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ALTERNATIVES TO AMALGAM
Health Canada now advises dentists to limit use of mercury amalgam and to provide their patients with sufficient information to make an informed choice regarding the materials used to fill their teeth, including information on the risks and benefits of the material and suitable alternatives. This clinic does not offer mercury amalgam fillings as an option. You are free to consult with another dentist should you wish to have your teeth restored with amalgam. When the time comes to replace an old filling or to restore a new cavity, this clinic offers the following restorative materials:
1- DIRECT COMPOSITES Indications: When the cavity to be restored is of small size (less than half the width of the tooth). Preparation: The cavity is first cleaned out and sealed with a liquid resin. The composite is then placed in a paste form and polymerized (hardened) with an intense light. Composites are made of approximately of 85% silica and 15% resin.
Advantages: White in color, they are more esthetically pleasing. They are much more biocompatible than mercury amalgams and may be repaired without replacing the whole restoration. It is the least expensive of all the alternatives to amalgam.
Disadvantages: Some wear down more rapidly in tooth clenchers and grinders. The tooth may remain
2 - CEREC CERAMIC INLAYS Indications: When the cavity or the restoration to be replaced is larger, involving supporting cusps (working points of the tooth).Preparation: Ceramic inlays are designed and machined in-house by computer (CAD-CAM) finished in a single appointment.Advantages: Optimal conservation of sound tooth structure. White in color, they are very esthetic and give the tooth about 90% of his original strength. They are also more resistant to wear and fracture than direct composites. Very long lasting.Disadvantages: Cost is moderately high.
3- GOLD INLAYS
Indication: Same as for other inlays. Fabrication: Necessarily in a commercial laboratory - in two appointments. Advantages: Very strong and durable restoration, gentle to the opposite tooth or filling. Disadvantages: Because of color, very unesthetic. Gold inlays may become uncemented and require recementation occasionnally. Metals are less biocompatible than composites, as a general rule. Not recommended if other metals (amalgams, partials, etc,) in the mouth. Cost is moderately high.
4- CROWNS Indications: When the restoration or cavity is most extensive and the tooth must be protected with a stronger structure. Best solution for grinders and clenchers!
Fabrication: The center of the tooth is rebuilt with composite and the outside of the tooth is ground down. The crown (or cap that covers the tooth) can be made out of porcelain, gold or a mixture of gold covered with porcelain.Advantages: Best long term protection for any tooth. Very esthetically pleasing when porcelain is used. Excellent function and strength. Very long lasting.Disadvantages: Less biologically conservative for the tooth (6% chance of root canal treatment). Risk of bioincompatibility with other metal alloys in the mouth. Higher cost. Each tooth and each mouth must be individually assessed to determine the best material or best combination to be used. Please share your needs and expectations with us, we will suggest the appropriate materials to meet them.
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