A common question that I get asked by patients everyday is whether or not their silver filling(s) should be removed.
My response is most often, “Why do you want to do that?”
The “silver filling”, better known to us dentists, as the amalgam restoration. The restoration is a mixture of many metals (alloy) and held together by mercury. Actually, when packed correctly by the dentist, the filling should consist of 50% mercury by weight.
Prior to being packed into your prepared tooth by the dentist, the prepackaged capsule is activated in an amalgamator machine. Instantly upon activation, by this countertop positioned machine which is in close proximity of the dental assistant , the mercury component begins to chemically bind to the other various loose metals. The dentist must work quickly with his/her assistant to transfer this alloy into the prepared caries-free tooth box. This alloy then begins to harden over a period of 3-5 minutes. In the process of “setting”, the amalgam filling is being packed into the prepared “trapezoidal box “. This prepared box must have an undercut shape. It is this wide base shape that keeps the filling mechanically locked into place for the duration. IMPORTANT POINT HERE: Until the “Free Mercury” sets into it’s stable form via a chemical-molecular bind to the other metals in the mix, it is reactive and toxic. After a filling sets, the mercury is no longer reactive and deemed inert; non toxic.
I haven’t placed an amalgam since 1995. I do not like the thought of mercury in my mouth. A personal choice.
Quick Story: I have a friend who is a medical doctor. A nurse accidentally knocked over, shattering one of those free standing blood pressure things (sphygmometer) in a patient examining room. That device contains a tall glass filled column of mercury in it. The consequence of the broken device which released free mercury was Epic. The fire department arrived, H.A.S.M.A.T. and the E.P.A. were soon on site. The area was isolated, debrided, disinfected, decontaminated. All carpets were removed and the office was closed for Five days.
In my office, I have installed a very special dedicated amalgam debris capturing system. Essentially a mercury trap in my water waste line. This capturing system binds particulate excavated amalgam preventing it from being released and deposited into Long Island Sound. The E.P.A. would fine me tens of thousands of dollars if I did not have it.
It doesn’t make sense why dentists are allowed to place amalgam in the mouths of any living creature. I am not member of the ADA for this reason. I don’t believe in the organization’s stance regarding amalgams.
Amalgams weaken teeth and make teeth more susceptible to future fracturing due to the nature of the inverted preparation of the box.
Amalgams are ugly.
I generally Do Not want to remove amalgams. The mercury in a fully cured set filling is stable and not reactive. The toxicity concerns are not valid AFTER the setting of the materials.
Esthetic concerns? I’ll replace the restoration if you are aware of the potential consequences. I use a rubber dam to aid in the isolation during the removal of larger amalgams to minimize patients’ ingestion of the product.
Every time I pick up a dental drill and lay it into a tooth, there is a chance that I may disturb the nerve of the tooth and unwittingly subject the patient to a “recreational root canal treatment”. Many amalgams are deep, initially placed close to the nerve. I will begrudging remove them should you desire that of me.
Instead,,,,,, Let sleeping dogs lie. I will be the first one to suggest taking, “that large silver out” soon as you have the slightest concerns of cold sensitivity (flexing of the undermined tooth), biting pain ( cracked tooth syndrome -see previous blogs) or the fracturing of a cusp. Silver Fillings have a long track record.
Today, we have more durable, esthetic, non health controversial materials that will provide a beautiful esthetic result.
“If it ain’t broke, don’t touch” is generally the safe approach for assessing silver fillings.
Robert Emilio, with over his 24 years of experience continues to enjoy practicing on his friends and family Five days week ( and sometimes six days ). He boasts a practice of over 9000 active patients. He enthusiastically seeks additional training to advance his craft. He currently holds a Master in Implantology with the I.C.O.I.( an internationally recognized professional establishment in Implant dentistry) and emphasizes Digital Dentistry. Services include pediatric dentistry, teeth whitening, dentures, porcelain veneers, tooth extractions, treating bruxism, and advanced full mouth dental implant reconstruction. He has on site state-of-art capabilities for same day crown delivery; prosthetic fabrication via CEREC. He also provides gentle care via routine general dentistry including root canal therapy, and always in a cosmetic artistic approach. He employs both Guided and Non-Guided Implant surgery techniques. In addition on site, he utilizes a CBCT to aid in diagnostic radiography.
Dr. Emilio Always Accepts New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.
His goal is to keep his patients’, “Teeth and Gums Healthy For Life”.
Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week
OPEN on Weekdays. 7:30am -8:00pm (M<T<W<T)
Weekends (Saturday only). 8:00am-2:00pm
111 East Avenue, Norwalk, Connecticut 06851.
You can always contact me directly via email firstname.lastname@example.org
Office (203)8 66-7164 www.robertemiliodds.com.