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Is My Dentist Too Old School?

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I’ve been going to my dentist for over 15 years. I really like him, but I’m wondering if he’s losing his touch. I don’t think he always keeps up with his field anymore. I asked him to remove one of my dental fillings because of the amalgam content and he said it’s not safe to do that and I should just leave it in. Can you please explain to me if it is not safe to remove because I’ll ingest some mercury, why it is supposedly safe to have it in my mouth at all?

Carrie

Dear Carrie,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

Mercury-Free Dentists Know How to Do Sanitary Amalgam Removals

You asked a great question. Why should a patient feel safe having mercury in their filling if it is considered unsafe to remove it? Your dentist should be asking the same question. The truth is, you can have this filling removed safely if that is what you want. However, you’ll have to go to a different dentist to have it done.

You’ll want a dentist who knows how to do a sanitary amalgam removal. You could do an internet search for a “mercury-free dentist” online. They’ll know the proper method for preventing you from inhaling any mercury vapors or swallowing any bits. You shouldn’t have much trouble finding one unless you live in a very isolated area.

That leads me to the other issue you brought up. Your dentist not keeping up with the advancements in his field. This is actually a big issue. While most states have a minimum amount of continuing education dentists must take every year, some dentists do just that—the bare minimum.

You want a dentist who is passionate about his work. Science changes all the time. That’s because we learn more as we go along. I once looked at an old magazine which had an advertisement promoting the superiority of lead paint. Now we know it is toxic. This is why you want a medical professional to keep up. It’s a lot of work doing that, which is why a passion for your field makes it easier to keep up. It’s likely time for you to find a dentist who still has that passion.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Composite filling hurts

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I needed a dental filling on a back tooth. My dentist prefers placing the silver ones, but I didn’t really want that. I kind of pressured him to place the white one. Now I’m worried I made a mistake. The tooth hurts when I chew. I checked when I’m not eating and clenched, but it’s fine then. It only hurts when I’m biting down on something. Can this be fixed or am I stuck with it?

Brooke

Dear Brooke,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

When it comes to choosing your filling, you did a great job. Composite fillings are much better than their amalgam counterparts. However, you need a dentist who is able to to place them properly.

Bonding a composite filling has a totally different technique than their silver counterparts. If not done properly, it can cause the pain you are describing.

This can be eliminated by having the crown re-done the right way. There is also an occasional problem with small composite fillings. We aren’t sure what causes it, but we do know if the dentist uses a self-etching primer or a glass ionomer base under the filling you won’t have pain.

You Need a Mercury-free Dentist

If you want this to be done properly, you’ll need a dentist to understand the procedure. I’m sure your dentist did the best he knew how, but at this point you need someone else, unless he’s willing to learn.

Either you or your dentist can contact a mercury free dentist who understands the right technique and can re-do your filling properly.

I hope this helps. It’s always better to find a different dentist for a procedure you have your heart set on in which your dentist is trying to steer you away from.

Usually, it means they don’t know this procedure as well, but they don’t want to admit it.

This blog is brought to you by New Orleans Dentist Dr. Duane Dulaune.

Dentist Won’t Remove My Mercury Fillings

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I have a mouthful of silver fillings. I learned a few weeks ago they are mostly made of mercury. This terrifies me because of the neurotoxicity. I went to my dentist and asked him to remove them and replace them with the white fillings. He refused because he said it’s too dangerous for me because I’ll inhale the mercury. If it’s too dangerous to take out, surely it’s too dangerous to keep in. What should I do?

Maya

Dear Maya,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

It is understandable that you’re nervous about having a large amount of mercury in your mouth. There is a special procedure known as a sanitary amalgam removal which is designed to protect you from inhaling or swallowing any mercury.

However, it sounds like your dentist doesn’t know that procedure. It wouldn’t be safe for you to have him do the removal. If you are serious about removing them, your best option would be to locate a mercury-free dentist in your area. Almost all of them know how to do this procedure and already has the necessary equipment.

