Kicking Silver Fillings to the Curb

The curb is the proper place for rubbish, after all – although, actually, a different disposal method is needed for the amalgam used to make silver fillings. The main component of amalgam is mercury, and mercury is a potent neurotoxin. Amalgam has to be disposed of as hazardous waste.

Yet there are still many dentists who insist that mercury is perfectly safe when mixed with a few other metals and packed into human teeth, despite all evidence to the contrary.

Fortunately, there are plenty of other materials we can use to restore teeth – materials that are extremely strong, durable, and, unlike amalgam, extremely biocompatible and much more aesthetic.

One Alternative: Tooth-Colored Composite

For simple fillings, the main alternative to mercury amalgam is composite. Any composite is a combination of three major components: a plastic-like resin; fillers, typically made of small particles of glass or ceramics; and additives that help bind these, as well as pigments that make the material tooth-colored.

Because composite is virtually indistinguishable from natural tooth structure, we can use it for more than just fillings. It can be used for veneers, for instance, or temporary crowns.

Even better: When placing composite fillings, we don’t have to remove as much natural tooth structure as is needed when placing amalgam. More of the tooth’s natural strength and integrity is preserved.

Some have expressed concern that composite may contain BPA or similar compounds. Others have expressed concern about fluoride. However, many modern formulations are made without these problem ingredients, making them a safe option for dental work.

Somewhat similar to composite is a material called glass ionomer, which some dentists will use for temporary fillings or in baby teeth. It, too, is tooth colored, but it’s not as strong as composite and always includes fluoride. That makes it a no-go in our office, where we use only biocompatible materials: no fluoride, no metal, no BPA.

More Alternatives: Zirconia, Porcelain, & Other Ceramics

When decay is especially extensive, a larger restoration may be needed to repair it – an inlay, onlay, or crown. While it’s possible to make these kinds of indirect restorations with composite, it’s more common to make them from ceramic.

Ceramic materials such as zirconia and porcelain are popular because of their impressive strength, durability, and aesthetics. Ceramic restorations are fabricated in a dental lab to perfectly fit the prepared tooth and are precisely color-matched to blend seamlessly with your natural teeth.

Inlays are used when a tooth has moderate decay or damage that is too extensive for a simple filling. The decayed or damaged area is removed, and an impression is taken to create a custom ceramic inlay that fits into the tooth’s surface between the cusps.

Onlays are similar to inlays but cover a larger area, including one or more tooth cusps. They’re used when the damage is more extensive but still does not require a full crown.

Crowns are the most extensive restoration, covering the entire visible portion of a tooth. They’re used when a tooth has significant damage or decay. Crowns require more extensive tooth preparation but provide maximum protection and strength.

Inlay, onlay, or crown? Ultimately, the choice depends on the extent of the damage and the amount of remaining healthy tooth structure. Regardless of the restoration type, however, in our office, it will be made from zirconia or another ceramic and bonded to your tooth with a nontoxic cement.

Biocompatibility Testing: When You Want to Be Absolutely Sure…

One reason why we lean on zirconia so hard in our office – not just for restorations but dental implants, too – is that it’s broadly biocompatible. Most people can tolerate it just fine. Ceramic allergies are extremely rare.

Each brand and formulation of composite, on the other hand, may contain ingredients that are generally safe but which some people can be reactive to. This is where biocompatibility testing comes into play.

A simple blood test can be done to determine which products are the best fit for your unique biochemistry and least likely to trigger an allergic response. It’s the best insurance we have to make sure that you won’t wind up with restorations that can make you sick in the way that amalgam can make you sick.

We are committed to providing the healthiest dental care available – care that not only preserves the look and function of your teeth but that supports your health all ways around.