tooth filling - amalgam vs porcelain/white/composite

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guitarplayer
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tooth filling - amalgam vs porcelain/white/composite

Post by guitarplayer »

In the past I had a porcelain/white/composite filling done on my lower right 5th tooth, and all was fine but then it chipped something like 1,5 years later. I am now looking into fixing/replacing it, and while doing so I read about pros and cons of amalgam/silver/metal vs porcelain/white/composite.

I don't care about appearance, but I do care about health and durability.

* durability - amalgam fillings are said to be more durable, particularly for the back teeth that do most work in chewing. Porcelain fillings are said to chip more easily, and fair enough since this is what happened to my filling (on muesli that was not soaked).

* health - amalgam fillings are said to release some mercury when installed which could affect health. A dentist I visited in the past had told me there was no point in replacing the silver fillings that were already there from the health point of view which I would take as an honest advice since it was against the financial interest of the dentist. Reportedly, decades of research in this area failed to prove any impact of inputting amalgam fillings on health. I have not read that very much about it though.

Anyone did research on this?

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Bankai
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by Bankai »

I remember Dr Greger citing a paper in one of his videos showing that eating c. 2 cans of tuna per year causes a similar mercury exposure to what a single filling releases (over a year). It's so negligible that it's not a factor at all.

I'd probably not go out of my way to replace a perfectly fine filling for cosmetic reasons, unless it's very visible. However, if it's chipped, it's a good opportunity to 'upgrade' - the difference in cost is irrelevant, but I'd not discount esthetic factor. You might not care, but most other people do.

Gilberto de Piento
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by Gilberto de Piento »

As my fillings need replacement I've been getting the white ones. My dentist says the white ones are less likely to result in cracks of the remaining tooth among other advantages.

binarybill
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by binarybill »

A close family member was a dentist, so I grew up with a greater appreciation of the inner workings of dentistry.

Once composite fillings were developed, amalgam continued to be used to fill teeth as it is cheaper, mainly in terms of the time to complete the procedure.

Health

Of the fillings that I have, all are white composite. I would not have amalgam fillings in my mouth. I have not read any of the scientific literature on the subject. My decision is based on the precautionary principle. While there have been doubts over amalgam for decades, to the best of my knowledge, there have never been any doubts over the health implications of composite fillings.

Durability

As far as longevity is concerned, my oldest composite fillings are perhaps 20 years old with no signs of visible damage. However, I could not say whether amalgam or composite is likely to last longer.

I have taught myself to chew cautiously and slowly. Two small test bites are better than one large chomp. It does take slightly longer to eat but it removes some of the strain from your teeth.

guitarplayer
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by guitarplayer »

Thanks for your perspectives!

I think I will go for a white composite. Sadly, the National Health Service in the UK only does the silver ones on back teeth, so I will need to go through the hassle of finding a private provider. In the UK it is actually quite a bit more, on the Internet I read £100 for a white one privately vs £24 for a silver one gov subsidized. Of course, I am using my teeth at least daily so this price difference is irrelevant, indeed.

I do laugh out loud quite a lot so a silver one would show. :)

I have been putting it off for a few months actually, initially because dentists did not operate at all due to covid. I am just trying to brush my teeth straight after eating, a bit paranoid that some bit of food will stay in the 'crack' and a decay will develop. Also try to clean it with my tongue obsessively, ha.

I have been thinking about dental tourism which is something I used to do, but Covid makes it much more expensive with obligatory (expensive!) covid tests at airports, so I think the price of the one filling in the UK privately will be lower overall, lest things change in the autumn.

Again thanks for your thoughts.

Stahlmann
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by Stahlmann »

Let's play a game. Your age and number of fillings or total money left at dentist.

BTW, what's the trick with flossing teeth with filling on the verge? I mean I have filling on 6th down left teeth and when I clean it by putting (and then coming back) flossing line between 5th and 6th I'm destroying the filling a bit every time :(... I lost one filling after 9 months. Not only that, but I think I will ask for filling down it and making gap wider next time. However, it seems not recommended move. #secondworldproblems

zbigi
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by zbigi »

Stahlmann wrote:
Tue Feb 08, 2022 4:06 am
Let's play a game. Your age and number of fillings or total money left at dentist.
40, 0 and $0. I clean my teeth just once a day, don't floss, ate sweets and drank coke regularly for many years. In spite of this, I never had any problems with teeth. I suspect it's just lucky genetics.

guitarplayer
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by guitarplayer »

Stahlmann wrote:
Tue Feb 08, 2022 4:06 am
when I clean it by putting (and then coming back) flossing line between 5th and 6th I'm destroying the filling a bit every time :(... I lost one filling after 9 months. Not only that, but I think I will ask for filling down it and making gap wider next time. However, it seems not recommended move. #secondworldproblems
How come you are destroying the filling? I would think that hardness of filling >> hardness of dental floss. Maybe the filling that was lost after 9 months was a job poorly done?

Re the OP, I got myself a composite in Sep last year. Have been flossing once or twice daily but yes around that filling it is a bit of a struggle and I sometimes end up breaking the floss (rather than the filling!).

One idea is to get in with the floss down the gap, then pull it out horizontally so that you don't have to pull it back up through the tight gap.

Stahlmann
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by Stahlmann »

guitarplayer wrote:
Tue Feb 08, 2022 11:33 am
How come you are destroying the filling? I would think that hardness of filling >> hardness of dental floss. Maybe the filling that was lost after 9 months was a job poorly done?
I irritated the filling (it's located on the verge of teeth) and... one day it's simply fell out. They claim it can live 10 years, this is why me extreme cheapskate side is suffering. I haven't used ultra-thin dental floss, for the educational purposes I tended to use thin strand I have near, I also reused it. I changed my mind and looking for something ultra thin, dentist grade.

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Sclass
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by Sclass »

binarybill wrote:
Sun Jun 20, 2021 12:52 pm
I have taught myself to chew cautiously and slowly. Two small test bites are better than one large chomp. It does take slightly longer to eat but it removes some of the strain from your teeth.
This is brilliant.

I have some bridgework on my lower incisors that lasts a lot longer if I’m careful. I need a repair once every five years.

$400 repair bills did miracles for modifying my table manners. I use a knife and fork to keep milage down on the bridgework.

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Sclass
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by Sclass »

Stahlmann wrote:
Tue Feb 08, 2022 4:06 am
Let's play a game. Your age and number of fillings or total money left at dentist.

BTW, what's the trick with flossing teeth with filling on the verge? I mean I have filling on 6th down left teeth and when I clean it by putting (and then coming
Hey great point. I recently told my dentist we only have fifty cleanings left to go. :lol: I plan to give him business as long as he keeps his shop open. The daily cost is negligible for good teeth.

So my wife had this exact issue with a filling that went between the teeth. The floss would snag on the filling and she’d pull it out. It happened several times till her dentist got tired of reinstalling it and bought a special tool to carefully smooth out its edge so the floss wouldn’t catch. I think her dentist became more skilled at making the filling during the process.

Also experiment with waxed floss and floss with a tighter twist to the fibers. There is a lot of variability in how floss is twisted up and waxed (or not).

The other thing to try is a floss threader. Thread the floss under the filling and avoid it all together. This is the economical solution.

aptruncata
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Re: tooth filling - amalgam vs porcelain/white/composite

Post by aptruncata »

I think what important to note is the exposure over time.
while eating 2 cans of tuna may give you similar dose, the one in your mouth has easy access to your blood stream/stomach and for a very long time.
For people who are allergic to metal such as tin and Nickle be ware.

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