Survey data were obtained from 144 dentists and 116 patients concerning their attitudes and preferences toward direct composite and amalgam restorations in the posterior segment. Some dentists report that they take the initiative in recommending direct composites in these cases and others report that patients request them. Selection criteria for direct composite posterior restorations are similar to those advocated in the dental literature. Those characteristics of alternative materials emphasized in obtaining informed consent mirror the characteristics of the materials dentists report most often performing. Patients report an interest in tooth-colored restorations and trust dentists' professional opinion, but also express a strong desire for full information as part of informed consent.