure needs to be drilled away and removed by your Dentist, which maintains more of the strength and integrity of the natural tooth.
  • Composite resin strengthens the tooth that is filled because the composite resin actually bonds within the tooth structure.
  • Composite resin fillings rarely have areas of the tooth that are thin or weak, so that cusps rarely fracture off.
  • Composite resin fillings do not conduct heat and therefore do not expand and contract with heat and cold in your mouth, which helps facilitate tooth fractures near metal fillings.
  • Without back-cut areas or temperature movement, there is not any stress put upon weak areas of the composite filled tooth as occurs with metal fillings.
  • Composite fillings do not have any unbounded area between tooth and filling to allow moisture and bacteria to enter and cause decay and aide fractures.

In Cosmetic Dentistry, composite resin is the material of choice for most fillings, including very large posterior ones. The Cosmetic Dentists at Brookside Dental have not used silver amalgam as tooth filling material since the early to mid 1990’s. In that time, we have never had a patient tell us that they would prefer amalgam fillings instead of the tooth-colored fillings. Tooth-colored fillings take much more time and artistry by your Cosmetic Dentist than do silver fillings and therefore have more expensive fees than amalgam fillings. The higher cost of materials and labor related to tooth-colored fillings may preclude them as an option for some people. However, at Brookside Dental, we only use composite resin tooth-colored material for fillings in both anterior and posterior teeth, because we think that from the patients’ perspective, both the long-term health of the tooth and the person are enhanced by the use of these natural appearing composite filling materials. For additional information on composite tooth-colored fillings and other cosmetic dentistry techniques, you can visit our main website or our cosmetic dental clinic in Bellevue, WA.