[Replacing Silver Fillings A Biomimetic Lesson from Dr. Matt Nejad Register for my free course at: FreeBiomimeticDentalCourse.com]
[Matt Nejad]
Hey guys this is Dr. Matt Nejad and in this video we're going to be talking
about when silver fillings should be replaced. This
is one of my favorite topics because patients are always asking about this
during new patient exams and consultations and
I thought it would be very useful to share the decision making process in
deciding when to replace the silver filling. First off, what is a silver [What is A Silver Filling?]
filling and basically a silver filling consists of mercury,
tin, copper, other trace metals that combine to form an alloy [-Mercury -Tin -Copper -Trace Metals]
and there's a lot of controversy regarding this because of the mercury
content. In this video, we're going to be covering [Overview -The Problem with Silver Fillings]
the problem with silver fillings, the different replacement options, and [-Different Replacement Options]
finally the advantages of the biomimetic approach. [-Advantages of the Biomimetic Approach]
First we're going to cover the problem with silver fillings.
There is so much controversy over silver fillings because of the mercury content
and we all know that mercury is totally unnecessary and totally
unsafe for us, but the controversy is regarding how
much mercury is safe and if you ask me
the goal should be to minimize and eliminate mercury wherever we can.
The problem though is that the studies show that the mercury that's released
from silver fillings is most likely below the threshold of
what would actually result in adverse health effects and currently the
FDA and the World Health Organization all believe that these materials are
safe and while I don't have any major issue
with those statements, I do think it's important to realize
that mercury is toxic, it is avoidable, and that we have better [-Toxic -Avoidable -Better Options]
options. Furthermore, silver fillings are not
ideal because they do not mimic your natural tooth structure. They're [Do NOT mimic natural tooth structure]
nothing like your enamel and dentin and they do not adhesively join the tooth [Do NOT adhesively join tooth together]
together so they lead to all sorts of problems, such as
cracks, fractures, recurrent decay, leakage, and even a higher incidence of [Silver Filling Problems -Cracks -Fractures -Recurrent Decay -Leakage -Root Canals]
root canals, so there's better materials and it's important to realize that
silver filling does not meet any of the major goals of an
ideal filling material. Fortunately, advancements in dental materials
and techniques have given us the ability to more naturally restore your tooth
back to its normal strength and function and we do have better materials that do
meet the requirements for an ideal filling material.
Speaking of the goals for an ideal filling material, the properties we're [Goals For An Ideal Filling Material]
looking for are that the filling material is
non-toxic biocompatible, forms a strong seal to [-Non-toxic -Biocompatible -Forms a Strong Seal]
prevent leakage, cavities, and decay,
has properties similar to natural tooth structure including [-Properites similar to natural tooth structure]
your enamel, dentin, and the dentin enamel junction called the DEJ,
and that it restores the strength and function of the teeth back to normal. [-Restores the strength and function of the tooth]
Silver fillings do not adequately restore the properties of natural teeth.
They are extremely stiff because they're made of metal
and they do not glue or restore the tooth back together adhesively and what
happens is, as a result, the tooth that has a silver filling
develops cracks and fractures because as you
function and chew on the tooth, it's bending and flexing more
because it does not have its normal structural integrity.
When replacing silver fillings, it's important to know the different
treatment options. The goal of replacement is to restore
the properties of a natural, intact tooth and that
brings us to a few different options, but it's important to note that
dentistry is not the delivery of a product,
it's a service and that means that whether you get a white filling or an
inlay, the quality depends on who provides the
restoration and you can't just compare the results
you get with one provider and another because the number one most important
variable in the success of your treatment
is the quality and the skill of the person providing the dentistry.
[The provider is the most important factor in the success of your treatment]
With that said, the different replacement options for silver fillings [Silver Filling Replacement Options:]
include a white filling known as a composite restoration, [White Filling (Composite Restoration)]
a ceramic inlay or onlay for those times when there is more tooth missing or [Ceramic inlay or onlay]
damaged, and then three a crown, but that's [Crown (Avoidable with Biomimetic Approach)]
usually avoidable with the biomimetic approach.
Let's talk about changing silver fillings to white fillings, otherwise [Replacing Silver Filling To White Filling (Composite Restorations)]
known as composite restorations. There's a lot of different composite
restoration material on the market. That means that you have stiff materials,
strong materials, quick materials with a lot of different properties so
when you're getting a white filling or a composite restoration,
it's important to note there's so many different options, but this
is the ideal replacement option for silver fillings that were small
and for teeth that are relatively intact with very little damaged tooth structure,
that means tooth structure that is free of decay,
cavities, cracks, and fractures and when there
isn't a lot of silver filling and there is a lot of your tooth remaining,
then a white filling with a very good approach
can be the absolute best restoration and prevent a whole lot of problems.
Replacing a silver filling for a crown should always be [Replacing Silver Filling With Crown]
the last option, but unfortunately it's a very common practice.
