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If you’ve ever had a tooth with a black mercury filling crack
or break, you know that the new tooth-color options for replacing black
mercury fillings are much better for the tooth and are certainly much
more cosmetic!
The Cosmetic Advantages
of Bonded Materials
When patients ask me about replacing their ugly old black fillings,
most often their concern is about the way those old fillings look. But
the health of the teeth with those old black mercury fillings and possible
mercury contamination should be even more of a concern.
I no longer use black mercury fillings, and haven’t in almost
20 years. The reason I use the newer options is because they are
not only much more cosmetic, but even more importantly, the newer options
are much healthier and stronger for the teeth.
Let's talk first about the cosmetic results of the new methods of replacing
black mercury fillings. The results speak for themselves:
CASE 1 - I replaced these old black fillings with cosmetic bonded inlays. Not
only was the cosmetic result fantastic, but these teeth were significantly
stronger, having been bonded together with the porcelain.
CASE 2 - This patient HATED the look of the black mercury filling showing
on this tooth when she smiled. The result -- you can't even see
where the edge of the new bonded composite resin filling is when we were
done.
Again, not only a cosmetic improvement, but a huge improvement in the
health and strength of the tooth.
Are Mercury Fillings Sabotaging Your Teeth?
 The newest cosmetic procedures are much healthier for the teeth. Consider
these factors about black mercury fillings:
1. |
The only thing that holds a black mercury filling
in is that the deep portion is larger than the outer portion (this
is called an undercut). |
There is no adhesion between the tooth and the filling. As you
chew on the tooth, time after time, the weakened cusps of the tooth flex
away from the filling (see diagram below) and it gets brittle and breaks.
In the following diagram, note the lower tooth on the left has not been
weakened by a black mercury filling. When the upper tooth bites
against it, the cusps do not flex, because the tooth is strong. But
the lower tooth on the right has a black mercury filling in it, weakening
the tooth, allowing it to flex outward when the upper tooth chews against
it.
This constant flexing (like bending a coat hanger wire back and
forth) causes the tooth to become brittle. With time, the cracks
start to form under and around the fillings as seen in the diagrams
below.
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Cracks under the filling |
Cracks deeper just about to break and
already into the nerve |
The entire side of the tooth broken
off |
Tooth broken down the root |
2. |
You know that metals absorb temperature
faster than other substances. And
you probably know that as substances absorb heat they swell (enlarge). And
when they absorb cold, they shrink. |
Just imagine -- when you eat or drink something hot, the black mercury
(metal) fillings absorb the heat before the rest of the tooth does, and
the filling swells inside the tooth. This too pushes the sides
of the tooth around the filling and flexes them outwards, causing the
same damaging effects of brittling of the tooth structure.
And when you eat or drink something cold, the filling shrinks inside
the tooth, creating a gap between the filling and the tooth. This
allows some seepage of saliva and bacteria down in-between the tooth
and filling.
3. |
Black mercury fillings tarnish and corrode
over time. They develop what we call ‘ditching’,
which means gaps around the fillings. The metal fillings
can also crack often. |
Why Bonded is Better
Bonded tooth-color restorations on the other hand, do a much better job
of insulating against changes in temperature. We actually 'bond'
them to the surrounding tooth structure so that the tooth is no more
flexible than it was before it even had its first cavity. So
the nerve is not constantly irritated from hot or cold; bacteria and
saliva do not seep under the filling; and probably most important,
it prevents over-flexing and brittleness of the tooth, helping to prevent
cracking of the teeth which helps prevent the need for crowns, root
canals, and even the loss of a tooth.
Below are several additional ‘before & after’ examples
of the bonded fillings that Dr. Kurthy has done:
Not only can old black mercury fillings be replaced with newer cosmetic
options, but those old discolored acrylic/plastic fillings can also be
replaced as seen below:
And these new restorations can even be used to cover up unsightly and
sensitive areas of gum recession as seen below.
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