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Why White Fillings

Why White Fillings? You’ve been hearing the scuttlebutt about mercury and white fillings
for a while now.  I’ve actually read research articles by a Dr Prescott Weston (no relation)
who has shown using special lights developed for mining that amalgam or silver fillings
release a constant flow of mercury vapor.  Look at this video presentation derived from
this research and presented by the International Academy of Oral Medicine and Toxicology.
You’ll be amazed… if not horrified.

But that’s not even the reason why we prefer to place composite restorations.  If you are
repairing anything… it is best to replace it with a material that has the same characteristics
of the structure you’re replacing.  This is why good body shops replace rusted fenders with
metal rather than putty fillers like Bondo.  Consider that silver is nothing like tooth structure.
Sure it was a good solution to fill a hole in a tooth because it gets hard quickly and molds
in the tooth fairly easily.  But, it changes shape at different temperatures than tooth structure
and it’s basically just squished into a hole and held in place by “mechanical” retention.

White fillings are a composite of extremely small porcelain particles in a resin matrix that
bonds to the tooth structure both mechanically as well as chemically.  This provides for a
stronger restoration that can hold unsupported cusps or tooth structure together and help
prevent further damage.  A silver filling preparation has to be at least 2 mm deep and 3 mm
wide to instrument the amalgam into the prep.   In short, the hole has to be bigger than the
decay just so the filling will stick.

A white filling can replace just the decay and is not dependent upon preparation design for
retention.  Some composite material actually are formulated to flow into the grooves of a tooth
that has been cleaned with a very small diamond.  Many times anesthesia is not required and
you don’t have to wait until a cavity is big enough to restore it.  You can conservatively restore
decay as soon as it is detectible.  Cool huh?!

The materials used as little as five years ago for white fillings have been much improved.
With the invention of Nano hybrid composites, the particle size of the porcelain has been
dramatically reduced to provide to a more dense, highly filled (close to 90% porcelain), and
very polish able and therefore stain resistant restoration.  Imagine a room filled with beach balls
as the original composite formula.  Today’s nanohybrid composites would be more like filling the
same room with golf balls.  This is similar in theory to why we use fluoride.  Four fluoride
ions fit into the same matrix as one calcium ion based on their chemical valence or attraction.
Teeth treated with fluoride are four times stronger than untreated teeth due to this increase
in density.  Makes sense, doesn’t it?!

Many people say “You don’t see that one in the back anyway”.  To me, the esthetics of a
restoration is my least concern.  If I could place fillings that were green but lasted for infinity,
I’d have green teeth myself.  A FILLING THAT BONDS THE TOOTH TOGETHER,
seals out micro leakage for a longer period, and has physical properties very similar to the
structure it is replacing is ALWAYS a better solution.  And hey…don’t they look GREAT!

Now the whammy… not all insurance companies want to pay for the extra $20 or so dollars
it costs for these restorations.  Until you as a consumer make enough noise about how an
insurance company can dictate the quality of care you receive, they’ll continue to get away
with paying only for minimal quality at your health’s expense.  Don’t get me started, but
the logical mind realizes that you can only fill a tooth so many times before you run out
of tooth.  Doesn’t it make sense to use the best stuff the first time?  We think you’re worth it!

Not convinced yet?