WHITE FILLINGS AND REMOVING AMALGAM
Whether you want your amalgam fillings removed or need a hole fixed, white fillings are standard at our practice.
REMOVING AMALGAM FROM THE MOUTH
Mercury is in the world around us and although it has been linked to some serious health conditions such as Alzheimer’s disease, multiple sclerosis, kidney and brain damage, in general terms it has been deemed safe in low doses.
Despite this, it would seem sensible not to have it if possible. Visually, reactions are commonly seen in the mouth where these fillings lie directly adjacent to cheeks and gums, therefore in some instances it is wise to change an amalgam for a white filling in order to relax the immune system and reduce the inflammatory cells.
HOW ARE PEOPLE EXPOSED TO MERCURY?
Mercury exists in various forms, and people are exposed to each in different ways. The most common way people in the UK are exposed to mercury is by eating fish containing methylmercury.
Dental fillings come under a heading of metallic elemental mercury, which will be covered below.
EXPOSURES TO METHYLMERCURY
Methylmercury, a highly toxic organic compound, is the form of mercury people in the UK encounter most frequently. Almost all people in the world have at least trace amounts of methylmercury in their bodies, reflecting its prevalence in the environment. However, most people have mercury levels in their bodies below the level associated with possible health effects.
Nearly all methylmercury exposures in the UK occur through eating fish and shellfish that contain higher levels of methylmercury.
HOW DOES METHYLMERCURY GET INTO THE FISH AND SHELLFISH?
Mercury gets into the air from a number of sources. Once in the air, mercury eventually settles into bodies of water like lakes and streams, or onto land, where it can be washed into water.
Microorganisms in waterbodies can change it into methylmercury, where it builds up in fish and shellfish.
Mercury is used in dentistry in dental amalgam, also known as “silver filling”. Dental amalgam is a direct filling material used in restoring teeth. It is made up of approximately 40-50% mercury, 25% silver, and 25-35% a mixture of copper, zinc and tin.
Over time there is slow corrosion causing a mild breakdown of the metal.
The positives are that the metal is poisonous to the bacteria and that the dental body have deemed them safe to use and still remains the choice of filling for back teeth under the NHS.
Despite these assurances, in this day and age the material would never be considered if it came to the market in the present day and it would seem sensible to assume that no level of mercury is safe for human consumption.
AMALGAM AND MERCURY REMOVAL
White filling replacements have become standard practice when removing old amalgam sliver and black fillings outside the NHS. The techniques used must be undertaken under strict conditions to ensure successful long-term outcomes and predictability.
Primarily, we use a sealed dam to ensure that all product is kept away from the throat and airway. Copious amounts of water spray also help to cool the amalgam and reduce/eliminate any vapours produced.
There are two types of white filling:
1. PLASTIC COMPOSITE RESINS
A putty material, which is set with a light to make it hard. The putty is constructed using small glass beads trapped within an acrylic resin matrix. The outcome is highly aesthetic and their durability is mid-term (5-8 years on average), depending on the size of the filling and how much work it is doing.
2. GLASS CERAMIC INSERTS
More durable white fillings can be constructed using glass ceramic, which are glued into the teeth to mimic the enamel coating of the original tooth-structure. These fillings are stronger and therefore have a long-term durability (10-14 years on average). The glass ceramic inserts can be further subdivided into Direct and In-direct methods of placement.
DIRECT GLASS CERAMIC FILLINGS
Cerana - preformed studs of ceramic will fit into refined cavity shapes to make the white filling stronger and longer lasting.
INDIRECT GLASS CERAMIC FILLINGS
Porcelain inlays and onlays - handmade porcelain fillings made to fit specific shapes with the aim of providing a strong and durable white filling. These are made for each individual tooth in a laboratory using a furnace to sinter the glass into precise shapes.