How to replace a lot of amalgam fillings

Amalgam fillings have been around for over a 100 years and have helped form the foundation that modern dentistry is built on. They show amazing longevity as a restoration and are quick and cheap to provide. Unfortunately it is an inflexible material that offers no internal strength to the tooth being restored. Because they do not flex like a tooth under chewing pressure they tend to transmit all the stresses into the weakened tooth, which will lead to fractures developing. Popularity for this filling material amongst the general public has fallen dramatically as claims about adverse affects on medical health have been reported. To date no clear link with any medical condition (other than allergy to the material) has been shown but the controversy surrounding it has lead to a reduction of 50% or more in use throughout the Western world with Scandinavia now banning it’s use outright on environmental grounds (along with all other mercury containing products).

At StoneRock we do still use the material but clearly this is patient choice and all options are discussed. That said my use of it in general fillings has all but stopped over the past few years the alternative white fillings are now offering a same level of strength and wear resistance whilst being more flexible and obviously much nicer looking. We do not encourage patients to routinely change all of their existing amalgam fillings on health grounds as there is no clear scientific evidence to show the removal of old fillings leads to an improvement in any pre-existing systemic condition. That said patient choice is king and if any one requests their removal then we will discuss with them the appropriate alternatives. For the most part this will usually be direct white fillings or, where the tooth is in need of extra support, cast restorations such as crowns or overlays. A new addition to this list is the fibre reinforced composite filling, which utilises the extra strength provided by a mesh of glass fibres placed under the filling to reduce the risk of tooth fracture.

The case below gives an example of all of the above options and was carried out because of teeth breaking and being sensitive around old amalgam fillings. The work was completed over 2 visits and has given the patient a very comfortable and durable set of restorations that will strengthen the remaining teeth. The work was carried out under a device known as rubber dam that isolates the teeth from the rest of the mouth and prevents any water or debris spraying to the back of the patient’s mouth making the whole process much more comfortable.

If you would like to know more about the techniques used here or would like information about changing any of your old fillings then please do not hesitate to contact us on 01580 752202 and we will be happy to help.