In the past, dental patients had no choice regarding material used for their fillings-it was metal, metal or metal. Thankfully, today, there's an alternative since most folks don't want a mouth full of obvious metal (amalgam) fillings. But, when it comes to dental health, is it really better to choose white porcelain/composite fillings over the older variety? Porcelain/composite fillings do appear to have some definite advantages.

In addition to the obvious cosmetic drawbacks, problems associated with metal fillings include:

· Material does not harden immediately - Patients must wait to chew on it for at least a couple of hours.

· Expansion and contraction of the filling -- Metal fillings expand and contract with heat and cold, making your teeth more sensitive to hot and cold foods and beverages.

· Tooth Damage related to expansion and contraction -- Metal fillings' expansion and contraction can cause tooth damage, including cracked teeth.

· Mercury content -- Metal fillings contain mercury. In a 2008 report, the Food and Drug Administration (FDA) admitted that mercury fillings may not be safe and could be associated with health problems.

· More tooth structure lost -- More of the original tooth structure is lost when the patient chooses metal over porcelain/composite because the dentist has to prepare a larger area.

· Not universally available -- Metal fillings are no longer universally available, and your dentist may already have eliminated them from his/her practice.

Porcelain/composite fillings offer several key advantages;

· No mercury content - If you choose a porcelain/composite filling, the material typically contains acrylic and glass particles, so the risk of mercury toxicity is eliminated.

· Material hardens immediately - Patients can chew on the filling directly following filling placement.

· Less tooth structure lost - Dentists can prepare a smaller area for the filling-meaning less drilling.

· No expansion/contraction of filling - No expansion/contraction of the filling occurs to make your teeth more susceptible to cracking.

Of course, it goes without saying that porcelain/composite fillings look completely natural rather than detracting from your smile as metal fillings do. Still, it's important to be aware of a few points regarding white/composite fillings:

· The composite filling material is typically more expensive.

· The process of placing the filling usually takes a bit longer than metal.

· Composite fillings do stain over time, and do not become whiter through bleaching. Thus, it's important to undergo routine professional cleanings.

· Composite fillings work well on back teeth, but are not quite as durable as metal.

· Insurance companies will sometimes not pay for porcelain/composite fillings on back teeth.