A Gentle Touch to Seal Dental Imperfections
High-quality, Beautiful Dental Fillings
For hundreds of years, dental fillings have been used to restore teeth. Dental fillings are placed in teeth where a dentist has had to remove tooth structure due to decay or fracture. In recent years, filling materials have been substantially improved by many technological advancements. Although silver amalgam was the dominant choice years ago, today, we have several other preferred options for tooth restoration, including tooth-colored composite filling materials and cementable resins and porcelains.
Dental Filling Procedure
Decayed teeth require fillings to restore the strength and health of natural teeth.
The decayed portion of the tooth is removed from the sound tooth structure.
Filling materials are shaped to match the look and feel of natural teeth. Traditionally, silver or amalgam material has been the filling of choice.
Today, many modern materials can be used to mimic the color and texture of natural teeth.
Safety of Dental Amalgam Fillings
Teeth are meant to last a lifetime. The younger generation is growing up with fewer tooth-related problems than any previous generation. However, dentists aren’t running out of work, and there are still many dental problems that need professional help.
Historically, the options for the patient were relatively limited as to the type of filling materials used. Tooth-colored fillings (composites) generally work well in the front (anterior) teeth because they don’t have to withstand the tremendous forces exerted against them when chewing. This article will concentrate on options for restoring back (posterior) teeth.
In the past, the filling material of choice was silver/mercury containing a filling called amalgam. Amalgam has been in use for more than 150 years and has restored the teeth of more than 100 million Americans. These amalgam fillings are about 50% mercury, 35% silver, and 15% tin and copper. However, in the last few years, there has been a shift away from the traditional amalgam fillings to more aesthetic, tooth-colored, posterior composite fillings. Some dentists don’t use amalgam fillings any longer, and some patients insist on using composite fillings simply because of their appearance. This shift toward composite fillings is purely for looks. Dentists the last few years are seeing problems with posterior composite fillings, and the pendulum is swinging back to using more amalgam, or some other stronger option, in posterior teeth.
An endodontist (root canal specialist) who practices in Tooele part-time said that failed posterior composite fillings are a major factor in keeping him busy.
One dentist recently wrote that there is only one bad thing about amalgam fillings… They aren’t white (tooth-colored), and there is only one good thing about posterior composite fillings… they are tooth-colored.
Studies have shown that the average tooth-colored posterior composite filling lasts less than five years, while the average lifespan of an amalgam filling is twelve years. As the size of the filling gets larger, the lifespan discrepancy gets even worse.
In addition to the dark appearance of amalgam fillings, people shy away from them because they contain mercury. Extensive research has failed to show credible evidence of ill health effects from amalgam fillings with the exception of fewer than 100 reported cases of allergic reaction to one of the constituents of the amalgam. In fact, a patient would have to have 2740 amalgam fillings in order to reach a threshold limit value of 82.2 micrograms of mercury per day which level is considered dangerous for occupational exposure in the United States. The mercury is bound to the other metals in the amalgam just as bricks and mortar are bound together in a brick wall. If the mercury leached out of the filling, the filling would disintegrate. That does not occur.
Two recent long–term, randomized, controlled clinical trials of elementary school children found no significant difference in neurological behavioral performances between children who received amalgam restorations and those who received only composite fillings.
A Google search of “mercury fillings” can pull up some very scary statistics and testimonials. However, the U.S. Food and Drug Administration, the U.S. Public Health Service, the World Health Organization, the Centers for Disease Control and Prevention, the National Institutes of Health, and the U.S. Department of Health and Human Services all have found dental amalgam to be a safe and effective dental restorative material. Which are you going to believe?
The official statement of the American Dental Association as recently as July of 2008 states: “Based on available scientific information, amalgam continues to be a safe and effective restorative material. There currently appears to be no justification for discontinuing the use of dental amalgam.”
There are claims that amalgam causes all sorts of systemic health problems. However, many organizations officially do not condemn amalgam. For example, the Alzheimer’s Association states, “According to the best available scientific evidence, there is no relationship between silver dental fillings and Alzheimer’s.” The National Multiple Sclerosis Society (MS) states, “There is no scientific evidence to connect the development of MS or other neurological diseases with dental fillings containing mercury.” The New England Journal of Medicine says, “Patients who have questions about the potential relation between mercury fillings and degenerative diseases can be assured that the available evidence shows no connection.” Consumer Reports states, “As far as we know, in this well–studied area, your silver amalgam fillings are doing you no harm. If you need fillings in your back teeth, amalgams remain the cheapest, most durable choice.”
“No harm” and “cheapest and most durable choice” are great statements for the continued use of amalgam. There are good tooth-colored options for posterior teeth (not composites), but their cost is five to ten times the cost of an amalgam restoration. The bottom line is: DON’T BE AFRAID OF TIME–TESTED, RELIABLE, AND REASONABLY PRICED AMALGAM FILLINGS.
Sources quoted are available on request.
Clair Vernon DMD
271 South Main
Quotes from Reader’s Digest July 2009
“Composite (tooth-colored) fillings are popular, but a metal filling is going to be more durable, especially for bigger jobs.” Brody Hildebrand, DDS
“I have amalgam fillings in my own mouth. There’s no proof that they do any harm. Convincing patients to remove their fillings for health reasons is quackery.” Michael Alkon, DMD, Holmdel, New Jersey