Female at the dentist
Dr Chris Darby

Dr Chris Darby

Are You Considering Having Your Mercury Amalgams Fillings Removed?

10 Things To Know Before Removing Your Mercury Silver Amalgam Fillings

So you are considering having your Silver Mercury Amalgam fillings removed. Well done! Having reviewed the current medical and dental literature I agree with your decision to have them replaced. However, before you get into the dental chair there are a few things I would like you to consider.

1) What do you expect from us before, during and after the procedure?

2) What do we expect of you – before, during and after the procedure?

3) What are your option to numb the tooth up?

4) What do we do to protect you and your health?

5) What filling material to place in the cavity? Are there choices?

6) Is the tooth brittle and does it need reinforcing to try to prevent it from splitting with normal chewing in the future? 

7) What symptoms post treatment are normal and will go away and what are not and will just get worse?

Firstly, whenever doing any surgical procedure there are some risks that you need to consider, so when we drill into a tooth we are drilling into human tissue with nerves, and blood vessels. We are drilling into the tooth because a disease has attacked the tooth.  As health care professionals we control disease in our patient’s mouths, we do not fix the disease. As a Holistic Dentist I expect to see my patients on an ongoing basis for many years to help them control the dental diseases in their mouth. my recommendations are for now with the information i have today. when we see each other in 1 year, 2, years, 5 years and 10 years the situation will be completely different. My goal is always to get my patient’s mouths healthy and then see them every 6 months to maintain their mouth in a healthy state. as a team we have a chance of controlling the disease in your mouth. 

1) There are different ways to numb your tooth up. the most common way is to use local anaesthetic. It has a 92% success rate at getting teeth completely numb. So if your tooth is ever not numb – put your hand up and tell us, so that we can get it numb before we continue.

The things that can influence this are:

– Having a good nights sleep the night before will raise your pain threshold and make your visit more relaxing. so please go to bed early and wake us refreshed. 

– Coming to the appointment on time, with enough time to sit for a few minutes relaxing in our lounge room will make the appointment calm and more pleasant for all of us. We teach all our patients a calming breathing technique. We suggest you do this breathing while you spend your 5 minutes in our lounge room, having a cup of tea provided by our wonderful staff. If we have not had a chance to teach our Calming Breathing Technique then please ask us next time we meet.

– Taking certain drugs and supplements can decrease the effectiveness of local anesthetics (LA). For example Vitamin C and certain multivitamins will prevent the LA from numbing up your tooth. So please do not take any supplements within 24 hours of your dental appointment.

– Be calm and relaxed raises your pain threshold. Thus we want you to totally understand everything you wish to know about your treatment – no surprises. So ask any questions so you are totally informed and sure of the procedure. 

– We have head phones and classical or popular music for you to listen to during your treatment. Some people like to bring their own music. Either way we are happy to “indulge” and pamper you a little to make your visit as pleasant as possible.

– Be a Total Coward. If you are uncomfortable in any way please do not stay quiet. Put your hand up to stop us and we will take everything out of your mouth and immediately deal with your concerns. No concern is too small. Some people even stopped us to tell us that they are pleasantly surprised how comfortable they are.

2) What do we expect during the appointment:

– Having treatment – you may choose to:

– Have no Local anesthetic. If the cavity is small then this is a reasonable option. However, if you are nervous, or have had bad, painful dental visits in the past then I do not suggest you choose this option at your first visits. A lot of our long term patients choose no LA when they are more relaxed and have built us trust in us. And remember if it turns out to be uncomfortable at any point you can always put your hand up and say you have changed your mind and have your tooth put to sleep. 

– Have just Local anesthetic. We always put topical anesthetic on the gum to numb it up before putting your tooth to sleep, to make the injection comfortable, and then we place a needle beside the tooth to put it to sleep. 

– If LA is not enough then we have a number of other choices from Sedation – or sleep dentistry to General Anaesthetic to Penthrox. Just ask us.

– During the treatment we will place a rubber dam over your tooth so that the tooth is outside the mouth and no mercury filling material can be swallowed. Also we place an Oxygen mask over your nose so no mercury vapor can be inhaled. We offer you a bite block so that your jaw joint and jaw muscles can relax during the procedure and we have highly trained staff so that we can work efficiently and precisely to get your work done as quickly as possible. I often hear – “Oh did you get all 3 fillings done in that short time?” Yes – no problem. we have great systems, and great staff and so we are very efficient.”

