Amalgam Fillings: Removal Considerations

The dental industry was faced with patient hysteria after the potential dangers of amalgam fillings were made public by the media. Patients rushed to their dentist’s office in a hurry to have these fillings removed and instead replaced with composite fillings or other restorations. This was despite the fact that few patients actually experienced any outward symptoms of the alleged mercury leakage. Some patients took a more sensible approach and waited before having any of their amalgam fillings removed.

If we look beyond the actual composition of mercury fillings, we can see that they have some distinct disadvantages over alternatives. For one, amalgam is a radiopaque material, which can make diagnosing leakage difficult. Caries will usually erupt along the edges of the filling on the occlusal (biting) surface, and work their way down the tooth. A patient can benefit from having the amalgam removed by preventing extensive decay from permeating the tooth and eventually requiring root canal therapy.

If according to a dentist’s examination the filled teeth don’t show any signs of decay, it may be best to leave the amalgam intact. You have to realize that these fillings rely on mechanical retention, which requires a great deal of tooth preparation. When the amalgam comes out, there may not be sufficient remaining tooth structure to support a composite filling. Instead, you may need to get a dental crown or an inlay/onlay. At minimum, you can expect to pay $1,000 to restore the tooth. You can read more about this option on this page. The moral of the story is to leave the filling alone if its not causing issues. Another point to consider is that teeth filled with this material may be more prone to fracturing due to the thermal expansion and contraction of the amalgam material.

The most pervasive complaint about amalgam fillings is that they are unaesthetic. This shouldn’t be a major concern with the posterior (rear) area of the mouth, but nevertheless it bothers some people. The cost of removing an invisible filling from the back of your mouth isn’t justified unless other issues (like allergies to the amalgam) are present. Beyond the financial risk, consider the health risk that removal poses. Drilling away at amalgam not only releases toxic dust into your mouth, but also heats up the filling expediting mercury leaching. Most dentists will take extra precautions like using a dental dam to isolate the rest of your mouth, but you can be sure this will come at an extra cost. Carefully weigh the pros and cons to see if this is something you want to pursue.

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