One of the largest and most ongoing controversies in dental medicine is the debate around amalgam fillings and mercury content. While the toxic properties of the substance mercury are well documented and understood, there has been no incontrovertible proof of the amount of mercury that people with amalgam fillings are exposed to on a daily basis. The estimates range from miniscule amounts to significant measurements and amalgam fillings are being blamed for everything from autoimmune disorders to mental instability. Until documented studies are conducted they remain a popular choice among dentists and dental patients. To date, all official organizations connected to world health and dentistry have found no reason for patients to be concerned about their amalgam fillings, regardless of their age. They are popular for several reasons, including their ease of application, their incredible resistance to wear and tear (even when in the heavy working molars) and their inexpensive materials. They have become less popular however, with the ready availability of composite fillings that offer the durability of the amalgams, but with the added benefits of a natural appearance and the lack of questionable materials.
Additional disadvantages to the use of amalgam fillings includes the need to remove more tooth tissue in order to accommodate an amalgam filling, and the unattractive appearance of the dark grey material which can easily be seen when an individual speaks, smiles or laughs. Additionally, many people with amalgam fillings complain of increased sensitivity when they have a filling placed, but most state that this diminishes and disappears after the span of a few days or weeks. As a restorative material, amalgam fillings are incredibly reliable, and even amateur dentists have an easy time applying them. This is something that distinguishes them from composite fillings, which require the tooth to be treated with adhesives and resins and then sealed with special lighting equipment. Because amalgams are much less complicated, their ease of application and durability makes them more appealing to patients who do not like to spend time in the dentist’s chair. The best method of determining the type of filling that is appropriate to the patient’s need is by visiting their dentist and discussing the situation. Most people discover they need fillings after a routine exam or because of pain or discomfort in a specific tooth or area of the mouth. Using visual and x-ray exams, the dentist will determine where the decay or cavity is causing trouble and then discuss with their patient the options they have in treating it.
If costs are a concern, most patients will opt to have an amalgam filling, but if aesthetics are the greater focus then a natural looking composite is likely the right choice. Additionally, the dentist will be aware of the bite habits of the patient, and if a heavy or hard bite and teeth grinding or jaw clenching occurs frequently, they may recommend an amalgam over a composite filing. A final consideration about the selection of amalgam fillings over composite filings involves dental insurance – currently most dental insurance providers offer full coverage of the less expensive amalgam fillings, while not all will cover the more costly, but equally affective composites. This means that ultimately, the patient and dentist must discuss the wisest choices according to a patient’s needs and budget.