Many adults recall having “silver teeth” during childhood. These distinctive dental restorations were common in pediatric dentistry for decades, playing an important role in maintaining oral health. Understanding what these “silver teeth” were, why they were widely used, and their eventual fate can demystify this familiar part of growing up.
Understanding “Silver Teeth”
“Silver teeth” in childhood dentistry typically referred to two main types of restorations: dental amalgam fillings and stainless steel crowns. Dental amalgam is a mixture of metals, predominantly composed of liquid elemental mercury and a powdered alloy. This alloy includes silver, tin, and copper, with approximately half of the amalgam’s weight being elemental mercury. The combination of these metals gives amalgam its characteristic silver-like appearance when first placed, which can darken over time.
Stainless steel crowns (SSCs) are pre-formed, silver-colored caps designed to cover an entire primary tooth. These crowns are made from stainless steel, an alloy primarily consisting of iron, chromium, and nickel. SSCs are placed over teeth with extensive decay or damage, providing a full and durable covering. Their metallic composition results in a distinct silver gleam.
Reasons for Their Use in Childhood
The widespread use of silver dental materials in children’s dentistry stemmed from several practical advantages beneficial for primary teeth. Both dental amalgam and stainless steel crowns offered significant durability, allowing them to withstand chewing forces until primary teeth naturally exfoliated. This robustness was important because primary teeth act as placeholders, guiding the eruption of permanent teeth and aiding in speech and eating.
These materials were also more cost-effective compared to tooth-colored alternatives available at the time. The ease and speed of placement were additional benefits, especially when treating young patients who might find it challenging to cooperate during longer dental procedures. Amalgam, for example, was less sensitive to moisture during placement than early composite resins, making it a more predictable option. Stainless steel crowns could often be placed in a single visit, reducing the need for multiple appointments.
Safety Considerations and Evolution of Dental Materials
Concerns regarding the safety of dental amalgam, primarily due to its mercury content, have been discussed. Dental amalgam releases low levels of mercury vapor, which can be inhaled and absorbed by the lungs. However, major dental and health organizations, including the U.S. Food and Drug Administration (FDA) and the American Dental Association (ADA), state that available scientific evidence does not show that exposure to mercury from dental amalgam leads to adverse health effects in the general population. The FDA updated its guidance in 2020, recommending that certain high-risk groups, such as pregnant women, nursing women, and children, avoid amalgam whenever possible, though it does not recommend removing existing, intact amalgam fillings.
The decline in amalgam use has been influenced by several factors beyond safety concerns. Aesthetic preferences have shifted, with patients and parents increasingly favoring tooth-colored restorations that blend seamlessly with natural teeth. Advancements in alternative materials, such as composite resins and glass ionomer cements, have provided viable and durable tooth-colored options. Environmental concerns regarding mercury waste management have also contributed to the move away from amalgam.
When Primary Teeth with Fillings Come Out
Primary teeth, often called “baby teeth,” naturally loosen and fall out to make way for the permanent teeth erupting beneath them. This process is known as natural exfoliation. The roots of primary teeth gradually resorb, meaning they are absorbed by the body, which causes the tooth to become loose.
When a primary tooth containing a silver filling (amalgam) or a stainless steel crown is ready to exfoliate, it typically comes out on its own, along with the restoration. There is no need for special dental intervention to remove these restorations separately. These teeth and their attached restorations are then usually discarded.