If you have gone to your dentist regularly and kept up with your oral health maintenance appointments, you have probably noticed that dentistry has dramatically changed over the years. The old way of thought was to drill, fill and bill. Visits to the dentist were never really pleasant, for the patient nor the doctor. Therefore, it was difficult to give your oral health significant value. The old school of thought was to take care of any active decay, infection, or any other problem that was causing pain and discomfort. Thanks to the advancements in research, equipment, and material, dentistry has completely shifted its focus. The new school of thought trains and educates dentists to provide preventive care and foresee potential problems before they occur. This new approach not only saves the patient discomfort and frustration, but also unforeseen costs of having larger procedures and more involved treatments.
As an educated consumer you may have heard the term preventative dentistry. On average it costs far less to prevent a problem than to treat it once it has occurred. To clarify, one example of preventative dentistry would be the dilemma of changing out old, defective, leaking silver mercury filling, also known as amalgam, and replacing it with tooth colored composite resin material. Other than the obvious aesthetic benefit of composite resin restorations, there are some great advantages over the older amalgam fillings which I will mention briefly.
For many years amalgam provided a great service in the field of dentistry. Besides gold, silver fillings were one of the strongest and longest lasting materials available in dentistry. After decades of treating teeth, we discovered the disadvantages of silver mercury fillings. Although silver fillings last a very long time, they don’t create a tight seal where the tooth and the filling materials come together. The lack of a tight seal allows cavity causing bacteria to enter the tooth and develop deep cavities under the existing amalgam filling. Although this may not cause immediate pain or discomfort, if left untreated it will lead to root canal therapy and other definitive restorations.
In addition, as our teeth flex from daily use, rigid restorative materials — like silvery mercury amalgam — act as a wedge inside the tooth, causing fatigue on the tooth apparent in the form of fracture lines. Over time, these fracture lines become larger, depending on how strong the forces are and the size of the restoration. The fracture lines weaken the structural integrity of the tooth, causing it to eventually fracture in three possible ways. The first and least involved is a fracture above the gumline. Most often this can be repaired with a full or partial coverage crown or cap. Second, the fracture can occur at or below the gumline. To repair this type of fracture, in addition to the crown, at least two extra procedures are required. These additional treatments can include root canal therapy and a surgical procedure to expose more tooth structure above the gumline to support the restoration. The third and worst type of fracture could occur along the vertical axis of the tooth extending into the supporting bone and deeming the tooth non-restorable. At this juncture the only option would be to remove the tooth and evaluate possible replacement modalities.
All of these problems can be easily avoided by following your dentist’s recommendation for an upgraded restoration. Like many other aspects of our world, dentistry has evolved with technology. Today, we have more advanced equipment and materials that serve us better, last longer and are more aesthetic. One such advancement is tooth-colored composite resin fillings. In contrast to the old adage of “don’t fix it unless it’s broken,” preventative dentistry promotes fixing it before it’s broken. Replacing your amalgam fillings with composite resin is one of these suggested procedures. This can save you time, money, pain, teeth and frustration. On most occasions, treatment plans can be prioritized and done in phases to help you achieve perfect oral health in a timely fashion.