I have been using composite resin for 23 years. I have taken a lot of continuing education on the topic, self-study, and a lot of clinical experience using the material. I joke sometimes that I think I can build a rocket ship with the stuff. Placing composite resin fillings takes more time, skill, knowledge and expertise, ….and patience, than does amalgam. Composite material is also less “forgiving” than amalgam, which is to say that the margin for error is much slimmer than that of amalgam use. Composite resin material needs to be more carefully and meticulously placed than amalgam, with no moisture contamination. They take a lot more time. The material itself is also much more expensive, as are the instruments used to work with the material, as well as the UV light curing units, which can be upwards of $1000 or more. Therefore, the fillings cost more to patients. Contrast this with amalgam, which is cheap and quick, and is more “forgiving” to less than ideal placement. So the answer to the question of “which is better” , depends on the skill, knowledge and expertise of the dentist placing the fillings. Like anything else, a poorly performed procedure of any kind will end up with poor results. It’s like asking the question, “which is better transportation, an old bicycle or a Ferrari?” Well, if you know how to drive and have experience with Ferrari’s in particular, the answer is clear. If you are a poor driver, and can’t even get the car in gear, you won’t go very fast and your best choice might be to stick with the bicycle until you learn to drive. So, YES…..an expertly performed composite resin is far superior than an expertly performed silver amalgam filling, all else being equal. However, a poorly performed silver amalgam filling probably has an edge over a poorly performed composite resin filling. That’s not exactly a raving endorsement of silver fillings, but it’s the truth and about as good as it gets for amalgam.
There are still many dentists today who place silver amalgam fillings on back teeth. Maybe some dentists truly feel that it is superior to composite resin, but I could not disagree more. Most others place silver for the reason stated above; it is quick, cheap, and familiar. Many dentists who participate with certain insurance companies are also penalized by these companies for doing composite resin, i.e. the reimbursements are so low that it is prohibitive, and amalgam restorations are chosen instead. With that being said, there are fewer dentists placing amalgam with each passing year, and by the end of my career it may be difficult to actually find a dentist that still uses silver amalgam. That’s the direction dentistry is headed, it’s just taking some folks a little longer to get there.
I hope I answered some of your questions about composite resin and silver amalgam.