Amalgam silver fillings are the traditional type of fillings which have been placed by dentists millions of times over many years.
Before the invention of tooth coloured composite fillings amalgam fillings were the only material available to restore holes in teeth. There has been a lot of research into the possible complications of amalgam fillings primarily because they contain mercury, which is known to be toxic. A lot of this research has been in-conclusive but there is now a EU directive stating that there should be no use of amalgam in: the treatment of deciduous teeth; in children under 15 years; or pregnant or breastfeeding women, except when strictly deemed necessary by the practitioner on the ground of specific medical needs of the patient. Therefore we now avoid using amalgam fillings where-ever possible.
Why Are Amalgam Fillings Useful?
In certain circumstances, however, amalgam is still a very useful filling material. Traditionally where teeth were prepared for an amalgam filling the decayed tooth and a margin of normal tooth would be removed sometimes extending beneath the gum. When these large filling eventually fail they can be very difficult to restore with a composite tooth coloured filling as it may be difficult to keep the tooth dry and impossible to get the blue light to set the filling in the deepest part of the tooth and a glass ionomer filling would not be strong enough. Here the alternative to replacing the failed filling with another amalgam filling may be the need for a more extensive restoration such as a crown. The options and pros and cons would of course be discussed at the treatment planning stage.
How Are Amalgam Fillings Placed?
The procedure for an amalgam filling is that first the area is numbed up with an injection. If we are restoring an upper tooth the injection is placed in the gum directly over the tooth and left for a few minutes to work. This will numb the tooth and those either side of it. If we are restoring a lower tooth we will quite often need to carry out a different injection known as a dental block. Here the injection is placed behind the back lower tooth and numbs the nerve before it enters the bone. As this bundle of nerves contains the nerves which run to the lips and tongue these will quite often be numb as well. Once the tooth is numb it will be prepared removing any decay and unsatisfactory old restorations. A lining may be placed underneath the filling to protect the nerve in the deepest part of the cavity and a band may be placed around the tooth to enable the filling to be packed appropriately. Once the filling has been built up and shaped the bite is checked against the opposing teeth and altered if necessary. Amalgam fillings take time to set and you will need to avoid hard foods for the first 24 hours to allow the filling to set properly. As the filling is metal it is not unusual to get some temperature sensitivity which may take time to settle especially after a large filling is placed. It may be necessary to have a further appointment to polish the restoration or this may be done at the next check-up appointment.
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As with all treatments the options and pros and cons of the treatment are discussed in detail at the treatment planning stage. This provides the information needed to make informed consent for the treatment. Please do not hesitate to contact us and book in today.