Mercury-free Fillings and Tooth Color

Before you get your white fillings, you want to think about your tooth color. The filling material can be made to match your teeth. However, the color is permanent. If you decide to whiten your teeth later, your natural tooth structure will whiten, but not the composite fillings.

That doesn’t bother some people at all. If you feel that way, then no problem. However, if it will bug you the simple solution is the get your teeth bleached before you switch out your fillings. You can do that two different ways.

Your first option is to have your dentist make you custom fitted trays and provide you with professional strength whitening gel. This will allow you to whiten at home as well as control the level of whitening.

If you want it to work faster, so you can get your fillings removed sooner, you can look at Zoom Whitening. This is an in-office procedure which gets your teeth very white in just one appointment.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Will Mercury-free Fillings Stop My Migraines?

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I keep having these unexplained migraines. Sometimes they’re debilitating. My doctor can’t find a cause and just wants to give me pills to take every day. They’re anti-seizure drugs, but they make me move slower. I feel less in-touch. Recently, I read that amalgam fillings cause underlying health problems and doctors have a hard time diagnosing them. Could this be the cause of my migraines? Would replacing them with mercury-free fillings help?

Laura

Dear Laura,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

Before we go into replacing them it’s important I tell you that the official position of the American Dental Association is that amalgam fillings are completely safe and their studies have shown the amount of mercury released in the fillings is within acceptable limits.

That being said, many have disputed those tests pointing out that they only tested the fillings under static instead of real-world conditions. Other tests, done in more realistic conditions, have shown the opposite.

There are theories that the mercury content is leading to underlying health problems, including high blood pressure and migraines. If you’ve already eliminated other neurological causes with an MRI, then it wouldn’t hurt to replace your amalgam fillings for mercury-free fillings, but it’s not a guaranteed solution.

You should also be aware that not every dentist can do the replacement safely.

To Safely Replace Your Fillings You Need a Mercury-free Dentist

During the removal processes, without taking the right procedure for a sanitary amalgam removal, you have a great chance of swallowing mercury or inhaling mercury vapors. However, using the right precautions protects you from that.

Mercury melts at room temperature. It needs to be kept cool during the process. A wise dentist will keep cold water on it while working. They also need to use a stopper dam and keep you from inhaling the vapors. If your dentist is a mercury-free dentist, they’ll know and be prepared for this.

You’ll find there are many other advantages as well. Also, if you have any visible fillings (which have probably been an embarrassment to you) you’ll not only have a natural looking smile with fillings that match your natural tooth color, you can finally get a bright white smile as well.

Before, if you’d have whitened your teeth, it would have just made the difference more obvious. Now, if you whiten your teeth ahead of time, you’ll be able to get the filling material made to match the color exactly. You’d have to whiten first. Once the fillings are made, the color can’t be adjusted.

This blog is brought to you by New Orleans dentist Dr. Duane Delaune.

Cavities and Metal Allergies

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I’d been having some health issues. In exasperation, my medical doctor (who is a saint by the way) decided to do some wide-ranging allergy testing. It turns out I have developed rather challenging metal allergies. I can avoid quite a bit of metal, but I have metal fillings. Do you have a recommendation of what to do? My dentist seems to be blowing it off, but I’m ready to feel normal and hopefully healthy again.

Samantha

Dear Samantha,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

It sounds like you have a great medical doctor and an apathetic dentist. If you have a metal allergy, it is in your best interest to have your fillings removed and replaced with metal-free fillings. Your dentist isn’t going to be the best one to do this. It has to be done very carefully because the main ingredient in your silver fillings is mercury.

You don’t want to just remove them. If you do, there’s a very good chance you’ll swallow some mercury or inhale mercury vapors. I’m pretty sure you do not want a known neurotoxin in your body.

