Should I replace my old dental fillings?
Our dental work does not usually last our entire lifetime. Due to the amount of daily wear and tear from biting forces, acids from our food and temperature changes in the mouth, our dental work starts to deteriorate. When older amalgam fillings start to wear out, they usually appear corroded around the margins, which can allow more bacteria to enter the space between the tooth and filling and cause another cavity to form.
Another problem that can occur from aging amalgam fillings is from the expansion of the material every time the mouth experiences a shift in temperature during eating and drinking. This can cause the amalgam to expand, putting stress on the surrounding tooth structure and resulting in cracks throughout the remaining tooth structure. Over time, this can lead to fractured teeth and, depending on the severity of the fracture, tooth loss.
Amalgam has been widely used in dentistry for decades. At one point in time, it was the most cost-effective material available. Modern dentistry has introduced a wider variety of dental materials that are both safer for human health as well as better for the tooth in the long-term.
What is amalgam?
Amalgam is a dental material that is made up of an alloy usually composed of silver, tin and copper as well as elemental mercury. This material is very durable, and often, patients with older amalgam fillings have had them for many years.
In recent years, there have been concerns over the safety of amalgam as a dental material due to environmental as well as potential health risks. Research has shown amalgam fillings release mercury vapor at certain temperatures and can be released by brushing, grinding, and chewing forces on the filling. There is insufficient research to prove if these levels are toxic for human health at this time.
At high enough levels, mercury poisoning can cause many health problems, contributing to the progression of autoimmune disorders and many neurological problems. Because there is inadequate research to prove that amalgam fillings cause toxic levels of mercury vapor to be released into the body, the ADA (American Dental Academy) still deems amalgam to be a safe and effective dental material in the United States.
Many dentists today have chosen not to use amalgam fillings in their practice, but studies show that up to 50% of dentists in the U.S. are still using this material regularly. One reason for this is the low cost of the material both to the provider as well as the patient.
Fortunately, we have many dental materials available to us today that do not pose such health or environmental concerns. White composite fillings and metal-free crowns offer patients a healthier and more aesthetically pleasing alternative.
Should I replace my amalgams?
Fillings that have signs of corrosion, leaking margins or that are causing discoloration of the tooth or cracks should be replaced. In general, it is a good idea to leave stable amalgam fillings alone until they become compromised. Your Lincoln, NE dentist will examine the condition of all of your existing dental work at each of your continuing care appointments and inform you of any signs of breakdown. If your filling is small to medium-sized, often it can be replaced with a white composite filling. If your filling is large, and accounts for 50% of the tooth structure or more, your Lincoln, NE dentist may talk to you about a metal-free crown as a better option to offer your tooth more chewing support.
Solution for an area with a stained or discolored dental filling: A new tooth (dental) filling.
A new filling may be necessary to replace a stained or discolored dental filling. If anticipated new tooth filling is small, a tooth-colored restoration can be placed that will look natural and match surrounding teeth and color.
Solution for front areas with extensive old existing fillings: Porcelain Crowns
Porcelain crown offers a more dramatic and longer lasting fix as a replacement options for teeth with extensive dental fillings. Porcelain crowns are made of a high-grade porcelain that looks natural, blends beautifully with the surrounding teeth, and is resistant to staining or discoloration. With porcelain crowns, your teeth will get extra support and yet look beautiful and healthy.
Is it safe to replace amalgam fillings?
Our offices use an air filtration system called IQAir which helps to remove excess mercury vapor in the air as well as other harmful aerosols created in the dental office. This system can clean 90% of all ultra-fine particles during operating hours. Each unit in our offices is equipped with individual air-vacuum units the help to remove these vapors in close proximity to the patient’s face during removal. In addition to this, we use the Isolite system which is a modern day dental-dam alternative to help isolate the tooth, remove any debris or vapors created during the removal process. In addition to this, we dispose of amalgam particles in compliance with OSHA standards to avoid environmental contamination.
Commonly Asked Questions About Amalgam Fillings
Are amalgam fillings bad for you? Your Lincoln, NE dentist answers…
There is insufficient research available to definitively answer this question, but some recent studies have shown amalgam dental material to slowly release mercury vapors through activities like chewing, brushing the teeth and increasing the temperature of the mouth by eating/drinking. It is up to the patient to decide if they feel comfortable using this material as a restoration. At Lincoln Family Dentistry, we do not place amalgam fillings.
Are amalgam fillings still used today? Your Lincoln, NE dentist answers…
Amalgam fillings have been used in dentistry for 150 years. Today, it is estimated that a little less than 50% of dentists regularly use amalgam in their practice in the U.S. The ADA still accepts amalgam as safe and effective as a dental material. Many other countries have banned amalgam due to concerns about environmental contamination.
Which filling is right for your teeth? Your Lincoln, NE dentist answers…
There are many types of filling materials available today, from amalgam to gold, porcelain and composite resin. Your dentist will always choose a material for your tooth based on the shape and size of the cavity. For chewing support, your tooth will need to have great longevity. In general, for small to medium sized cavities, white composite resin filling material is very durable. Unlike amalgam, it is chemically bonded to the tooth structure. This allows your dentist to remove only the decayed tooth structure when preparing your tooth. Amalgam fillings require that additional tooth structure beyond the cavity is removed to create an undercut. This is because amalgam material is simply packed into the undercut rather than bonded into place to help it stay into place.
Can mercury leak from dental fillings? Your Lincoln, NE dentist answers…
There is some research suggesting that amalgam fillings can release mercury vapors when material is heated up. It is unclear whether this is related to metal toxicity at this point. The ADA still accepts amalgam fillings as safe and effective. At Lincoln Family Dentistry, we do not use amalgam dental material.
What is the cost of replacing dental fillings?
Most dental fillings are covered by most dental insurances at 80%. If you do not have dental insurance, cost of dental fillings can be more affordable by using Lincoln Dental Plans.
Some dental insurances will even cover dental veneers at 50 % but not all insurance plans will do so.
As for dental crowns, the cost of placing dental crowns may be covered at 50%
Wishing you health and happiness,
Dr. Kelly O’Hara
About the author:
Kelly O’Hara is a Lincoln, NE dentist who practices family dentistry. Dr. O’Hara uses the most biocompatible dental materials available and is extremely knowledgeable about the safe amalgam removal. To schedule an appointment with Dr. O’Hara, request an appointment online or call the office at (402)-467-1000.