The Dangers of Amalgam Fillings

The main issue I have with amalgam fillings is what they can do to the teeth themselves. If an amalgam filling is small then it is of very low risk. If it extends over the front or back edge and there is any sign of cracking then it is high risk. If it runs from front to back of a tooth then it is also high risk. Why is it high risk? This is because of the mechanical risk it poses to the tooth. An amalgam filling does not attach to the tooth and as such the sides of the tooth can flex around the filling when we put pressure on them. This leads to cracks and eventually breaking of the tooth. Also when the sides of the tooth are flexing saliva will get down between tooth and filling which causes the filling to corrode. The corrosion products are larger than the original filling and as such the filling starts to swell, this puts more pressure on the surrounding tooth and also leads to breakage of the tooth. So often patients come in with a piece of tooth and proudly declare “but the filling is intact” – that is the wrong way round. I would prefer the filling to break as we can repair that. That is why I don’t like amalgam fillings. The alternatives are simple – a plastic white filling or a ceramic cap (dentists talk about crowns and onlays). Both of these have pros and cons. The plastic fillings look great and are relatively simple, without having to remove much tooth tissue, but unless they are small they can be weak, and not provide any mechanical support to the tooth. Alternatively, ceramic caps are great looking, and have tremendous durability with excellent mechanical strength, but require more to be done to the tooth, with a loss of more tooth structure and a very small risk to the nerve of the tooth, which may result in the need for root canal afterwards. All of these advantages and disadvantages need to be discussed with your dentist on an individual and tooth by tooth case. Please call us if you want to know more. Hope that helps