WHY SILVER FILLINGS CRACK AND HAVE CAVITY UNDER NEATH?
The majority of patients who come in a dental office as an emergency usually have one thing in common: fracture of mercury silver filling with recurrent decay and pain upon chewing. To save the tooth, root canal and crown is always the treatment of choice.
Why silver fillings crack and have cavity underneath? Amalgam tends to expand over time. This ongoing expansion especially in large fillings will cause the tooth to crack. Silver fillings can also discolor teeth because the expansion causes leakage between the amalgam and the tooth. This allows moisture, bacteria to leak in, which in turns making the tooth turn black, decayed, fracture.
Even though placing silver filling is the best way to stop decay for financially challenged patients, these fillings will fracture and have recurrent decay. They will always need root canal and crown in the future or in a worst scenario, tooth loss resulting in implant or a bridge to replace the missing tooth.
How do we prevent teeth with large amalgam fillings from fracture, decayed, from getting root canal and crown or even extraction?
By replacing the old silver fillings with either tooth-colored fillings or porcelain inlay/onlay, the natural color of the tooth can be restored and tooth structure will be reinforced.
Should you replace silver filling with direct composite filing or indirect porcelain inlay/onlay?
- Direct composite fillings must be placed under absolute controlled environment. This means there should be no moisture/saliva contamination, incremental layering of composites to prevent shrinkage. Direct composite filling placement is technique sensitive. Only dentists who wear surgical loupes can perform the procedure precisely to a fraction of a millimeter.
- Indirect porcelain inlay/onlay are fabricated outside of the mouth and bonded to the tooth. Since porcelain has no shrinkage, it is the best choice to replace silver filling and prevent a root canal/crown in the future.
Mercury silver fillings will leak due to expansion over time. As a result, every time we remove amalgam,
we always find mercury discoloration, decay and fracture underneath.
Jennifer N. Nguyen, D.M.D, is a member of many prestigious dental organizations including the American Academy of Implant Dentistry, the American Academy of Laser Dentistry, the American Academy of Cosmetic Dentistry, the International Association of Aesthetic Dentistry, the American Dental Association
Dr. Nguyen has written numerous articles on full mouth reconstruction. Dr. Nguyen has devoted her time to the study of comprehensive aesthetic dentistry and currently served as an Examiner/Consultant for the NERB – Northeast Regional Board which administers State Board and granted license to dentist and dental hygienist. She is currently practicing at SOFTOUCH DENTAL in Lake Mary, Florida and can be contacted at (407) 323-1010 www.softouchdental.org
