A tough question. can anyone answer it?!
Question: A tough question. can anyone answer it.?
i just had white fillings put in and i wanted silver ones...can i get them redrilled and refilled.? or would that hurt too much.? can the dentist fix their money grubbing mistake.? or should i go legally into this matter.?Health Question & Answer
Answers:
Sure you can There is a lot to your question. Are the fillings in the front or in the back.? Are they shallow fillings or deeper.? I hate it when there is a miscommunication with our patients. It is uneccessary and embarrassing. But remember any drilling into a tooth hurts the nerve. Removing white filling often means removing more tooth structure. At this point do you really want to remove the fillings.? Sure white fillings on back teeth that involve more than 1 surface have 1/4-1/3 the lifespan, but do you really want to subject your teeth to further drilling.?
By the way, I am going to add an email to a lady that was asking about composite fillings for her kids. It may provide you with some info, and it may help you if you do decide to have your dentist replace the fillings.
This will be long and difficult. It is very involved and not simple at all.
I have been a dentist for 16 years, so what you are going to get are FACTS...not the fears of people.
Unfortunately your kids have cavities. You now need to get the decay removed and a filling placed. But what kind of filling.? lets look at the question from a few angles.
1)Safety--White composite as a glass based resin contain silica. And we all know from breast implants that silicon is not safe. At least in the amount leaked out by a bag of it. What comes off those soft white fillings as they wear down (and they wear down much more than the mercury amalgam fillings do) goes down your throat. also many composites and sealants contain Bisphenol-A, you know that compound from soft plastic bottles that everyone is worried about. Now I am not sure of what other toxic chemical are in composite, but there are others. Safe to say the point is that composite fillings have toxic chemicals within it just as amalgam does.
--Amalgam is a mixture of 5 metals. Silver, tin, copper, zinc and mercury. I don't feel any metal atoms in your body are good, but certainly heavy metals like mercury are not. The big question is how much mercury will you get off of your filling every day. The answer is an infinitesimally small amount. Much less than you get from eating a fish. Where you are exposed to the most mercury is right when the filling is placed. That is why you insist that your dentist uses a properly positioned rubber dam when an amalgam filling is removed or placed. Once placed though, the filling hardens and the mercury exposure drops to a very, very small amount.
2)Properties--Amalgam--After a cavity preparation is made, the amalgam is packed down into the hole. The filling is just held in there mechanically. Like any metal around water, it corrodes. The corrosion products help to fill in any microscopic gaps. Basically it self-seals itself. Then it pretty much sits there for 20 years. After that time, the edge may start to ditch and form some gaps. So replacing it may be in order. But when you replace the filling the inside of the tooth may be a little discoloured, but it will still be hard. Clean it up a little and then place another filling. Should be goods for another 20 years.
--Composite--is bonded to the mineralized tissues of the tooth, the enamel and the dentin. Bonded means that phosphoric acid is placed on the enamel and dentin after the cavity preparation has been done. If etched a second or two too little or too much, the bond will be greatly reduced. It is therefore very technique sensitive. Even the way the acid is washed off and the tooth is dried is critical. Then a priming and bonding agent is applied. Basically a glue that goes into the channels (created by the acid) that go into the tooth. Then the white composite is placed next to the bonding agent, a light is shone on it and the filling hardens. This is the point where the biggest problems occurs. As the filling material hardens, it also shrinks. It shrinks the most at the points that are farthest from the light source. Now think about that. Usually the deepest part is somewhere near the gumline. So it shrinks next to the gumline where
it will be exposed to saliva and where bacteria tend to collect. Not good. In a very short time, bacteria and saliva leak into the tooth by many millimeters. And this is even on a tooth where the dentist has been absolutely meticulous with the placement technique. So, this is why composite has a very much higher rate of recurrent decay than does amalgam. So in a much shorter time frame, you get the tooth under the filling decaying and becoming soft. Now, depending upon how often the patient sees the dentist and how often x-rays are done will play a part in how long the recurrent decay goes undetected and how much tooth is lost. Often when you go to remove the old filling, the tooth under the filling is just mush. Much more tooth is lost much faster with a composite filling than with an amalgam filling. I have heard many dentists say composite is the Endodontists best friend. That means means that composite is responsible for an increase in the
number of root canals.
