Runar D. Johnson, D.D.S.
 
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Fillings and Replacement Options


Unfortunately, and for far too long, dentistry has had to rely on and utilize potentially toxic metals in the oral environment because there were not any acceptable alternatives available. Now, however, the new technology and scientific advances that have been made are providing a variety of non-metal materials that can be used instead of the traditional metals.

No material is perfect for everyone. The potential for reaction exists for any foreign material implanted into the body. Amalgam fillings have been standard practice in dentistry for the past 150 years, but with so much controversy regarding mercury fillings, what are the alternatives?

A Word About Mercury Fillings

Amalgam fillings contain silver, copper, tin, zinc and 50% mercury. Mercury is released from “silver fillings” in the form of a vapor (www.iaomt.org/videos). It accumulates in all the body tissues. It damages enzyme systems, cell walls, reduces kidney function and creates antibiotic resistant bacteria in the gut. Mercury has been implicated in neurological damage, similar to Alzheimer’s. Mercury poisoning can be difficult to diagnose since its symptoms often mimic other medical conditions, including psychological disturbances, oral abnormalities, gastrointestinal problems and cardiovascular, neurological, respiratory, immune and endocrine disorders. It can affect the skin, lead to impaired kidney function and contribute to chronic fatigue, joint pain and muscle weakness. Manufacturer’s directions accompanying dental amalgam include the statement that, “Mercury has been reported to be associated with a wide variety of health effects, including reproductive toxicity.” It has been shown to pass through the placenta into the fetal blood supply, tissues and even into the mothers’ milk. *

(This dental office does not use mercury fillings)

What To Do?
Educate yourself. Research the facts. Choose an experienced holistic dentist who follows specific protocols for protecting you from mercury exposure during treatment and can assess alternative materials. Mercury is very persistent in body tissues. It needs to be removed from both the mouth and body, which may involve nutritional recommendations, supplements, chelating therapy, sauna treatments and other procedures.

It is important for each patient to understand that it is their own choice to have mercury fillings removed and there are no guarantees that any ailments will be cured.

Having mercury removed from your mouth does not remove the toxins from your body. Supplements are required before and during mercury removal to help protect the body during the procedure. If you are working with a naturopath, it’s recommended to customize your supplements prior to starting treatment. If that is not an option, basic supplements are available in this office.

There are several options available for replacing the mercury fillings. The most common materials are composite, porcelain and gold.

During the mercury removal process, a rubber dam is placed on the teeth to keep the area dry to get maximum bond strength from restorative material to tooth substance. A special vacuum tip, Clean Up from Sweden, is used on the high speed vacuum system to remove the amalgam fragments and transfer the mercury vapor out of the room, protecting the patient and dental staff.

It is nearly impossible to tell if there is any mercury underneath any existing crowns you may have, even with an x-ray. Commonly, you can check the history of each crown with your previous dentist to see if the mercury was removed prior to placing the crown. If that information is not available, the only other option is to cut the crown off, remove the mercury and place a new crown.

Detoxifying the body is recommended after all mercury is removed. Dr. Johnson recommends Detox Max.

It's always difficult to give an exact cost estimate for treatment needed without seeing the patient first. Dr. Johnson needs to establish if there is enough tooth structure to place a composite filling or if the tooth needs the support of a crown.  A filling is charged according to how many surfaces of the tooth are involved, so the cost varies from tooth to tooth.  Dr. Johnson will determine how many fillings can be done in one appointment and the order in which they should be removed.

An exam is the only way to give the best treatment options possible, maybe even some options you may not have considered, and a more accurate cost estimate.

Resources:
International Academy of Oral Medicine and Toxicology: 407-298-2450 www.iamot.org
Holistic Dental Association: 970-259-1091
American Academy of Biological Dentistry: 813-659-5385
Sam Ziff, Michael F. Ziff, D.D.S.: "Dentistry Without Mercury".
*Paul Rubin & Cynthia Logan, (The Eco-Vision Journal, May – June 2002)


Composite Fillings

Composite materials have been used for more than 25 years in fillings placed in the front teeth, but newer materials are available on the market today that have a much different structural formulation which can withstand the forces used when chewing on our back teeth. Their composition is essentially one of a quartz-filled Bis-GMA resin and are instantly hardened by ultraviolet light.
There are several aspects of these new materials that are very encouraging: they do not contain mercury, they are esthetically pleasing, they do not generate any electrical currents, there is less loss of your natural tooth structure because the dentist doesn't have to do extensive preparation for the new materials. The end product using these materials can truly be called restorations rather than fillings. Amalgam doesn't resort anything. Composites are bonded to remaining tooth structure, are thermally insulating and with the bases and bonding agents used to place the composite, there is much more protection for the pulp and enamel structure of the tooth. In fact, there is scientific evidence indicating that tooth strength increases and that the tooth can be restored to up to 98 percent of its original predecayed state.

Sam Ziff, Michael F. Ziff, D.D.S.: "Dentistry Without Mercury".


Gold

Gold has been used in dentistry longer than amalgam and has been shown to be relatively biocompatible. The gold normally used in dentistry is an alloy, which means that it has been mixed with some other metal or element to give it certain structural characteristics. These are usually palladium, copper or cobalt. The actual percentage of gold contained in these alloys will vary from 2 percent to 92 percent depending on the manufacturer and the price range desired. Cheaper gold alloys often have base metals added. These additional metals could pose problems. A good dentist however, only uses good materials.*
Dr. Johnson uses gold with minimal other metals, usually platinum and indium and in some circumstances silver and copper. No palladium or cobalt as studies have indicated these are more toxic than other metals.


Sam Ziff, Michael F. Ziff, D.D.S.: "Dentistry Without Mercury".


Porcelain

Porcelains are heat and pressure cured, which imparts different structural and finishing properties to the final product. Normally this is done in a dental laboratory. This type of material is excellent for metal free crowns and for cosmetic dentistry applications such as very thin laminates that can be bonded to your teeth, (with little or, in some cases, no tooth preparation), to cover bad stains, or to close spaces between the teeth.

Sam Ziff, Michael F. Ziff, D.D.S.: "Dentistry Without Mercury".


Dentures, Partials, Implants

There is now a metal-free partial denture material available. These flouropolymer thermoplastic materials are chemically inert and possess remarkable stability. If a metal structure is necessary for strength and durability, titanium and gold have been acceptable metals for most people.

Titanium is used for many dental applications and instruments, such as orthodontic wires, endodontic files, dental implants, and cast restorations. The popularity of titanium is primarily due to its good mechanical properties, its high corrosion resistance, and its excellent biocompatibility. A thorough review of the medical and dental literature reveals, however, that titanium can also cause chemical-biological interactions. Tissue discoloration and allergic reactions in patients who have come in contact with titanium have been reported. The biostability of titanium is becoming increasingly questioned. At the same time, new technologies and materials, such as high-performance ceramics, are emerging which could replace titanium in dentistry in the not-too-distant future.—

 

 

 

 

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