Today there is an increasing awareness about mercury and its toxicity as a dental filling. As a result, there is a greater trend amidst patients wanting to remove silver fillings not just for esthetics but also for health reasons. Conventional dentists as well as holistic dentists are assisting in removal of the silver fillings in the US and European countries.
However, the replacement choices for silver/mercury fillings are very few. Those replacement choices are as follows:
- Replacing with another new silver-mercury filling: Believe or not, this is the most wanted option by insurance companies as it is the cheapest for their bottom line! Hence it is still done many a times.
- Replacing with white bonding material: This is a plastic material also called as composite filling. Many conventional dentists as well as holistic dentists use this as first replacement choice!
- Replacing with White Ceramic-Porcelain material: Insurance companies will find all possible reasons to deny this and usually pay only for silver-mercury or plastic filling material. This is however the best replacement choice.
- Replacing with Full crown or cap: This can range from metal only crowns to metal-porcelain combination crowns or only pure porcelain crowns. No matter which material is used, a crown is usually an aggressive treatment choice. This should be used as a last resort.
Unfortunately, from each of these above four choices, almost all have aggressively destructive elements built in their treatment protocol. Therefore, of these few choices, both the dentist as well as patient need to be diligent as to which is the best choice for their own individual needs.
The highest demand after removing silver/mercury fillings by most patients is to get the teeth filled with tooth colored materials. Due to ease and quickness with which a white plastic filling can be done, majority of times, most dentists will opt for a white plastic filling material as the treatment of choice. (Read disadvantages of white plastic fillings)
The best treatment of choice after a mercury filling has been removed is getting a CAD-CAM computerized 3D all ceramic restoration. It is precise, pure ceramic and highly efficient and when done well can be an everlasting restoration.
In my practice, my focus has always been that of Preservation and highest honoring and conservation of nature given tooth structure. Hence, my focus is to give the best option with best technology with highest efficiency and one, which is ever lasting. Over the past 30 years, CAD-CAM technology ventured into dentistry and dentists can literally design and mill a filling in 3D in matter of minutes. I have personally done thousands of these fillings and created in my patients, a permanent shift towards everlasting, bio-compatible and esthetic fillings. Unfortunately, despite the 30years of its availability only about 1% of dentist in the entire world use this technology!
What can patients do if their dentist does not have the CAD-CAM technology?
- Ask that he/she go invest in that technology! By doing this you are a patient are helping create a transformational change in dentistry.
- Ask that the dentist find a way to do conservative Inlay/Onlay using conventional labs that use CAD-CAM technology to make these conservative ceramic fillings. Takes a little longer than CAD-CAM single visit dentistry but still better than getting plastic fillings or aggressive crowns.
- Look for a dentist who already has CAD-CAM technology and has been doing conservative restorations for many years. There is a good learning curve associated with this technology and hence find a dentist who knows what he or she is doing with the CAD-CAM technology. But also make sure that the CAD-CAM dentist is not using the technology to make crowns instead of partial crowns or inlays. (Read Choosing Inlay, Onlay and Partial crowns)
I have a very simple practice philosophy when it comes to replacing mercury filling. Don’t take out one poison and put in another poison instead! Replace it once but replace it everlasting with natural and long-lasting material choices. Knowing what gets replaced after a mercury filling in each of your tooth thus becomes vitally important. Choosing a new mercury, plastic filling or aggressive crowns are not my practice treatment choices.
After all it is your life, your body, your teeth and YOUR smile. Choose Wisely….!