Four Questions you need to ask before you get rid of the silver…
Patients in Vernon are like people all across Canada. They want white, comfortable, long-lasting teeth. To that end, people often request that I remove their old silver amalgam restorations and replace them with white composite fillings. In these cases, I like to make sure that my patient and I discuss 4 important points. If you’re considering having old silver amalgam fillings removed, make sure to ask you ask your dentist:
1. What is the condition of the remaining tooth structure? This is the first and most important consideration that drives individual tooth restorative decisions, because it puts the focus where it should be: On improving the prognosis (future outlook) of the tooth itself. Fillings are initially placed, in most cases, to address decayed or eroded areas of teeth. While fillings serve quite well in that capacity, the damage initially done that led to the filling is not “reversed” by placement of the filling. Over years, the tooth flexes under loading, more or less in proportion to the size of the filling that was required. In other words: Bigger fillings generally live in weaker, more poorly sealed teeth. Weak teeth are at increased risk of fracture. It’s important that you first determine what kind of shape each of your teeth are in.
2. What’s the condition of each of the teeth in my mouth? This question is important because you’ll want to consider what other work may need to be done in each area of your mouth prior to diving in and getting started. You’d be disappointed if we did 2 new white fillings on your lower left, but we ignored the broken crown that “never felt right” just behind them…which could have been made to match, feel better, and fit better with the fillings had we planned ahead to do all the work concurrently. A big picture approach with the long term in mind always makes sense.
3. What risks do I take just by removing the old filling? It’s important that my patients understand what removing an old filling and placing a new filling or crown means to the tooth. The process can irritate the nerve inside the tooth, resulting in temperature or bite sensitivity, while other teeth won’t respond negatively at all! Some teeth, having been irritated over many years by a filling, can’t tolerate the process of replacing a filling and will flare up, requiring a root canal treatment. Thankfully, this is relatively uncommon and most patients find the process manageable with only minor or no sensitivity.
4. What sort of a restoration will actually lower the risk to my tooth? My entire practice revolves around a key central philosophy: REDUCE RISK. This means that every treatment that I advise for you aims to reduce the chance that something could go wrong later. Teeth that are weakened from holding large fillings can be restored again with another large filling, which does nothing to strengthen the tooth. The new filling simply fills the hole left behind when the old filling is removed. Alternatively, a crown or “cap” can be placed on a tooth that has been weakened, effectively encapsulating it and reducing its risk of fracture or breakage. I take the time to assess each tooth planned for restoration replacement and make specific recommendations for each with an eye towards one goal: Maximize the life of each tooth and prevent cracking. Sometimes this means replacing small fillings with new small fillings. Other times this means placing an aesthetic crown to encapsulate and strengthen a tooth.
Have questions about your teeth, jaw joint, aesthetics, or gums? I’m happy to answer them and help you achieve long-lasting oral health.