No Metal Please!

For many people today white fillings and whiter teeth are what they expect when going to the dentist. Many of us also still have 1 or 2 big metal fillings that was placed many years ago and for some even dates back to primary school dentistry.


Why don’t dentists like doing these fillings anymorealthough it seemed to last?.

Many of these fillings are 10 or even 20 years oldand logic tells us that they therefore must be good.
These metal fillings were placed by ways of an undercut in the tooth structure. ‘Good dentists’ were given that name, because their fillings never came out easily. The bigger the undercut, the stronger the retension. The downside is that big undercutsweakens the tooth significantly.
Furthermore these metal fillings also shrink and expand over time and this leads to crack formation!

No Metal Please! - Image 1
Many cracks are present due to expansion and shrinkage of amalgam fillings.
Patients would then often blame their new resin fillings as sensitive and would even sometimes go back to metal!
Disaster strikes as the cycle would just repeat itself!

Doctor my metal filling is sensitive.
One of the biggest complains that resulted though was that many of these fillings got sensitive or sections of the tooth just broke off, without the patient experiencing any pain. The dentist would then examine this old rusty filling and after an x-ray wouldjust reassurethe patient that no decay is present.
No need to do anythingor at least no decay is present. Today you often still hear: “My metal fillings are lasting very well” , but in reality the supporting tooth is badly damaged or cracked! These teeth often break while eating ‘pudding’ , ‘bread’ or who knows what.

What happens when these fillings are removed?
After careful removal of these old metal fillings, big cracks are often seen in the remaining tooth structure indicating areas of high stress.

No Metal Please! - Image 2

Note the badly discoloured teeth after removal of the old metal filling. Many cracks are also present under highmagnification due to the expansionand shrinkage of metal over time.


Many times these areas are just filled in again using white resin. This time a white filling is used to bond the tooth together.In the presence of cracks under the new filling, pain still exists. Drinking hot or cold drinks(temperaure difference) or biting down would result in movement of these cracks and therefore more pain.


CERAMIC please!
Dentists that use ceramic fillings know that these cracks must be removed before a new filling is placed.

The new protocol:
All cracks and crack lines are removed and any blue staining from previous metal fillings are cleaned out.
The new ceramic filling needs a new solid foundation where no movement takes place.
A new life is given to the tooth.

The result: – No blue staining
– No more cracks
– White healthy new look
– Zero sensitivity

With the new CEREC 3D system these fillings and crowns can now also be made in just 1 appointment!

So remember, next time you replace your metal fillings or have to get a big restoration, insist on ceramic.

Dr Francois Burger


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