A message from Boynton Beach dentist Dr. Michael Barr
This is a bit long, but I think you’ll find it interesting and informative.
Recently, the subject of silver-mercury fillings (also known as amalgam) has been in the media again. Most visibly, it was the subject of an episode of the “Dr. Oz” show on TV. My own personal opinion of Dr. Oz is… well… I’ll just say I don’t think very highly of him. In the past, he has given some VERY bad dental advice (such as brushing your teeth with lemon juice to “whiten” them… DON’T DO IT!).
I would like to preface this piece by saying that I have not used silver-mercury amalgam in my Boynton Beach practice in nearly 20 years.
At Palm Beach Smiles we offer our patients “white fillings.” There are advantages to these kinds of restorations. The silver mercury amalgams that have been around for 150 years are susceptible to expansion and contraction. This is caused by eating anything hot or cold. This means it’s possible to crack the tooth which will lead to other problems.
White fillings contain no mercury or metal and won’t expand or contract so they are not liable to cause cracking of the tooth. Our patients like white fillings for another reason – they look like natural teeth! Who wants a mouth filled with dark metal teeth?
While there are many patients who report feeling better after replacing their silver-mercury fillings, the bar of scientific proof is much higher. And, so far, there is not a single credible, “peer-reviewed” study that links silver amalgam fillings to any medical issue. At this point in time, scientists cannot link the presence of silver amalgam to any disease. Nor can scientists prove that removal of amalgam will prevent or cure any illness.
That all said, our government agencies seem to be at odds. The FDA (Food and Drug Administration) has said that amalgam fillings are safe.
Furthermore, many state dental boards will sanction or punish dentists who tell patients that silver amalgam is bad for them or should be removed for health reasons.
I haven’t used silver-mercury amalgam for nearly 20 years.
But my reasons have nothing to do with this mercury debate. I prefer composite resin for fillings, because it is a more conservative and cosmetic choice. Silver amalgam requires more removal of healthy tooth structure to mechanically lock the material into the cavity preparation. Composite resin BONDS to tooth structure. So, I can limit my cavity preparation to only removing decay and preserving as much healthy tooth structure as possible. The bonus: White composite fillings look great!
I have always based my professional judgment on science. If I’m going to make a recommendation, I have to be able to back it up with scientific fact. With that in mind, I cannot recommend categorical removal of silver amalgams with no defects or decay in hopes of curing or preventing any medical issues. However, I do acknowledge that patients have their own reasons, including cosmetic concerns. If my patients make an informed decision to have their amalgams removed, I am willing to help in any way I can.
It’s important to mention that any time we perform treatment on a tooth, it puts stress on that tooth. However, the vast majority of the time, replacing fillings does not result in any problems.
These photos are an actual case done by Dr. Barr at his Boynton Beach practice. (Mouse over the photos for more commentary.)
If you have questions, or would like a consultation, feel free to give us a call at (561) 736-2377.