The reason why you want to avoid doing a crown is that it
involves shaving even more of your healthy remaining tooth structure so
most of the time if you do have more damage to your existing tooth
and you can't do a white filling, then you want to look at an alternative
that is still more conservative than a crown and
with the biomimetic approach, there's several different options that will
conserve the maximum amount of your remaining tooth structure.
When you shave more of the tooth, you result in a lot of future complications,
a higher chance of root canals, a higher chance of fractures,
and even irritation to the gums, and a higher chance
of recurrent decay. These are all things that can be avoided and they're very
central to the biomimetic treatment philosophy.
Biomimetic dentistry means to mimic the natural tooth and when you're [What is Biomimetic Dentistry? "Mimic" "Natural Tooth"]
doing a restoration, it's important for us to try to copy the properties
and structure and restore the strength of a natural tooth.
The specific protocols, materials, and techniques of biomimetic dentistry give us
this ability and it's not one specific restoration
because biomimetic dentistry can be used for
all types of restorations including fillings, inlays, onlays,
and crowns. What makes a restoration biomimetic
is the materials and application technique and also
the provider or the dentist's actual approach in
performing the procedure, so it's very important to note that
most of these inlays and onlays, fillings, and crowns
are not performed with a biomimetic approach and we refer to these
as standard restorative techniques. As an example, let's look at a
white filling. You can have a standard white filling or
a biomimetic white filling and the difference comes down to
the materials, the technique, and even the protocols followed during the procedure.
When you do a standard white filling, it's common to
perform the filling in a larger bulk. It doesn't usually look like tooth
structure, it's a lot flatter. When you see it, you'll notice that the
margins aren't as ideal and the shape isn't as ideal
and as a result what happens is even though you have the white filling,
you're not getting the goal of getting a very strong seal,
you're not restoring the properties of the tooth back to the full potential,
and it's short of our biomimetic goals. On the other hand, a biomimetic white
filling is done in a way that takes more time so
oftentimes there's either more layers or the placement of fiber based materials
and the combination of protocol and technique
and even the conditions with which the filling is placed
result in a far superior restoration which has a better seal,
better strength, better function, and even better aesthetic [Seamless margins + Natural Shape]
outlook and this makes a biomimetic filling significantly different from a
standard white filling that you see all over. You might be asking yourself
why would anyone do a standard white filling and the answer for that is
simple, it takes less time and in certain
practice settings or even in insurance-based practices,
it's impossible to spend the amount of time
necessary to do a biomimetic restoration. Like a lot of other things, there's
different ranges of qualities when doing a
filling and when you're doing a biomimetic restoration, the fact of the
matter is, it takes more time, more skill, and
more attention to detail and when you don't do those things, your filling
is considered to be standard and when you do the biomimetic filling and you do
all the different steps and protocols, what happens is you're controlling the
shrinkage of the filling material and because you've controlled the
shrinkage of the material, you make sure there's
no gaps, you ensure that you have the strongest possible
adhesion or bonding to the tooth and the result is superior because of the
steps you've taken to ensure this quality,
it's not just a yes or no, it's more a specific goal of achieving the final
outcome of a biomimetic restoration. Can I change my silver filling to a [Frequently Asked Questions Can I change my silver filling to a white filling?]
white filling? The answer to that is absolutely yes
though, in a lot of practices, you're told that you need to replace the silver
filling with a crown, that's not true for a lot of
different silver fillings, most of the time you can do either a white filling
or a ceramic inlay. The important details to consider are to
see how big your silver filling was and also
how much of your tooth structure is still healthy and intact.
When you have a lot of healthy, intact tooth structure,
then it's easy to replace with a composite or white filling,
but when you have a lot of damaged tooth structure, then you need to consider
something that restores the structural integrity of the tooth,
such as the ceramic inlay or an onlay. How much does it cost to replace silver [How much does it cost to replace silver fillings with white fillings?]
fillings with white fillings? The cost for replacing a silver filling
with the white filling depends on what type of restoration
and where it's done. You can have a white filling that's done quickly [Cost Depends On -Size -Technique -Provider]
and it would not be biomimetic based on everything we discussed
earlier in this video. That could be as cheap as $50 or $80 depending on [Standard Filling: $50-$600]
the size. However, in practices across the nation,
the fee for a composite filling can be as high as
$1,500 when it's very large and it's [Biomimetic Filling: $200-$1,500]
essentially an alternative to a crown or an onlay. So the answer to the question
is somewhere between eighty dollars and fifteen hundred dollars depending on the [Please Note Cost Does Not Ensure Quality]
specifics and also depending on the quality with
which the restoration is provided. Thanks for watching this
video. I hope you enjoyed and learned a lot about how to replace your silver
fillings and all the different treatment options, especially the advantages of a
biomimetic approach. For more similar content to this, please
make sure to subscribe to my channel.
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[Matt Nejad]