Silver Amalgam Fillings

Baby boomers, how old are your metal silver fillings?  30?  40?  50 years old?  Many dental offices proclaim to be "metal-free", primarily meaning they don't do silver amalgam fillings.  Do they mention that the "metal free" alternative to amalgam, composite resin fillings (which in fact contain metal in their inorganic filler particles and use aluminum oxide as pigment)*, last closer to 10 years? 

Is that a benefit to the patient, or to the dental office that gets to replace the failed filling every 10 years?  So, what about amalgam?  Its usage in the United States is declining every year.  It is probably the least attractive looking filling material we have.  However, it gives the most years-of-service-per-dollar-spent of any filling material.  

There are situations where composite resin is a poor choice for a filling material.  We believe there is a place for silver amalgam and we still use it, giving our patients the option.  The conservative amalgams in this image were placed by Dr. Knox in 2015.

*Ref:  Malcmacher L.  The metal-free practice scam.  Dental Economics, Oct. 2011

Want the science?  Rasines Alcaraz MG, et. al. (2014) Direct composite resin fillings versus amalgam fillings for permanent or adult posterior teeth.  Cochrane Database Systematic Review 31(3) CD005620.