Add to that that composite is much softer than amalgam and so it wears down much faster than the much harder amalgam. So if a filling doesn't need replacement because of decay under it, then it might need replacement because it wears down. In any case, composite fillings last a quarter to a third the time of composite fillings.
3)Longevity--Composite lasts 5-7 years if you are lucky. Amalgam lasts 20 years. Amalgam has been used as a dental restorative material for like 170 years. There are NO scientific studies that have definitively connected the use of amalgam to any disease. And think of this, dentists, even though they wear gloves and masks have a much much higher exposure to these harmful materials then do a single patient with even 10-20 fillings. And dentists and their staff show a no higher incidence of disease than do the regular population.
Composite lasts much longer in front teeth as opposed to back teeth and much longer in adult teeth as opposed to children's teeth. Now why is that. As I said already, composite depends on bonding to tooth enamel and dentin. Composite forms a great bond to enamel. However, its bond to dentin is negligible. It doesn't really bond to dentin. Now, knowing this it should be apparent why composite is better in certain situations. In a shallow one surface filling that is confined to just the enamel this is where composite is best. It is shallow so it is not far from the light so it doesn't shrink as much. also it is bonding to enamel alone, which it forms a great bond with. However, most fillings are two or more surfaces. So they extend deeper, like down to the gumline area between two teeth, and certainly into the dentin. So you should see now that you are not getting a good bond down deep as well as next to any dentin. Now, a cavity prep on a
front tooth has a much greater percentage of enamel to dentin. That is to say, most of the tooth you are bonding to is enamel, so this should give a good bond. Back teeth are much more dentin than enamel. So this is where you are not getting a great bond. So front teeth are better teeth to bond to generally than are back teeth. Kids teeth are different from adult teeth because, baby teeth are not as mineralized as adult teeth...they are softer, and the amount of enamel is much less than the amount of enamel in an adult tooth. So where you have less than a millimeter of enamel that forms the crown of a baby tooth, the comparable crown of an adult tooth is between 1-2 mm's. So, bonding to a baby tooth produces a much less bond than bonding to an adult tooth.
That is why, if your children need shallow one surface, just in the groove kind of filling, sure, composite should do fine and last until the baby tooth is lost. However, if they need the typical fillings that kids need, that is fillings that involve the surface of the tooth which is next to the neigh boring tooth, then you are better off placing amalgam fillings. Amalgam should last until the tooth is lost. Put composite in there, and I will bet in a year or two, they will need to be replaced, and they will be bigger than they were previously. also, there isn't a lot of room inside a tooth until you get to the nerve. If the decay gets to the nerve, then not only will the child be in pain, but they will likely need to have the nerve removed, a stainless steel crown placed, or the tooth removed and a space maintainer placed. I don't know how old your kids are, but remember the first baby molar should be in the mouth until the child is 11. The
second baby molar until the child is 12. Any filling that you do, you really want it to last until that time.
I hope I have made sense. I have tried to put it into terms a non dental person could understand. So you may ask why are dentists using composite in back teeth and in kids teeth, when amalgam would last longer and be stronger. It is not because composite is a better material than amalgam. I don't know of a single dentist that thinks that. It is simply not the case. There are only a few reason why. 1)In some cases, it is much easier to place a composite filling than an amalgam one. Some big filling in the back that requires a lot of material. Believe me placing a hard composite rather than an initially softer amalgam filling when the patient goes to bite down on your filling can be a lot less stressful. If they bite down and break that amalgam, you have to redo it. Bite down on a high composite, you just shave it down. 2)Composite fillings cost more. Dentists can make more money charging out composites. 3)Composite is like a make work dental material. Dentists know that white fillings will need more frequent servicing, so they keep making money off of them. 4)Patients want them. A smart dentist will not argue with his patients,but just give them what thHealth Question & Answer
By the way, I am going to add an email to a lady that was asking about composite fillings for her kids. It may provide you with some info, and it may help you if you do decide to have your dentist replace the fillings.
