Questions about amalgam fillings (and no, it's not about the mercury in them)?
Question:
Are dentists required to disclose and discuss filling options with patients before doing a procedure? Also, will grinding my teeth in my sleep make it more likely that the amalgam will cause a fracture? If it's a bonded amalgam will that make a difference?
I know I need to discuss this with my dentist and I plan to call tomorrow, but I'm anxious to get as much info as I can right now.
Answers:
There's LOTS of misinformation out there about amalgams. One of which is they fracture teeth. In over 30 years of practice, I've seen plenty of teeth with fractures in them, both with composites, amalgams, gold, and even no restorations. I believe your new dentist did you a service by placing the amalgam, especially if it is a bonded one [which is all I have placed since the late 1980's]. Amalgams last much longer than composites on posterior teeth and most offices just place the type of restoration that they feel is best for the situation. Maybe we should be giving our patients more choices but it would take a good discussion of restorative materials for the patient to really make an informed decision.
Yes, you should have been given options. Amalgams are a problem and yes, they can and will eventually fracture. Usually not right away, but you seem to be aware of the long term issues very well.
they both work the same.. whether you have amalgam or composite... if you grind your teeth at night you need to wear a night guard. by grinding your teeth you are wearing down the enamel which is not good.. and no not all docs tell you what they are using because not all docs use composites either.. composite are used more for cosmetic appearance.. i hope this helps...also i have amalgam in some of my teeth that i have had for about 10 years now and i have not had a problem with them.
as far as 'are they required to discuss filling options'... no, usually the insurance company dictates that to them... the insurances will pay for the white fillings on visible teeth and only pay for amalgam on non visible teeth... so you might want to check with what your insurance covers... if you have insurance...
personally my dentist has the opinion that the tooth colored ones fracture more easily and have to be replaced sooner than amalgam... i have had my amalgam fillings replaced only once in 30 years ... the tooth colored ones i had to have replaced 3 times in 2 yrs ... i dont grind my teeth though ...
no matter what filling type, definatley get a mouth guard to sleep in to save your teeth if you know that you grind them
amalgam is far more suitable for back teeth as it is a stronger and more durable material and therefore better able to deal with the wear and tear that is placed on the molars by chewing,grinding etc. if ur dentist could see evidence of grinding then that was probably why he chose metal filling for you.the white fillings really arent that strong for molars and should ideally be used for cosmesis only.they can tend to shrink back from the edges of the cavity allowing debris to creep down and further erode the tooth without it being visible.yes they look nicer but in the long run ur much better having amalgam ones. i've got loads of amalgam fillings and have had very few probs with them . to be honest even if i was offered white fillings in my back choppers i would refuse.
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