Amalgam VS Composite Fillings – The Controversy

Ever wondered what the difference was between silver and white dental fillings? Are amalgam fillings safe? What else is out there? Check out my video to find out!

An example of a composite (white) filling next to an older amalgam (silver) filling

What’s the Difference?

 

“Silver” fillings are actually a combination of silver, tin, copper, and typically about 50% liquid mercury. The term “amalgam” refers to the “amalgamation” of these metals to form a solid material!

“White” fillings are also a blend of other materials, hence the term “composites”. In these fillings you’ll find a liquid resin that binds fillers like silica, zirconia, and sometimes acrylics.

 

 

The Controversy

A short history of Dental Amalgam

Tin-mercury fillings have been around since 600 AD in China

Western dentists started using it in the 1830s and shortly after, something called the amalgam wars started in America. Apparently there were 3 of these “wars” and I’m hoping to find or write a book on this subject because it sounds amazing.

So from the beginning, there have been pro-amalgam and anti-amalgam dentists that have never managed to agree on whether or not the material should be used.

In recent years, several European countries have banned the use of amalgam fillings in children and pregnant women though it is still widely used in North America.

And the controversy in modern times surrounds the fact that one of the main ingredients, mercury, is toxic and has been linked to several diseases, including:

Brain damage/neurological problems, Alzheimer’s, Multiple Sclerosis (MS), Cancer, Crohn’s disease, etc.

However, the correlation between amalgam and these conditions (so far as I can find) is based solely on self-reported improvements in symptoms when the amalgam restorations were removed. Which means we can’t disprove the connection, but we can’t prove it either.

And what medicine and dentistry try to do is evidence based research to figure out how to best serve our patients.

What we do know is that mercury is released naturally in our environment – in amounts much larger than we’ve been able to measure coming from dental fillings. Most of the research cited by the “anti-amalgam” groups usually cite evidence of diseases caused by environmental mercury.

And the research so far indicates that the only measurable danger of mercury exposure happens when the dental amalgam is placed – hence the use of high-vacuum suctions and ideally the dreaded rubber dam. But even then, it’s considered well within safety limits.

However, what is also clear from the research that it’s hard to measure how much mercury is actually released from dental fillings.

Now if you love your conspiracy theories, here’s something to think about – what reason would the dentists or dental associations have to lie about the safety of dental amalgam? It’s a cheaper material, so dentists aren’t making extra money.

AND if it was linked to all these awful diseases, wouldn’t it make sense for dentists and their assistants to have a higher incidence of these problems? And wouldn’t the associations want to protect themselves from disease? 

 

Why do some dentists still use amalgam?

It’s less expensive, easier to place, lasts a long time, and many dentists  still believe it’s a better alternative to composites for children or people with a high risk of getting cavities

Also, there are some downsides to using the white composite fillings: they are not tolerant of water/saliva/blood so more technique-sensitive, more expensive, and some materials have BPA in them (although there are alternatives if you’re looking)

So why don’t I use amalgam?

Broken tooth around an older amalgam (silver) filling

Not because it’s toxic but because it’s outdated!

 

Composite resin (white) fillings can conserve more tooth structure because you’re not counting on the shape of

 

 the preparation to hold the filling in place.

 

We also have composite materials that can release fluoride and other ions to “recharge” the 

enamel. 
Esthetics also play a big role for many people, even kids.

And I see many more teeth break apart around amalgam fillings than I do composite fillings, although with a big enough filling, any tooth is bound to break no matter the material.

And on the chance that they do one day prove that amalgam fillings are toxic, I will already be ahead of the game.

 

I hope this post got you thinking. If you have any questions or comments I’d love to hear from you. If you like what you see, please share with your friends and follow me on Google +, Facebook, or Instagram!

And if you’re looking for a dentist in Kamloops, we are happily accepting new patients! You can contact us by clicking here!

A Tooth-Smart Halloween

Halloween is on the Horizon!

A Tooth-Smart Halloween

Halloween is almost upon us – we’ll be seeing all kinds of superheros, princesses, and scary monsters. But there’s nothing scarier out there than tooth decay!

Parents are always in the scariest position: not only giving out candy but handling the sugary hyperactivity and possible tummy aches. Not to mention trying to maintain good oral hygiene in the process.

Of course, a single sugar-filled night isn’t going to hurt anyone – but keeping the spoils and indulging over and over again can become problematic.

Here’s our top tips for preventing tooth decay!

  1. Choose wisely – Not all treats are the same. Encourage kids to eat candy that melts fast, like chocolate bars. Avoid sticky sweets like caramel that concentrate sugar on the teeth and can hurt fillings or braces. And stay away from sour snacks that can dissolve enamel.
  2. Drink Water – if you can’t brush your teeth right away, just rinsing with water after a sugary snack will help prevent cavities.
  3. Hide the extras! Store the excess and distribute over time – or better yet, find a Candy Buy Back and get some $$$!
  4. Avoid grazing – use the candy as dessert after meals, not as snacks during the day. Then the sugar-acid challenge is more easily buffered by the saliva and can’t damage the teeth.
  5. Eat a healthy meal before Trick or Treating – it’s much less tempting to eat all the candy spoils on a full stomach!
  6. Xylitol – stick with xylitol whenever you can. It’s a natural sweetener that doesn’t cause cavities and improves saliva flow.  Dr. Johns has an excellent selection and we have some samples in the office!

 

My Cavity Game Changer

I've found it - the thing that's going to change the way we treat cavities, especially in children. And I'm SO excited to introduce it at Horizon Dental.

cavity

I’ve found it – the thing that’s going to change the way we treat a cavity, especially in children. And I’m SO excited to introduce it at Horizon Dental.

This miracle product is called Silver Diamine Fluoride and I truly believe it’s the answer to many dental problems.

SDF can stop a cavity in it’s tracks and harden the affected tooth surfaces by just applying the liquid. Amazing! The silver ions destroy the bacterial invaders while the fluoride ion stops the tooth structure from softening. This allows natural tooth structure to form on the exposed dentin.

The only downside is that the silver becomes incorporated into the tooth, leaving an ugly dark mark.

HOWEVER – this may just be perfect for the very young and very old.

For young children that have trouble sitting for traditional dental fillings, SDF can buy some time! Maybe even prevent the need for fillings, if all the research holds true. And even if the tooth is darkened or discoloured, it’s going to be replaced in the future by a healthy adult tooth anyways.

For elderly patients suffering from dry mouth that can cause rampant root cavities, or patients with dementia or physical disabilities that make oral hygiene challenging, SDF can prevent dental infections without subjecting patients to long or expensive treatments.

It’s also QUICK and CHEAP! Applications only take 5 minutes and only costs about $30 (on average) – compared to a minimum $100 for a filling. AND no freezing or needles or dental drill required!

Of course, there are some limitations, such as size of the cavity. It’s not enough if you’re missing a large piece of tooth or have an affected nerve. But even so, this is a huge game changer my friends!

Children’s Dental Treatment and Sedation – is it safe? Is Halloween candy the worst?

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