This will be long and difficult. It is very involved and not simple at all.
I have been a dentist for 16 years, so what you are going to get are FACTS...not the fears of people.
Unfortunately your kids have cavities. You now need to get the decay removed and a filling placed. But what kind of filling.? lets look at the question from a few angles.
1)Safety--White composite as a glass based resin contain silica. And we all know from breast implants that silicon is not safe. At least in the amount leaked out by a bag of it. What comes off those soft white fillings as they wear down (and they wear down much more than the mercury amalgam fillings do) goes down your throat. also many composites and sealants contain Bisphenol-A, you know that compound from soft plastic bottles that everyone is worried about. Now I am not sure of what other toxic chemical are in composite, but there are others. Safe to say the point is that composite fillings have toxic chemicals within it just as amalgam does.
--Amalgam is a mixture of 5 metals. Silver, tin, copper, zinc and mercury. I don't feel any metal atoms in your body are good, but certainly heavy metals like mercury are not. The big question is how much mercury will you get off of your filling every day. The answer is an infinitesimally small amount. Much less than you get from eating a fish. Where you are exposed to the most mercury is right when the filling is placed. That is why you insist that your dentist uses a properly positioned rubber dam when an amalgam filling is removed or placed. Once placed though, the filling hardens and the mercury exposure drops to a very, very small amount.
2)Properties--Amalgam--After a cavity preparation is made, the amalgam is packed down into the hole. The filling is just held in there mechanically. Like any metal around water, it corrodes. The corrosion products help to fill in any microscopic gaps. Basically it self-seals itself. Then it pretty much sits there for 20 years. After that time, the edge may start to ditch and form some gaps. So replacing it may be in order. But when you replace the filling the inside of the tooth may be a little discoloured, but it will still be hard. Clean it up a little and then place another filling. Should be goods for another 20 years.
--Composite--is bonded to the mineralized tissues of the tooth, the enamel and the dentin. Bonded means that phosphoric acid is placed on the enamel and dentin after the cavity preparation has been done. If etched a second or two too little or too much, the bond will be greatly reduced. It is therefore very technique sensitive. Even the way the acid is washed off and the tooth is dried is critical. Then a priming and bonding agent is applied. Basically a glue that goes into the channels (created by the acid) that go into the tooth. Then the white composite is placed next to the bonding agent, a light is shone on it and the filling hardens. This is the point where the biggest problems occurs. As the filling material hardens, it also shrinks. It shrinks the most at the points that are farthest from the light source. Now think about that. Usually the deepest part is somewhere near the gumline. So it shrinks next to the gumline where
it will be exposed to saliva and where bacteria tend to collect. Not good. In a very short time, bacteria and saliva leak into the tooth by many millimeters. And this is even on a tooth where the dentist has been absolutely meticulous with the placement technique. So, this is why composite has a very much higher rate of recurrent decay than does amalgam. So in a much shorter time frame, you get the tooth under the filling decaying and becoming soft. Now, depending upon how often the patient sees the dentist and how often x-rays are done will play a part in how long the recurrent decay goes undetected and how much tooth is lost. Often when you go to remove the old filling, the tooth under the filling is just mush. Much more tooth is lost much faster with a composite filling than with an amalgam filling. I have heard many dentists say composite is the Endodontists best friend. That means means that composite is responsible for an increase in the
number of root canals.
Add to that that composite is much softer than amalgam and so it wears down much faster than the much harder amalgam. So if a filling doesn't need replacement because of decay under it, then it might need replacement because it wears down. In any case, composite fillings last a quarter to a third the time of composite fillings.
3)Longevity--Composite lasts 5-7 years if you are lucky. Amalgam lasts 20 years. Amalgam has been used as a dental restorative material for like 170 years. There are NO scientific studies that have definitively connected the use of amalgam to any disease. And think of this, dentists, even though they wear gloves and masks have a much much higher exposure to these harmful materials then do a single patient with even 10-20 fillings. And dentists and their staff show a no higher incidence of disease than do the regular population.
