If you have had a filling then you will know all about dental amalgam. But this is an area of dentistry which is can cause debate amongst some. But, what is all this dental amalgam fuss about?
Have you ever had a filling? Of course you have. If not, you are probably in the minority. The chances are you have also had an amalgam filling.
Fillings are possibly one of the common types of dental treatment. However how many of us ever think about what is used to fill the gaping holes in our teeth. I doubt many of us do, but perhaps we should. Some people think so; others believe this is just scare mongering.
Dental amalgam has been around for about 150 years. It is also one of the oldest materials used in modern cosmetic dentistry. Although there are moves to start using alternatives, until a cheaper version is developed, amalgam will continue to be prescribed. Conventional amalgam is made up of 43 - 54 per cent mercury with the remainder being an alloy powder such as silver, tin or copper. Occasionally, zinc, palladium or indium is used.
As intimated above, traditional amalgams are believed by some dentists to be problematic. For instance, the metal used is subject to corrosion making the product potentially unstable. Using mercury has also been criticised since it could potentially leach out into the blood stream. However there is little if any evidence to support the idea of dental amalgam being unsafe. The major issue is environmental, since unused mercury amalgam does get washed away into the water system.
What are the alternatives?
The commonest alternative is the ‘white’ filling. This is comprised of gold, porcelain and a glass polymer. Unfortunately, the white filling is expensive so is not offered on the NHS. It may also be beyond the reach of non NHS patients, so for most people amalgam is the only viable financial solution.
Oral Hygiene
Thankfully, dental health has improved dramatically over the last 30 years, with fewer fillings being treated. More teeth are also being saved. So while the use of amalgam is declining, it is still necessary for a variety of dental problems; not least where a patient has poor oral hygiene. It is also used if there is a problem with moisture control when the filling is being placed.
Teeth Problems
Amalgam is also used where a patient has particular teeth problems, and not just a cavity. For example, some patients use their back teeth predominantly for chewing. This can result in these teeth being ground down over time. The amalgam will help strengthen the teeth. Similarly, if a patient needs a crown fitting, amalgam is used as a foundation or support for the metal, ceramic and metal-ceramic combo crowns or caps.
Restorative Properties and Longevity
Despite any perceived health problems associated with using dental amalgam, it is unlikely to be superseded for some time yet, and not just because of cost. The major reason for its use is the ability for the amalgam to remain soft for a long period of time. This allows the dentist to manipulate the material to ensure proper treatment, without the worry of it hardening too soon. Once hardened, the amalgam remains in that state for a very long time. Replacement fillings do occur but repair is also easy to do.
Further, mercury has natural properties as an anti bacterial agent, something that ‘white’ fillings lack.
Although dental amalgam is widely used on people of all ages, it is not used for aesthetic purposes. Nor is it used if the restorative treatment is not large or if cost considerations are a low priority.
Finally, dental amalgam is not used if the patient is allergic to mercury or the other components of the amalgam.
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