Silver tooth caps: what they are, how they come off and what replaces them

A silver tooth is usually a silver-coloured metal cap, or an open-face silver design, cemented over a front tooth that was filed down to fit it. We don't fit them, but we do take them off: the tooth underneath is checked and rebuilt in tooth-coloured composite, matched to the teeth beside it.

The silver fillings in back teeth are a different thing, and they usually stay where they are.

Silver caps, silver designs and silver fillings

People say "silver tooth" for three different things, and only the first two are what we take off:

The American Dental Association and the US Food and Drug Administration (FDA) consider amalgam fillings safe. The FDA advises some groups, including pregnant women and young children, to avoid new amalgam fillings where possible, and does not recommend removing amalgam fillings that are in good condition. If an old filling breaks or decays, it can be replaced with a tooth-coloured filling.

Why people have silver caps taken off

• The look no longer suits them. Some people chose silver years ago and would now rather have a tooth-coloured front tooth.
• Pain or decay at the edge of the metal. Over the years the edge of a cap can stop sealing, and decay can start in the gap. Left untreated, decay under a cap can spread, and in time the tooth can be lost.

Your own tooth is under the silver

Under a silver cap is your own tooth, filed down when the cap was made. That enamel doesn't grow back, so once the silver is off, the tooth needs rebuilding.

We check it for decay and for how much sound tooth is left. Any decay is cleaned out first; if the tooth needs more than composite can give it, we explain what it needs before going on. If your cap has been on a long time, the signs in our guide to gold caps after many years apply to silver too.

How a silver cap comes off

The same way as gold: the tooth is numbed if needed, then the cap is cut through and lifted off. Each step is on our page about gold and silver tooth removal.

Please don't try to take a fixed silver cap off yourself. It is cemented to a filed-down tooth, and prising at it can crack that tooth. Here is why a fixed cap should not come off at home.

What replaces a silver cap

Tooth-coloured composite, bonded to your tooth and built up by hand in the chair, in a shade matched to the teeth beside it. There are no moulds to wait for and no laboratory.

If you'd also like lighter teeth, whiten first. Whitening doesn't change the colour of composite, so the rebuild is then matched to your new shade. See professional teeth whitening.

Composite can chip or stain over time, and it can be polished or repaired. To look after it, brush with a soft toothbrush and a fluoride toothpaste that isn't abrasive, clean between your teeth every day, don't use your teeth as tools, and go easy on coffee and tea. We check the rebuild at your check-ups.

Your questions about silver teeth