No Choice

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For a long time, i've been wanting to air my thoughts bout dental amalgams over the world wide web. But this being controversial issues, i held back, till now. This post was sparked by a letter i opened this morning, regarding the use of dental amalgams with mercury content.

The letter stated concerns arising from the inhalation/ingestion of mercury vapour, followed by lines after lines of affirmation that the use of amalgams do not exhibit adverse side effects.
I shall not comment much on the letter, but here are my views on the subject matter, dental amalgam.

AR(amalgam restorations) expand with age, allowing secondary decay to develop. These decays are hard to detect in its early stages and by the time something is done, it often is too late, leading to the need for more complicated procedures. In fact, there is no chemical bond between the tooth surface and an AR.

AR wedges against the tooth due to temperature changes. Overtime, the tooth cracks and often, a crown may be needed to restore its functionality, and this, has no guarantee that its gonna work.

In the long run, AR stains the walls of the cavity, giving rise to teeth assuming a grey tinge.

Other than obvious negative aesthetic issues, AR releases mercury vapour which might have an effect on the CNS. I for one wouldnt want to put my patients, myself and future generations(if any) at such risks.

As such, i think there should be a system of change implemented in the usage of dental amalgams. If there are researches done to prove its effect on the CNS, no matter how minute, should not be disregarded.

The dental profession is an acquired skill, and a rice bowl to many. What if you were told that these mercury vapour is accumulated in the body over time? What if your kid is having an AR plugged in today?

Its not that im trying to be anal and atas bout the usage of new generation materials. I think mercury, as much as it is 'bonded' with other metals and hence does not pose a risk to the exposed personnels, this risk should not be taken.

Since a switch in work environment, i've seen cases of tooth walls chipping, with the AR still retaining its shape-yah talk bout straight walls flat floors and undercuts. My stand is, i rather have a filling chipped than a tooth chipped.

If cost is all the one is on the look out for, i must say that it isnt too cost efficient in the long run. Yes, new aged materials may be more costly but they bond to the tooth, some have fluoride releasing properties (rechargeable or not huh?) and usually pose less issues down the road. The analogy is like driving a normal sedan vs a 4wheeled drive vehicle on loose gravel/mud. Both would run, but eventually, the normal sedan breaks down or requires much servicing before it tries to catch up with the 4WD.

I know my friends have no choice but to continue plugging in amalgams. I was once in that state but it was no dilemma to me. I stuck with the use of tooth coloured fillings on permanent teeth. It didnt matter much whether i would be questioned or not. I knew i was following a reasonable school of thought, and should not be held liable. In any case, i've always informed patients which tooth has a filling, and to return if they feel a sharp edge, chip or complete dislodge of material.

**

I cant erase the stupid things i did, i struggle just to find a better way.
So here i am, fighting and trying to hide the scars.
So take a breath and softly say goodbye.
The lonely road, the one that i should try to walk alone.
The queen has lost her crown again.

Goodbye.