Louis R. Garcia, DDS

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Composite Bonding Can Substitute For Porcelain Crowns

Dominion Ridge Dentistry Amalgam 5

Many patients see Dominion Ridge Dentistry asking to update their silver fillings. They want their old metal fillings taken out and exchanged with tooth colored fillings. You can see side-by-side examples in the photo to the left of bonded white fillings vs. metal amalgam fillings. Patients often cite esthetic and health concerns about their metal fillings. It’s a fact that the esthetics of a smile can be dramatically enhanced with a more natural, tooth-colored restoration. In addition to this, there are several reasons that would explain why it’s smart to update to a tooth-colored porcelain “filling” or a resin composite filling.

Everything wears out, and your silver fillings are no exception. They withstand stress-filled and heavy biting forces daily, and as they age, they crack, leak and may also bring about damaging fractures in teeth. Over time, metal amalgam fillings can actually absorb water, causing them to swell and break away from the tooth. When this happens, your tooth is far more liable to decay and sensitivity.

Mercury/Silver fillings have some negatives worth listing that ought to be considered if it’s time to replace your restorations:

• Silver fillings are less attractive than tooth-colored fillings. Think about it, they scream out, “I am a metal filling put here because this person didn’t take care of their teeth very well!”

• Amalgam expands and contracts when exposed to hot and cold extremes inside your mouth. The constant expansion and contraction with temperature might initiate cracks and fractures in teeth. There may not be any kind of symptoms for a while, but these teeth may become sensitive as the fracture expands or opens when you bite down or chew. It isn’t abnormal for patients to come in curious about how they broke their tooth when they were eating something soft such as bread or a banana. What they don’t know is that the tooth more than likely had a fracture in it well before it ultimately came apart.

• Silver fillings under frequent chewing stress are prone to metal fatigue or bending and flexing failure, a concept which may be grasped and shown by repeatedly bending a metal paperclip until it breaks.

• Metal fillings are harder and less flexible than the teeth they are molded into. The longer they are in the teeth, the more force they place on the remaining weak surfaces of the tooth leading to cracks and fractures.

• Metal fillings are not glued into the cavity. They simply sit in the tooth and act under pressure to wedge the tooth apart, just like a metal wedge can be used to split logs for firewood.

• A microscopic gap around the filling edge exists from the moment your silver filling is plugged into the tooth; and in this gap, constant corrosion and leakage occurs. This gap is big enough to permit bacteria and food particles to seep in over time and cause decay at the joint between the filling and the tooth. Composite fillings, however, are actually bonded to the tooth preparation area and seal the margins closed from bacterial invasion.

• In order to prepare a tooth for a composite filling, the tooth can be treated a great deal more gently and with less healthy tooth structure needing to be removed. And therefore, the dentist can maintain the maximum amount of healthy tooth structure as is possible

• Silver fillings necessitate drilling undercuts (think carving out a pumpkin) and taking away larger good portions from the tooth to be able to keep the mercury amalgam filling from falling out since it is not bonded directly to the tooth. These kinds of undercuts may also weaken the tooth as fillings get larger and doom that tooth to subsequent fracture down the road. These fractures can be significant leading to crowning the tooth to fix it and even catastrophic fractures leading to extraction of the tooth.

• Composites, with their opportunity to be conservative and using their adhesive characteristics, may reinforce and guard against fracture. Through intercepting the potential for cracking before experiencing the signs and symptoms of hot/cold sensitivity as well as biting pain, brand new conservative treatments including tooth-colored restorations or porcelain-bonded restorations are protecting against the negative effects of toothaches and broken teeth.

• Finally, in many dentists’ opinions, bonded natural-colored restoratives are probably safer than traditional fillings, because they don’t have any mercury. While the American Dental Association (ADA) states the use of mercury in metal fillings is safe, there’s an ongoing debate within the dental industry regarding the side effects of these mercury amalgam fillings. Many European countries have banned the use of mercury amalgam fillings to avoid any kind of risks associated with mercury.

Using a PROACTIVE rather than a REACTIVE approach to amalgam replacement is actually a choice many patients would expect to have Dominion Ridge Dentistry follow.






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