In order to prevent that, you’ll need a dentist who knows how to do what is known as a sanitary amalgam removal. The right dentist will use a stopper dam to prevent you from swallowing, they’ll also give you an apron to protect you from dust (because of your allergies). They’ll also need to run cold water on the fillings so the mercury doesn’t melt and use a fan to protect you from vapors.

It’s very involved and does require some specialized training and equipment. So, who should you get to remove your metal fillings and replace them with metal-free fillings?

Finding the Right Dentist to Remove Your Amalgam Fillings

Your best bet is to get a mercury-free dentist. They only place white, composite fillings which are both mercury and metal-free. They’ll also know the correct procedures in removing your old fillings in order to replace them.

You’ll find the metal-free fillings far superior to their old amalgam predecessors. While they have the obvious benefit of matching your natural tooth color, they have clinical advantages too. They can strengthen your teeth and they prevent your dentist from having to remove healthy tooth structure. Their bonding procedure is more advanced and allows you to keep more of your tooth.

This blog is brought to you by New Orleans Dentist Dr. Duan Delaune.

Is U.S. Violating UN Agreement on Mercury Fillings?

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I thought the United States agreed to phase out mercury fillings when they signed the Minamata Convention Agreement, yet there are still thousands of dentists using amalgam fillings all over the country 5 years later. Can we demand our dentist (and more helpful financially our insurance) stop using them because of the agreement?

Maggie

Dear Maggie,

Image left of silver amalgam fillings loaded with mercury. Image right: mercury-free composite fillings

First, you’re right that there has been very little evidence the United States followed through with the agreement signed. However, the Minamata Convention agreement wasn’t about the fillings themselves. There’s no agreement to ban those or phase them out.

The agreement was based on a village in Japan that was absolutely devastated by mercury poisoning in the water. 900 people died as a result and more than double that became ill. There’s no record of the cognitive impact but I’m sure it’s much higher.

What the agreement actually deals with is the disposal of mercury to keep it from polluting the environment and therefore people. Every dentist should be aware of the agreement because the main ingredient in amalgam (silver) fillings is mercury. Whether or not they’re following the recommendations is hard to tell. But, most dentists will be environmentally conscious.

If You Want Mercury-free Fillings

While you’re right that there are many dentists still using amalgam fillings, there are also an increasing number of mercury-free dentists. They’ll be happy to give you composite fillings. In fact, in many cases it’s all they offer.

If you happen to have some leftover amalgam fillings you want to rid yourself of, most mercury-free dentists know how to do sanitary amalgam removals. That allows you to safely switch out your fillings for healthier options without worrying about inhaling the mercury vapors.

White Fillings and White Teeth

When you have white fillings, you want your dentist to match them to your teeth, especially if you have any visible fillings. They can. However, you need to be aware that once the fillings are made the color can’t be changed. So, if you’ve considered whitening your teeth at some future time, you may want to do it before you get your filings switched out.

This blog is brought to you by Dr. Duane Delaune.

Can Children Have White Fillings?

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My pediatric dentist says that children cannot have white fillings. I’m not too keen on putting the silver fillings in their mouth. I heard they’re made mostly of mercury. He says they’re perfectly safe and are made mostly of silver, but I just don’t have a good feeling about it. Is it true that children can’t have the white fillings?

Sasha M. – Wisconsin

Sasha,

Your pediatric dentist is being a little misleading. While amalgam fillings are often called silver fillings, that decision was made for marketing purposes. There is silver in the fillings, but the largest ingredient is mercury.

The American Dental Society has declared amalgam fillings are perfectly safe. There have been numerous studies to back them up. However, that doesn’t’ make many patients feel any better about putting a toxin in their bodies. Mercury free dentists understand that and provide composite (white) fillings for their patients.

As far as white fillings for children, it is possible, but it isn’t easy. They have to stay perfectly still during the procedure to ensure no moisture gets on the filling. That is difficult for most children. Only you’ll know if your child can handle that. If so, call around to pediatric dentists and ask if they do white fillings. You’re bound to find one. If you don’t, try a general dentist who enjoys treating children. If your child would have trouble sitting still, but you’re still determined to do white fillings, try a mercury free dentist who also does sedation dentistry.

