Category Archives: Dental Fillings

Pain from Composite Filling

I recently had my first composite filling done. I sort of had to pressure my dentist into it because he usually places the old silver amalgam fillings. He finally relented and agreed. Since then, my tooth hurts when I chew. Oddly, it doesn’t hurt under normal circumstances. I can even clench my teeth and nothing. But, if I am chewing there is a sharp pain which lasts a second. Did my dentist do something wrong?

Aaron

Dear Aaron,

While composite fillings are far superior to their amalgam dental filling compatriots, the procedure for bonding them is completely different. If your dentist does not normally place them, he will not be aware of the different techniques needed.

I wonder if you had a small filling placed. The pain you described is an unusual phenomenon we see mostly with small composite fillings. Fortunately, there is a way to prevent the problem, or in your case, fix the problem.

If a dentist uses either a self-etching primer or a glass ionomer base, we are seeing this issue practically eliminated. I would talk to your dentist about the problem and ask him to re-do the fillings using a glass ionomer base.

I am surprised your dentist is still almost exclusively placing amalgam fillings. Most dentists have moved on to the composite technology which is healthier for your teeth and contains no mercury. It may be time for you to find a dentist who is more interested in keeping up with the technology and advancements in his or her field.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Should I Remove My Amalgam Fillings?

My dentist is suggesting I replace my amalgam fillings. He told me there is nothing wrong with them, but he thinks it is best to replace them with composite fillings. I am wondering if I really need to do this. I don’t have money right now, but he hinted they will go eventually and it’s better to change them when everything is okay. What is your opinion of this?

Jenn

Dear Jenn,

Before and after mercury free fillings

No, you don’t have to change out these dental fillings. While I am grateful that your dentist was honest enough to tell you that there was nothing wrong with your fillings, I am suspicious of the low-key pressure he is putting on you to replace these fillings.

Composite fillings are better than amalgam fillings, but if they are not cracking and are not leaking it is not necessary. Your dentist could just keep an eye on them and then let you know when they truly needed to be replaced. It is not fair for him to pressure you like that.

If it gets to the point that you do need them replaced then I want you to make sure he knows how to do a sanitary amalgam removal. These silver amalgam fillings have mercury as their main ingredient. There are special procedures and equipment that need to be in place in order to keep you from inhaling any mercury vapors or swallowing any pieces of the filling.

If he doesn’t know the procedure for a sanitary amalgam removal, then look for a mercury-free dentist.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Dentist Wants to Replace all My Fillings

I have quite a few fillings in my mouth and my dentist says they all need to be replaced. I’m having a hard time fathoming that they all need to be replaced. Is this really necessary?

Mandy

Dear Mandy,

A lot of my response will depend on a few factors. Are they silver amalgam fillings or white composite fillings? If they are amalgam fillings, is he planning on replacing them with more of the silver fillings? I would not let him do that.

As fillings age, they start to deteriorate. If you have amalgam fillings, it is possible they have started to leak. This is dangerous for both you and your teeth. These also tend to crack or erode faster as well. The main ingredient in amalgam fillings is mercury, so you don’t want to let this deteriorate in your mouth.

Additionally, eroding or leaky fillings will allow bacteria to seep in. This leads to tooth decay. These usually go unnoticed until it develops into an infection. Then you have a dental emergency on your hands and will need a root canal treatment.

If your dentist is wanting to replace them with composite fillings, I would feel better about that. These are better for your teeth and completely mercury-free. They also bond directly to your teeth, which will strenghten them.

Make Sure You See a Mercury-Free Dentist

If you are getting your dental fillings replaced, you definitely need to do it with a mercury-free dentist. They know how to do a sanitary amalgam removal. Mercury is a known toxin, so you do not want to accidentally swallow any mercury or inhale any mercury vapors.

Mercury-free dentists have the proper equipment and understand the porcedure to keep you from mercury exposure.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck. We offer pediatric services.

White Fillings in Children

I have a question about white fillings. My son needs his first filling. I am really uncomfortable with the silver fillings because of the mercury in them. I asked my dentist about getting him a white filling but he said they don’t work well in children. Why is that? Will the silver ones be dangerous for him?

Mallory

Dear Mallory,

Let’s start with your last question first. Are the silver fillings dangerous? The American Dental Association still says that silver amalgam fillings are safe. Understandably, though, many patients and parents are uncomfortable with the high mercury content.

While composite (white) fillings are a tad trickier with children, that doesn’t mean they are not able to have white fillings. The struggle is because the composite material has to stay completely dry while it is being placed. That can be tricky for wiggly little ones.

If having a composite filling is important to you, I have found that using some nitrous oxide allows the children to completely relax if their nerves are making them figity. Most of the time they end up sleeping through the procedure.

That being said, I wouldn’t push your current dentist into this. The technique for placing composite fillings is completely different from placing amalgam fillings. I have often found that dentists who try to steer you to a different procedure are actually doing that to keep from admitting they can’t do the one you want. If you pressure him into the other procedure, he will likely not do it correctly.

I suggest that you look for a dentist who advertises as a mercury-free dentist and then see if they are also a pediatric dentist. They don’t have to be a pediatric specialist. Instead, they can be a general dentist who enjoys treating children. They are qualified and do a pediatric rotation so your children will be in good hands.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Do Amalgam Fillings Stain Teeth?

I have two amalgam fillings that cover about 70% of my tooth. I want to remove them and replace them with composite fillings. He said the amalgam stains teeth and they won’t look nearly as good. Is that true? Should I leave the amalgam fillings on?

Meredith

Dear Meredith,

While there is some staining of teeth with amalgam fillings, they will always look better with composite fillings. Always. In addition, while amalgam fillings simply rest on the tooth, composite fillings are bonded directly to the tooth which strengthens the tooth and puts it at less of a risk for fracture.

I suspect your dentist said that to disuade you from switching. This is likely because he is uncomfortable placing composite fillings. They are placed with a completely different technique than he or she is used to placing the old amalgam fillings.

I don’t recommend you push him into doing it though. There are horror stories of patients who ended up needing a root canal treatment after a dentist placed them incorrectly. Even if it isn’t that bad, you could end up with other issues.

If you want this done right, I suggest going to a dentist who is familiar with placing them. You can do an internet search using the term mercury-free dentist. These dentists only place composite fillings and have the technique down pat.

I have one other concern I’d like to address. You mentioned your current fillings cover 70% of your tooth. In that case, your dentist really should have done a dental crown to adequately protect your tooth. This additional information puts me more in doubt of his abilities. You may want to start looking for another dentist, who can better meet your needs.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.