Cavities used to be filled with gold. This method was viable, but the demand for more affordable products drove researchers to develop amalgam. Since the early 1800s, "silver fillings" have been the norm. That is a long time for a product to be used without some sort of improvement.
It has been discovered that modern dental materials, and even gold, offer more advantages than can be found with amalgam.
Aside from the concentration of mercury in amalgam fillings, which is a concern to many patients today, there are disadvantages to this material that we find significant. Amalgam contains several metals. Metal restorations cannot be seen through on dental x-rays. This means that a problem may be hidden from view. Because the margins, or borders, of amalgam fillings weaken over time as a result of expansion and contraction, the development of decay beneath the filling is a very real possibility. Also, this expansion and contraction eventually causes tiny fractures in the natural tooth structure, making it vulnerable to further damage. On a cosmetic level, teeth with old amalgam fillings can become darkened as the material is absorbed into the enamel.
At Kingsgate Dental Clinic, fillings are done with tooth-colored composite material. This method has achieved beautiful results, and also longer lasting results. Composite fillings are conservative because they are bonded to the tooth. This means that minimal reduction of tooth structure is necessary. Once the material has hardened into place, its margins remain tight because composite does not expand and contract as aggressively as metal. In fact, it is very similar to enamel in its response to hot and cold temperatures. Composite fillings can support healthy teeth for many years.
Because amalgam fillings contain mercury, the removal of existing fillings should be handled with care. Dr. Kelley performs amalgam removal after placing a rubber dam around the tooth to isolate it from the rest of the mouth. The tiny particles of mercury that come away from the filling as it is drilled down are caught by the rubber sheeting, rather than absorbed into the skin in the mouth or on the face. As the procedure is performed, high volume suction is also kept near the mouth to immediately extract particles from the area.