– Feel free to ask us all the ways we protect you mercury release from your mercury amalgam fillings next time you visit us.

– We have different filling materials that we can use to fill your tooth after removing the silver mercury amalgam filling. They include Composites – releasing or not releasing BPA’s (Bisphenol A’s), gold, porcelain etc. Please ask us about the different filling materials so that we can give you what you want and what is best and safest for you. 

– Once the filling is complete we need make sure that the filling is not high or proud in the bite. This may sound easy except that teeth can feel down to 7 microns. That is one third of the thickness of a  human hair which is 21 microns. The problem with this is that if I leave a filling 14 microns “high” then you will not be able to tell when your tooth numb and I cannot see 14 microns even under my microscope so when you go to bed that night you will try to grind that “high” filling down and your tooth will become sensitive to hot and cold. Probably you will notice the tooth feeling slightly strange when the LA wears off, but not enough to alarm you. But over the next few days that tooth will become sensitive to hot and cold and then it will concern you. What is the lesson here? If the bite feels strange in any way when the anesthetic wears off then you need to ring us and organize to come in and get the bite adjusted and the new filling polished.  If you do not then the tooth will get sorer and sorer and the nerve may die. 

3) Most of the time we are pleasantly surprised how few people have pain or discomfort after having their teeth filled. However, there are some things to know to be able to make you time after your dental visit predictable.

– Teeth have a very large nerve supply and when we drill into a tooth we drill into the dentine. The dentine is full of nerves and so when we drill it is not uncommon for the nerve to become inflamed and sore. So what symptoms are OK after having a filling and what are not?

– Sensitivity to cold or Hot: this means that you have a hot or cold drink which causes the tooth to be sore when touched and after you swallow it the pain goes away almost immediately, in a few seconds. This is a sign that your nerve is inflamed but usually this sort of sensitivity will go away in a couple of weeks. As long as it continues to improve then all is good. You can take some anti-inflammatory medications or other herbal remedies if you want. We have a therapeutic laser that may help settle things down more quickly. Feel free to give the clinic a call.

 – Aching to Hot or cold: if you experience pain that lingers on after swallowing the hot or cold then this is not a good symptom. This again is a symptom of an inflamed nerve. The deeper the decay or cavity was the greater the chance the nerve may die and an abscess will be forming. If the pain persists, or you are ever woken at night with pain then I am sorry but the nerve has died and you need to return for more treatment.

– Bite feels strange. If the bite feels strange AT ALL after having a filling, then this is a sign that the filling is slightly high. Unfortunately, the modern white fillings are too hard for your teeth to grind down and so the tooth gets pushed into your gums from the grinding that occurs when you are asleep (your body trying to fix the problem) and you develop a bruise on the end of the tooth and the tooth becomes sensitive to hot and cold. This is not going to get better until the dentist polishes the new filling down into the correct bite. It only takes 7 microns  for the filling to be “too high” so please if the filling feels strange to bite then it is most likely due to a slightly high filling and a 5 minute polishing dental visit will fix the problem and stop the tooth from becoming sensitive to Cold or hot and possibly the nerve from dying.

– Tooth sore to bite.if it is not sore to bite due to a recent high filling then it may be a crack in the tooth. Silver amalgam fillings are 50% mercury and are known for causing teeth to crack.  If the tooth is sore to bite hard grainy foods and you get a sharp pain on biting seeds or pips this is usually a sign that your tooth has a fracture or split. The split may be small but studies tell us it will get bigger is ignored. Mercury  is known for its ability to expand when heated and contract when cooled. This is great in a thermometer to tell the temperature however, when a silver amalgam filling is in a tooth it is made up of 50% mercury. This mercury expands when we drink and eat hot foods and contracts when we have cold foods and drinks. Thus Mercury containing fillings are known to crack teeth. Most of them we cannot detect. Some of them we can see. Presently our only treatment to save a cracked splitting tooth is a crown.

An Alternative to drug pain relief is Brauer Pain Relief medicine . 

4) Supplementation and overall body protection during the process of amalgam mercury removal.

– We have a list of supplements and chelation agents that can be used to protect you from any mercury release during the silver mercury contain filling removal process. ask us at your consult visit.

if you have any queries please give Lifetime Holistic Dental a ring on 03-9529 2920.

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