Amalgam Fillings

How to replace amalgam fillings

Amalgam fillings are silver-coloured fillings which have been used in dentistry for the past 150 years. It’s a combination of metals, and until recently have been the most popular and effective filling material.

But some people don’t like the look of them. And it turns out they’re not great for your teeth either.

Luckily, there is an alternative.

The dangers of amalgams

All amalgams eventually crack teeth, particularly if you’re a ‘grinder’ or a ‘clencher’. That’s because amalgams do not bond or cement to the tooth structure.

Rather, the amalgam is molded into the cavity, which has been undercut by the dentist, when it is in its malleable state. This means that when a load is put onto the tooth, eventually cracks will form at the base of the cavity.

How will I know if my fillings are cracking my teeth?

Warning signs that you might have fractures under the amalgams are tooth hypersensitivity, sensitivity to chewing, hot and cold sensitivity, and general achiness when biting into food and it feels a bit ‘sore-ish’.

Quite often when I remove a large amalgam there will be lots of stress fractures at the base. I can’t then just refill the cavity leaving those cracks, because if I do, when that person bites into something part of the tooth will break off.

If there is a crack, unfortunately a chunk of the tooth has to be removed. However, if there is no crack and the tooth does not have to be rebuilt, we use a crown.

My goal is to save as much of the natural tooth structure of my patients as possible.

Why save teeth?

Most people have maybe eighty to ninety years of life. I look at how old the patient is and how much tooth structure they’ve got left. I multiply that by having to replace that filling maybe three or four times in their lifetime.

I want to try to keep as much of the tooth as possible because if they’re twenty years old and they’ve already got a broken tooth, they’re going to be looking at having to replace that maybe four times in their life.

You don’t want to get to the age of seventy and find that there’s a stump left; you want something to be able to grab hold of. So the more you can save at any particular age the better.

Why is porcelain a good alternative to replace amalgam fillings?

Porcelains can be thin and strong and we don’t need to remove big chunks of tooth. The porcelains are such that we can now replace the missing part of the tooth with porcelain, and rebuild cusps and major parts of the teeth. In turn the teeth are strong because of the strength and quality of the porcelain. It chemically and physically bonds to the enamel and the dentin, which makes a stronger restoration. Not to mention they end up looking like beautiful, natural white teeth.