This blog is brought to you by Dr. Duane Delaune.

What is Mercury-free Dentistry?

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I keep seeing dentists call themselves “mercury free dentists”. What does that mean?

Bethany L. – Ohio

Bethany,

Traditional silver fillings, clinically called amalgam fillings, actually consist mostly of mercury. These were first developed in the 1800s. Though the main ingredient is mercury, they called them silver fillings—which makes for better marketing.

Mercury is a toxic substance.  You have likely heard the warnings about mercury in fish and the recommendation to limit your intake. Many patients are concerned about the mercury in dental fillings and are asking their dentists to provide mercury free fillings.

When a dentist calls himself (or herself) a mercury-free dentist, they mean they offer composite fillings. These are white fillings that have no mercury in them at all.

Not only do many dentists consider this a healthier option, they’re also better for your teeth than their amalgam counterparts–not to mention they look much more natural.

This blog is brought to you by Dr. Duane Delaune.

My New Dentist Is “Mercury Free” Do I Really Need to Remove My Fillings?

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I have a few amalgam fillings. They’ve never really given me a problem. However, my dentist retired and the new one is “mercury free”. I’ve only seen him twice, but both appointments he’s stressed that he’d like me to replace the fillings because of their mercury content. Is this really necessary?

Drew B. – Indiana

Drew,

First, I’m going to give you the politically correct answer. The American Dental Association (ADA) still says that amalgam (silver) fillings are safe. So, technically, according to the ADA you’re fine just leaving those fillings where they are.

That being said, they really have no idea how safe they are. The studies aren’t addressing how much mercury is being released into your system over your lifetime. Nor does it address if there are daily activities that cause more to be released or at what point mercury begins to create a negative impact on your health.

There have been studies that show eating, drinking, or brushing your teeth can release mercury in older fillings. Unfortunately, most of the studies done use a static model that doesn’t mimic real world conditions.

It’s up to you whether or not you replace them. Most mercury free dentists would prefer them to be replaced. It is up to you. If they’re old, that would increase the amount of mercury being released into your system. In that case, I’d definitely replace them. Just make sure your dentist knows how to do a sanitary amalgam removal.

This blog is brought to you by Dr. Duane Delaune.

Is my dentist trying to talk me out of replacing amalgam fillings?

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I recently made an appointment to have amalgam fillings removed from two back teeth and replaced with composite. My dentist kind of “warned” me that there might be some staining on my teeth from the silver fillings and to not expect my teeth to look completely white. Maybe I’m crazy, but it just really felt as if he was trying to talk me out of doing it altogether. Will these teeth be stained from the old fillings and if so, is there a way to remove the staining? Also, the fillings are pretty large – probably about 70% of my tooth. Will the white fillings be better than amalgam as far as strength and durability? — Steve

Steve,
It’s no secret that taking out old amalgam fillings and replacing them with white composite fillings will definitely look better. Your teeth might be slightly discolored from the amalgam fillings, but since it is on the back teeth, it shouldn’t be very noticeable at all.

With that said, it does sound very much like your dentist is in a round-about way trying to talk you out of the composite fillings. It’s probably because he is simply not comfortable doing them, but doesn’t want to come right out and say it. There’s a big difference in how composite fillings are placed in back teeth compared to amalgam and when it’s not done correctly there can be all sorts of problems and even damage to the teeth. If your dentist seems reluctant, don’t push the issue and instead, find another dentist who is trained in that area.

Another red flag to consider is the size of the fillings. If they are as big as you say, your dentist really should have done crowns. However, if you stick with fillings, composite will  definitely be stronger and more durable because they bond to the tooth where as amalgam fillings just sit in the tooth, making it’s easier for the tooth to break or fracture.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.