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Silver amalgam fillings, mercury toxicity and detox

What are the alternatives to 'silver fillings' ?

'Silver fillings' have been the material of choice for the last 150 years because they are relatively cheap and simple to use, their biocompatability was of little or no importance in bygone days. The alternatives tend to be a little more expensive and clinically more demanding in the application.

They fall into 3 main types:

  • Gold alloy restorations
  • Porcelain restorations
  • Composite restorations

Gold alloys are a mixture of gold and other metals to make the gold harder, they are usually cast to make inlays, onlays or crowns.

The advantages of gold restorations are:

  • They can be used on the biting surface of teeth
  • They do not corrode very readily
  • They fit very accurately
  • They are made in the lab and the bite is made to fit correctly
  • They fit between the adjacent teeth so food will not get stuck between your teeth

The disadvantages with gold restorations are:

  • They require a high level of skill to prepare and fit
  • They are held into place with dental cement and this does not strengthen the tooth
  • They are not tooth coloured and some people find them unsightly
  • Some people are sensitive to the metals in the alloys

Porcelain is made by fusing minerals like feldspar silica and alumina in a glass matrix at high temperatures to form a translucent material that is very tooth like in appearance.

The advantages of porcelain restorations are:

  • Natural tooth-like appearance
  • They are very durable and collect very little plaque

The disadvantages of porcelain restorations are:

  • They are very brittle
  • They tend to wear the opposing teeth excessively
  • It is very difficult to get an accurate fit

Composite fillings are made from a mixture or finely ground quartz and Bis-GMA resin. hey have very tooth-like qualities in both appearance and hardness. They were originally developed for anterior (front) teeth because of their tooth-like appearance, but more recently the amount of quartz filler has been increased and the particle size decreased to give them increased wear resistance for use in posterior (back) teeth. The composite restorations may be fabricated either directly in the mouth (direct), or made in the lab (indirect).

The advantages of direct composites are:

  • Bio-compatibility
  • Tooth-like in appearance and strength
  • Reduced electrical currents
  • Enhances tooth strength due to bonding of the fillings to the tooth
  • Cost effective

The disadvantages of direct composites are:

  • 70% of the material polymerizes in the mouth, the remaining material does not react and so stops the filling from being quite as strong as it might be
  • Some people have an allergic reaction to the unpolymerized material, especially those sensitive to petroleum products
  • The composite shrinks slightly on setting and so if the bond is not good it may leave an open margin which may lead to sensitivity or the filling not to last as long as we might hope
  • Composites are very demanding of the dentists skill

Indirect composite fillings are processed in the lab using heat, light and pressure this allows more of the material to be polymerized and the shrinkage to be controlled.

The advantages of indirect composite fillings are:

  • The lab controls the shrinkage so when the filling is bonded there are no open margins
  • The lab processed filling look like teeth, wear like teeth and are able to be made exactly - they are the most compatible tooth restoration
  • They have all the advantages of the gold and porcelain restorations with none of the disadvantages
  • They are a cost effective durable restoration.

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Stewart J. Wright, Holistic Dental Practitioner, Shore Street Dental Surgery, Cawdor Place, Shore Street, Oban PA34 4LQ

01631 563006