Metal Fillings

While we don’t recommend removing metal fillings, also known as silver or amalgam fillings, simply because they are metal, Keystone Dentistry does not replace old fillings or fill new cavities with amalgam. We were one of the first in Indiana to make this decision based on various experiences that opened our eyes to the pitfalls of this ancient technology, and we stand proudly behind that decision today.

Still asking why? We offer the following reasons:

• Amalgam (silver fillings) is composed of 50% MERCURY and other heavy metals, and has been banned for use as fillings in the mouth in Sweden, Denmark and Norway. It has also been banned in Germany, Austria, and Canada for use in pregnant women, ALL children and people with kidney problems.

• The American Dental Association in a recent court case (Superior Court, State of California; case #718228) has disavowed any implied endorsement of silver-mercury amalgam restorations, washed its hands of legal responsibility for the potential adverse effects from the use of dental amalgam and had denied any endorsement for the use of dental amalgam.

• Amalgam only “plugs the hole”, it does not reinforce the tooth or strengthen it in any way. Composite bonds to enamel and dentin with a bond strength of 20-25 MPa which is similar to the bond between the enamel and dentine layers of a natural tooth, i.e. composite strengthens the tooth and helps prevent its fracture.

• The leading clinicians in our field (Drs. Wm. Strupp, Gordon Christensen, Ross Nash, Wm. Dickerson, Raymond Bertolotti, Larry Rosenthal and many others) all support research which shows that expansion and inherent weakness of aging amalgams cause teeth to fracture and therefore need crowns, root canals or both.

• The latest generation of Class II composite materials have proven to wear “as well or better” than amalgams (10 year study by Dr. Gordon J. Christensen, Clinical Research Associates, Provo, UT).

• The teeth involved with all amalgams at least 10 to 15 years in age, sometimes reveal numerous fracture lines in the remaining enamel. Removal of the amalgams frequently shows fracture lines in the pulpal floor, due to the unsupportive nature of amalgam restorations and recurrent decay under the restoration which is not visible on x-ray. Placement of another amalgam may result in possible fracture of the tooth, pain, endodontic and/or crown procedures.

• The only alternative treatment for the large, undermined and unsupported cusps of the involved teeth would be crowns and core buildups which would be a considerably larger expense to you.

• Amalgam (silver filling) material is 100 + year old technology. There are far better materials to use to restore teeth to their full function, namely the latest generation of Class II composites (both direct and indirect).

If you have further questions, we would suggest to you the April, 1996 issue of Clinical Research Associates Newsletter (Dr. Gordon J. Christensen, Director) which details the advantages and excellent long term clinical performance of the current generation of Class II direct composites. You may also contact our office and ask one of our knowledgeable staff members.