Composite lasts much longer in front teeth as opposed to back teeth and much longer in adult teeth as opposed to children's teeth. Now why is that. As I said already, composite depends on bonding to tooth enamel and dentin. Composite forms a great bond to enamel. However, its bond to dentin is negligible. It doesn't really bond to dentin. Now, knowing this it should be apparent why composite is better in certain situations. In a shallow one surface filling that is confined to just the enamel this is where composite is best. It is shallow so it is not far from the light so it doesn't shrink as much. also it is bonding to enamel alone, which it forms a great bond with. However, most fillings are two or more surfaces. So they extend deeper, like down to the gumline area between two teeth, and certainly into the dentin. So you should see now that you are not getting a good bond down deep as well as next to any dentin. Now, a cavity prep on a
front tooth has a much greater percentage of enamel to dentin. That is to say, most of the tooth you are bonding to is enamel, so this should give a good bond. Back teeth are much more dentin than enamel. So this is where you are not getting a great bond. So front teeth are better teeth to bond to generally than are back teeth. Kids teeth are different from adult teeth because, baby teeth are not as mineralized as adult teeth...they are softer, and the amount of enamel is much less than the amount of enamel in an adult tooth. So where you have less than a millimeter of enamel that forms the crown of a baby tooth, the comparable crown of an adult tooth is between 1-2 mm's. So, bonding to a baby tooth produces a much less bond than bonding to an adult tooth.
That is why, if your children need shallow one surface, just in the groove kind of filling, sure, composite should do fine and last until the baby tooth is lost. However, if they need the typical fillings that kids need, that is fillings that involve the surface of the tooth which is next to the neigh boring tooth, then you are better off placing amalgam fillings. Amalgam should last until the tooth is lost. Put composite in there, and I will bet in a year or two, they will need to be replaced, and they will be bigger than they were previously. also, there isn't a lot of room inside a tooth until you get to the nerve. If the decay gets to the nerve, then not only will the child be in pain, but they will likely need to have the nerve removed, a stainless steel crown placed, or the tooth removed and a space maintainer placed. I don't know how old your kids are, but remember the first baby molar should be in the mouth until the child is 11. The
second baby molar until the child is 12. Any filling that you do, you really want it to last until that time.
I hope I have made sense. I have tried to put it into terms a non dental person could understand. So you may ask why are dentists using composite in back teeth and in kids teeth, when amalgam would last longer and be stronger. It is not because composite is a better material than amalgam. I don't know of a single dentist that thinks that. It is simply not the case. There are only a few reason why. 1)In some cases, it is much easier to place a composite filling than an amalgam one. Some big filling in the back that requires a lot of material. Believe me placing a hard composite rather than an initially softer amalgam filling when the patient goes to bite down on your filling can be a lot less stressful. If they bite down and break that amalgam, you have to redo it. Bite down on a high composite, you just shave it down. 2)Composite fillings cost more. Dentists can make more money charging out composites. 3)Composite is like a make work dental material. Dentists know that white fillings will need more frequent servicing, so they keep making money off of them. 4)Patients want them. A smart dentist will not argue with his patients,but just give them what thHealth Question & Answer
Most dentists don't like to use amalgam filling material (silver) and some practices don't even keep it in the office because it does contain a small amount of mercury and is not as esthetically pleasing as the composite resin (white). The amalgam lasts much longer, but has other adverse effects that can occur such as galvanic action (other metals, like aluminum foil, touching the filling and shocking the tooth). It shouldn't hurt at all if you wanted to have the tooth refilled, but be aware before you make your decision that every time a tooth is prepared (drilled) it weakens the tooth because small amounts of the tooth is taken out with the filling, making the tooth more prone to breaking. If it were me, I wouldn't bother having it refilled...Health Question & Answer
Dentist don't generally use the silver anymore from what my dentist told me and they are not safe because they can leak. Plus your mouth looks so much better without all the silver. My dentist told me that they were leaking too and I was really feeling sick before I had them removed but feel so much better too.Health Question & Answer