No, as long as your amalgam restorations (“silver fillings”) are sound — meaning their margins are sealed, there is no recurrent decay beneath, no fractures, and no black or brown shadows — you can leave them alone. At my practice, it's often recommended. It is traumatic for any tooth to get numb and go under the drill, and personally I try to keep existing fillings in the mouth for as long as we can get away with it. In general, fewer and fewer dental offices are offering amalgam every year because composite restorations (“white fillings” or “bondings”) offer superior esthetics and bond directly to healthy tooth structure. When composite restorations are placed correctly, they can easily last over a decade.

It’s important to note that any kind of restoration can fail in the presence of improper hygiene, so be sure to floss nightly, use an electric toothbrush, stay hydrated, avoid vaping or smoking, and stay away from sweet carbonated drinks or candy.

It's often apparent to the naked eye when amalgam restorations are starting to fail, which is why we take a full set of intraoral photos at Demibone during your first visit. Tracking your teeth's clinical presentation (or "visible health," let's say) will help us determine what needs to be treated and what we can leave alone. If you have a beautiful silver filling that hasn't changed much since you were 12, and its margins look sealed and smooth, and there are no shadows or internal discoloration… I say, let her live.