A controversial subject in the dental world, dental amalgam is a liquid mercury and metal alloy mixture used to fill cavities caused by tooth decay. BellaVista Dental Care’s Dr. Rashmi Bhatnagar says while research continues being conducted to determine the filling’s safety due to the presence of mercury, questions also sometimes arise as to whether patients with amalgam fillings should have it replaced.
“If there’s a fear – and I do have some patients that based on medical conditions are fearful of having anything metal-related in their body you can replace the amalgam for that reason,” she said.
However, Bhatnagar also reminds her patients that replacing amalgam fillings doesn’t come without at least one downside.
“You need to keep in mind, anytime you work on a tooth, the tooth is taking at least some trauma,” she said. “The question is whether you want to risk additional trauma on the tooth – which at the very least can create sensitivity – for something that wasn’t hurting before, and which hasn’t shown any clinical or radiographical decay.”
Should a patient decide to have amalgam replaced, it would be done so with a resin-based material, the properties of which carry different conductivity as far as hold and cold sensitivity go.
“If you’ve had an amalgam filling for 20 years, and you switch to a new material, you’re introducing a material you’re tooth isn’t accustomed to,” said Bhatnagar.
Should a filling, regardless of material, need additional work due to decay, Bhatnagar notes that not only would introducing a new material potentially cause additional sensitivity, it would mean creating a deeper and wider filling.
“If the tooth has no clinical or radiographical decay, I personally would opt not to do anything, whether that filling is amalgam or otherwise,” said Bhatnagar.