White Fillings vs Silver Fillings: Is the Upgrade Worth It?

Your treatment plan says something like “LR6 MOD amalgam, Band 2”, or the private quote has two prices for the same filling with £100 between them. You want to know whether that £100 buys you anything apart from looks.

Often it doesn’t, and sometimes it buys you a lot. Three things decide which: which tooth it is, how big the filling is, and what the NHS will pay for where you live. How the filling looks is the least important of the three, even though it’s the only one the practice brochure mentions.

First, decode what’s written on your plan

Before you compare materials, find out what’s actually being filled. UK treatment plans usually use a short code, and once you can read it you’ll know most of what matters.

Some practices use the international system instead, so LR6 shows up as 46 and UL2 as 22. Same tooth.

“LL6 O” is a small filling in the lower left first molar. “UR5 MOD” is a large filling in a premolar that will probably show when you laugh. These two need different answers, so it’s worth knowing which one you’ve got.

What the NHS actually covers

In England, a filling of either colour falls under Band 2, which also covers everything else in that course of treatment. The 2025–26 Band 2 charge was £75.30. Check nhs.uk for the current figure, because it usually goes up each April. Three fillings and a scale cost the same Band 2 charge as one filling.

The rule that catches people out is that the NHS pays for what’s clinically necessary, not what looks nicest. In practice:

• Front teeth (1 to 3): white composite is standard on the NHS. If you’re quoted a private fee to put a white filling in a front tooth, ask why.
• Back teeth (6 to 8): amalgam has long been the default NHS choice for molars because it lasts and copes with chewing forces. Many practices treat white fillings on molars as private.
• Premolars (4 and 5): this is the grey area. Practices differ, and so does how visible your premolars are.
• Under-15s and pregnant or breastfeeding patients: since July 2018, amalgam shouldn’t be used for these groups unless the dentist judges it strictly necessary. If that’s you, white should be offered on the NHS.

Scotland, Wales and Northern Ireland run their own fee systems, and Scotland reworked its NHS fees in late 2023. If you’re outside England, ask the practice directly: “Is a composite on this tooth available on the NHS here, or is it private?”

In England you’re allowed to have one tooth done privately while the rest of the course stays NHS. You pay the Band 2 charge for the NHS work plus the private fee for that one filling. The practice should write this down for you before starting. If they say it’s “all or nothing”, that isn’t how the rules work.

The material question, without the marketing

Amalgam is a metal alloy that includes mercury. It’s strong, forgiving to place, and in back teeth it often lasts 10 to 15 years or more. The dentist has to cut the cavity into a shape that locks the filling in, which can mean removing some healthy tooth.

Composite is a tooth-coloured resin that bonds to the tooth. Because it sticks, the dentist can often remove less healthy tooth, which matters most for small cavities. It takes longer to place. The tooth has to be kept completely dry, which is hard at the very back of the mouth. And in big, heavily loaded fillings on molars, composite tends to fail sooner, often lasting around 6 to 10 years depending on size and whether you grind your teeth.

On mercury: UK guidance is that amalgam is safe for the general population. Drilling out sound amalgam fillings because you’re worried about them isn’t recommended. Removing them releases more vapour than leaving them alone, and every replacement costs a bit more tooth.

So size changes the answer. On small fillings, composite is arguably the better clinical choice as well as the prettier one. On large back-tooth fillings, amalgam often wins on how long it lasts, and the gap only closes if your dentist is good with composite and you don’t grind.

Four worked examples

1. “LL6 O, small occlusal cavity. NHS amalgam in Band 2, or private composite £95.” This is a small filling in a molar nobody sees. Composite would keep a little more healthy tooth, and it rarely fails at this size. If £95 isn’t a stretch, it’s a reasonable upgrade. If it is, the amalgam is fine and you aren’t cutting corners.

2. “UR5 MOD. NHS amalgam, or private composite £165.” This is a large filling in a premolar that probably shows when you smile. Check it in a mirror: if you can see your upper 5s when you grin, a three-surface silver filling will be visible every day for a decade. This is the clearest case for paying. You’d pay £75.30 for the NHS course plus £165, so £240.30 in total. With amalgam you’d pay £75.30.

3. “LR7 MOD, replacing a large old filling. NHS amalgam, or private composite £210.” This is a big filling on a second molar, right at the back, where it’s hard to keep dry and chewing forces are high. Here the £210 mostly buys a look nobody will see, and it may not last as long. Unless you have a specific reason, such as an allergy, pregnancy or a strong personal preference, take the amalgam. Ask your dentist this word for word: “Would you put composite in this tooth if it were your own?”

4. “UL6, cracked cusp, large existing amalgam. Private quote: composite £240, or onlay £650.” The choice isn’t really white versus silver. When a tooth is this broken down, any direct filling is a patch. An onlay or crown (crowns are Band 3 on the NHS, £326.70 in 2025–26) covers the weak walls. Paying £240 for a white filling here can mean paying twice. Ask whether the tooth needs covering instead, and see the Treatment Options Compared guides for how crowns and onlays stack up.

Using ChatGPT or Claude to sanity-check your quote

AI tools are good at decoding jargon and suggesting what to ask. They can’t see your X-ray, and a model guessing what NHS charges are this year can be months out of date. Give it the facts it needs and ask it to show its reasoning.

Here’s a prompt that works well in ChatGPT, Claude, Gemini or Microsoft Copilot:

I'm an NHS patient in England. My treatment plan says:
- UR5 MOD composite, private, £165
- LL6 O amalgam, NHS
- Scale and polish, NHS
Band 2 charge: £75.30 (I've checked this on nhs.uk).

1. Explain each line in plain English.
2. What's my total cost, and is mixing NHS and private allowed?
3. For the UR5 MOD specifically, what are the trade-offs between
   composite and amalgam given the tooth position and filling size?
4. Give me 5 questions to ask my dentist before I agree.
Don't guess at prices you aren't sure of. Say so instead.

Put the band charge in yourself rather than asking the model for it. Also tell it which country you’re in, since the rules in Scotland, Wales and Northern Ireland are different. If the answer says white fillings on molars are “always” available on the NHS, or that amalgam is “banned in the UK”, it’s wrong. The EU’s 2025 ban doesn’t apply in Great Britain.

When to push back, or look elsewhere

A few things on a quote are worth questioning:

• A private fee for a white filling on a front tooth when you’re an NHS patient.
• Being told you can’t have one tooth private and the rest NHS.
• No mention of tooth or surfaces, just “white filling £180”. You can’t judge a price without knowing whether it’s an O or an MOD.
• Being encouraged to replace several intact amalgams for appearance, presented as a health issue.
• Composite private fees well above the local range. Outside London, somewhere around £90 to £200 per tooth is common depending on size. Central London practices often charge £150 to £300. Above that, ask what’s included.

If the practice is good, the dentist will explain why they recommend a particular material for that particular tooth without you having to drag it out of them. Ask: “Which would you choose for this tooth, and why?” If you get the same answer for every tooth on the plan whatever its size or position, that’s a template answer rather than advice about your teeth. A second opinion costs a Band 1 check-up at another NHS practice (£27.40 in 2025–26), which is less than the price difference on a single upgraded filling.