Amalgam Fillings Information PDF

Amalgam fillings-amalgam is an alloy of mercury, silver an tin Amalgam filling under NHS offered for back teeth as: increased strength, last longer under biting forces, esthetics not priority White filling offered on front teeth under NHS: aesthetics better, less tooth loss-composite bonds chemica...

Amalgam fillings-amalgam is an alloy of mercury, silver an tin Amalgam filling under NHS offered for back teeth as: increased strength, last longer under biting forces, esthetics not priority White filling offered on front teeth under NHS: aesthetics better, less tooth loss-composite bonds chemically to composite but amalgam cant Amalgam Composite ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------ Destructive to tooth as doesn't bond to tooth, but must drill tooth and placed in undercut Less tooth removal, Acc bonds to tooth so so more tooth structure preserved Not aesthetic white Susceptible to corrosion which can weaken it highly toxic Mercury material used, some patients sensitive/allergic to it. Increase in temp in mouth after drink increases release of mercury vapours in mouth. Chewing it releases mercury into system. Mercury poising causes tremors, headaches, kidney problems Very strong, good for large fillings in back molar Composite can be just as storng as amalgam if used optimally cheaper, can be completed by one sitting of dentist More expensive, longer treatment time Amalgam can last longer 8-10 years, strong resistance, resist biting less sensitive to moisture than composite Needs moisture control and dry environment when treating, require rubber dam 2016 European Commission recommended amalgam should be phased down due to toxic mercury vapours, contributing to wider mercury pollution Airborne mercury is a concern because it can spread over a wider area. Once mercury enters the air, it can reach land, bodies of water and vegetation through precipitation. When a pregnant woman is exposed to mercury, the effects can be very detrimental to the neurological development of the unborn child, according to the WHO. By 2020, all dental offices must be in compliance with the [[EPA\'s rule]](https://www.epa.gov/eg/dental-effluent-guidelines) on dental amalgam waste. The rule also affects dental schools and clinics. The rule sets [[specific regulations]](http://www.drna.com/blog/blog/71/why-amalgam-recycling-should-be-a-top-priority-for-dental-offices.php), including: - - - - Not much evidence to show mercury positing! Not much evidence to show low level of mercury vapour from amalgam fillings having harmful effects on health Current situation - Use of amalgam decreasing as patients and dentists prefer to use composite as amalgam requires more tooth removal - Amalgam still recognised as useful in certain treatments e.g. large molar fillings - Amalgam waste needs to be handled safely, collected by authorised waste management - Currently use of am isn't completely banned but could be a phase-down by 2030 due to environmental Other alternatives - Composite=aesthetic filling compared to silver amalgam - 4 restorations-amalgam=silver fillings, stay firmly planted in tooth - Resin composite=white coloured fillings, bond to teeth v strongly, more delicate procedure for dentists - Glass ionomer cement GIC- temp restorations - Hybrid-RMGIC resin modified GIC=semi permanent restorations Why should we be mindful of restorative cycle? - If restoration fails/break then tooth can be lost so we lose more tooth tissue. This will need to fixed with another restoration=repeated cycle of restoring tooth + losing more tissue