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is tooth #4 and #5 breaking down, see any decay?
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2 UpVoted this answer
I see no problem in this photo with either tooth. Having said this, most decay is diagnosed either clinincally, that is by seeing it with the eyes, or using x-ray to see between the teeth. My guess is that these amalgam fillings are fairly old. I do not like amalgam in bicuspid teeth because of their propensity to fracture the teeth, especially the Maxillary 1st bicuspid (the lower tooth in the photo).
1 UpVoted this answer
They both look like they are older fillings and the margins look like they might be starting to leak. With silver fillings it is difficult to tell sometimes if there is decay under the filling and many times after removing the filling decay is found and often there is a substantial amount. Replacing the silver filling with white composite fillings would be an advantage in that the teeth would look better, be less likely to break, and any future decay would be easier to diagnose. It would also be beneficial to consider crowns or onlays which would be a stronger and longer lasting alternative to composite fillings
1 UpVoted this answer
I do see the edges lifting around the previous silver fillings and often find recurrent decay or evidence of leakage under the old alloys when I replace them. The radiographs and your dentist's clinical evaluation give necessary information. I do agree that these fillings more than likely would benefit by being updated.
From a visual assessment it looks okay. When determining if a filling needs to be replaced, dentist normally determine this from looking at three things: visual assessment, radio graphic (xrays), and tactical feel. If two of three stand out, your oral health care provider makes a judgment call to replace the filling. If marginal break down is seen on the x-rays it is a good idea to have to replace the old filling. Think of it this way, if you don't replace them now, the tooth fractures in a fee years and you end up needing a root canal and crown, you will wish you would of replaced them. There is a increase in fracturing in the premolar area of tooth with an amalgam filling. For patients needing to have a filling replaced, it is better than have a crown and root canal down the road.
These fillings look old but more importantly they are wide from the tongue side to the cheek side. With time the tooth commonly begins to have microfractures in the cusps leading to cusp fracture. Depending on the current condition using transillumination with a bright light a white filing could be placed or for more support a ceramic protective cusp onlay could be placed. Ask your dentist for more information.
These fillings are very old and a judgment call by your trusted dentist is your best recommendation.