Replacing Old Silver Fillings

Many of our patients have old silver (amalgam) fillings.  Some of these fillings need to be replaced for various reasons.  Other people choose to replace theirs with a more cosmetic option.  This blog will explain why some old silver fillings need replacement and what you can expect from the process.

Why Do Silver Fillings Need Replaced?

There are multiple reasons that your dentist may recommend replacing old silver fillings.  The bottom line is the health of the tooth.  Old silver fillings can deteriorate over time, leaving your teeth vulnerable to decay or tooth cracks.

Each time your dentist and dental hygienist evaluate your teeth, they are checking for continued success of all of your existing dental work.  There are visual signs that a filling is no longer doing its job.  There can also be signs on the dental x-rays, showing a failure of an old filling.

Any of the following issues require replacement of an old silver filling.

• A new cavity underneath or at the edge of an existing filling – Many people do not realize that once a tooth has a filling, it can still get cavities. Actually, a tooth with a filling is more likely to get a cavity than a tooth that has never had dental work.  Bacteria love to accumulate right at the edge of fillings.  This makes it a high-risk site for cavities.
• An opening at the edge of the filling – Dentists call this an “open margin”. Some old silver fillings begin to pull away from the tooth, creating a small crevice between the filling and the tooth.  This crevice allows bacteria to penetrate underneath the filling, causing a hot spot for decay!
• A cracked filling – Over time, many silver fillings develop small stress cracks in the surface. These cracks also allow bacteria to seep into the tooth.  These cracks can result from heavy clenching or grinding while you sleep.  They can also develop from drastic changes in temperature (chewing ice).
• A crack in the tooth around the filling – This is one of the more common problems we see around old silver fillings. Due to the physical properties of silver filling material, it must be a certain size and thickness to stay in the tooth and do its job.  Sometimes the large size of these fillings puts extra stress on the tooth, making it more likely to crack.  These cracks in tooth structure, once they are visible, are an inroad for bacteria to get past the enamel quickly and start causing cavities.
• Broken tooth – In many cases, the filling itself is intact and in place, but the tooth around it breaks away. In order to rebuild the tooth properly, we must remove the old silver filling.

What Type of Dental Work is Required?

In general, there are three types of dental work as options for replacing old silver fillings.  The selection of which is best for your specific case depends on the degree of the problem.  The larger the problem, the more extensive the dental work to fix it.

1. Tooth-colored Filling – Small cavities or cracks do require replacement, and most of the time, we can replace the old filling with a new, tooth-colored composite filling. This treatment option requires a significant base of healthy tooth structure, so it is the best choice when the cavity or fracture is small.
2. Inlay/Onlay – Inlays and onlays are a more extensive dental treatment used to treat larger cavities or cracks. We can make these restorations from gold or porcelain to best meet your cosmetic and functional demands.
3. Dental Crowns – Large decay, a crack that extends into the tooth, or a broken tooth require a crown. A dental crown completely rebuilds the outer surface of the tooth by covering the core of the tooth all the way to the gums.

What Can I Expect from Filling Replacement?

For the patient, a filling replacement will not feel any different from any other dental work.  The local anesthetic ensures that you do not feel any pain during the procedure.  After removing the old silver filling material, your dentist prepares the tooth for the new filling, onlay, or dental crown.  A new filling takes only one visit.  An inlay, onlay or dental crown will take two visits with a provisional restoration.

After the replacement dental work, you can expect to feel some minor tooth sensitivity and discomfort.  Any drilling on the tooth causes mild inflammation in the nerve inside the tooth.  Sensitivity and tenderness on chewing is completely normal within the first 1-2 weeks after dental work.

If you experience discomfort that lasts longer than two weeks, you should come back to see us.  We want to ensure that you are as comfortable as possible with all of our dental work.

Can I Replace All of My Old Fillings?

Sometimes we get requests from patients to replace all of their old silver fillings.  This can be due to cosmetic reasons or health reasons.  A small section of the population can experience serious health problems as a result of the mercury in old silver fillings.

As far as the process for removing all of your old fillings, we approach that on a case-by-case basis.  Some patients can tolerate having large amounts of dental work performed in a single visit.  Others need to do the work in small increments.  Your dentist will help you decide which option is best for you.

Do You Have Old Silver Fillings that Need Replacement?

Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our restorative dentists.  We can show you which of your old fillings are at risk for problems and help you address them on your schedule.