Many people have metal fillings in their mouths, called dental amalgam fillings, which contain 50% mercury, combined with an alloy of other metals. It is still a matter of debate within certain groups of the dental community whether one should have amalgam fillings removed if there is no dental problem. We as dentists have a duty of care to our patients to present all the arguments for and against mercury fillings and we are concerned that patients anticipating resolution from specific conditions and symptoms are not mislead or their hopes allowed to be raised to unrealistic levels. Whilst dental amalgam has been used for over 100 years and is regarded as a robust and cheap material, our personal belief is that there are many suitable alternatives to dental amalgam, which also appear more natural.
What can we use as an alternative to mercury filling?
The alternative materials available on the market today are referred to as bonded resin ceramics, composite resins or just composites. These materials have been subjected to numerous clinical trials all over the world to determine whether they are biocompatible and safe to use in the human body. Our dentists have a combined experience of three decades with this material. As such we have a very strict protocol on placement of material resulting with a very high success rate. Occasionally there are anecdotes of people suffering from sensitivity or pain after having composite fillings or the fillings not lasting very long. Of course there is a difference in the qualities of different composite materials. This can lead to some products not lasting as long or appearing to discolour very quickly. As with everything else, the composite materials used at Integrated Dentalcare are of a premium quality. To increase their life expectancy the latest generation of composites contain ceramic nano-particles resulting in exhibited wear resistance similar to natural teeth. Are composite materials inert? Composite materials have been found to have oestrogen-mimicking properties. Unfortunately nothing in dentistry or medicine is 100% bio-inert. Recently, however, with the advent of CAD CAM milling technology and pressed ceramic, we have found a truly bio-compatible material. However, unlike composite which can be very conservatively used to repair the damage caused by infection – a process enhanced manifold by the use of the water laser – ceramic fillings do requires some modification of the healthy tooth structure to be used (much like amalgam). Nevertheless, they are a robust solution to composite fillings and are typically used to restore large defects. We follow a strict protocol when replacing your amalgam fillings.
Briefly, these include the following precautions:
- Isolation of the treatment area, usually by a technique known as ‘rubber dam’, to minimise exposure to debris in the mouth
- Use of high speed, distilled water-cooled instruments
- Use of high speed powerful suction system
- The option to use a nosepiece, to provide an alternative air source out of the immediate area to protect against nose inhalation of mercury vapour
- The option to use dampened gauze eye patches to keep flying particles or vapour out of the eyes
- Use of general protective coverings
- When drilling, the filling is sectioned into chunks and elevated where possible
- Nutritional support considerations, to support the immune system
- Restoration of remaining tooth structure with a premium quality resin material
- Patients may wish to consider wearing clothes covering as much skin as possible