Amalgam fillings are a contentious issue among dentists, but it never used to be that way.
Back in 1986 when Diana Ross sang the number one hit Chain Reaction and I graduated from dental college, amalgam fillings were the only fillings we worked with.
As time went on, amalgam was joined by white resin fillings for front teeth, with amalgam applied for back teeth fillings and resin for the front teeth.
Despite the confidence many of my colleagues had, and continue to have, in amalgam fillings, I felt my enthusiasm for amalgam waning when I started to see a lot of teeth fracturing when filled with this material.
So much so, that if I hedged a bet when a filled tooth fractured, nine out of ten times, it would be an amalgam filling. These aren’t good odds and through my practice, I found resin is much more giving to the tooth structure.
Why the argument?
The argument with around 50 percent of dentists in Australia and America is that amalgam fillings are the way to go. Although this percentage is a big drop from what it once was, these dentists are adamant amalgam fillings are the best solution.
The reason they argue amalgam is the best material is because they say resin fillings are more prone to decay developing.
My response? You just need to know how to do a resin filling.
Amalgam v. Resin
There is no doubt amalgam has its advantages. It’s strong, for sure. Actually, as a material, it is much stronger than the tooth itself. Believe it or not, that can be a problem, especially when the tooth is the hardest material in the human body. But even as strong as teeth are, they are no match for the strength of amalgam.
When the amalgam filling sets, it expands. When it expands, it can crack the tooth structure. Tiny fine fracture lines can form inside that tooth and those fracture lines can grow, and grow, and grow over time.
Another drawback of amalgam fillings is they shrink and contract with different temperature variances. These changes in temperature can be so great, they cause the tooth to split. In the worst cases, teeth can be lost. This is never the solution a dentist wants, because our philosophy is teeth are for life.
I’ve seen many examples where this exact situation has occurred and it’s why I encourage patients to replace their amalgam fillings with resin.
If you don’t, here are a couple of very typical scenarios you might experience:
- A simple amalgam filling causing very small fracture causing a tooth to split in two. What then? The tooth literally just comes out and has to be replaced with an implant.
- Large amalgam fillings can fracture a tooth right off, leaving the filling but no tooth. Really? Yes, really. The amalgam filling has destroyed the remaining tooth.
Our philosophy is teeth for life.
For us, a preventative approach for our patients is a no brainer. That’s why when we place our patients on a preventative maintenance program, we suggest, if they want to keep their teeth for life, we replace the amalgam fillings with resin.
There is no silver bullet
Are resin fillings the answer to everything?
No, but they expand much less than amalgam fillings and they are much kinder to the tooth structure. And that’s what we’re all about; kindness and not causing tooth destruction.
In 2000, I made a move to doing resin only fillings. I replaced all my own amalgam fillings, all my wife’s fillings, and my kids, well, they’ve never had an amalgam fillings; they only have resin. Apart from feeling very strongly about the importance and benefits of resin fillings, I wanted avoid crowns myself, should the filling fracture the tooth.
This dentist is rocking the boat
I’m passionate about people not having amalgam fillings.
I haven’t done an amalgam filling for 17 years and I have no plans to start doing them again either. The main reason? Because I care about my patients.
I know I’m going against a dental trend and I know people will argue otherwise, but really we don’t need something that’s seven times stronger than the tooth structure that has the potential to permanently damage tooth structure.
My opinion? We need to think a bit smarter than just using an amalgam filling.
Do you have amalgam fillings and wonder if there’s an alternative? Have you ever had a tooth fracture due to an amalgam filling?