Considering the removal and replacement of silver mercury amalgam fillings is a positive step toward better health. Based on current medical and dental literature, this decision is supported. However, before proceeding, there are several crucial factors to consider ensuring a safe and successful procedure.
1. The Treatment Partnership: Expectations and Outcomes
As health care professionals, we aim to control disease in your mouth, not just 'fix' it. As a holistic dentist, we anticipate a long-term relationship to maintain your oral health.
Understanding Dental Disease
When we drill into a tooth, we are addressing a site affected by disease. The tooth is human tissue containing nerves and blood vessels. Our goal is to make the necessary repairs and then see you every six months to maintain a healthy state. This is a team effort.
Pre-Treatment Considerations
Prior to sitting in the dental chair, you should understand the answers to the following questions, which form the basis of our procedure plan:
- What are your expectations of the clinic before, during, and after the procedure?
- What are our expectations of you—the patient—before, during, and after the procedure?
- What are the options for numbing the tooth?
- What protective measures do we take for your health and safety?
- What material choices are available for the new filling?
- Does the tooth need reinforcement to prevent future splitting?
- What post-treatment symptoms are normal versus those that require immediate attention?
2. Ensuring Comfort and Anaesthesia Success
Making your visit as pleasant and effective as possible is our priority.
Numbing the Tooth
Local anaesthesia (LA) is the most common method, with a 92% success rate. If your tooth is not numb, raise your hand and tell us immediately so we can ensure complete comfort before continuing.
Factors that influence LA effectiveness:
- Rest and Relaxation: Get a good night's sleep beforehand to raise your pain threshold. Arrive a few minutes early to relax in our lounge. We encourage the use of our Calming Breathing Technique (please ask us for a lesson).
- Medication and Supplements: Certain supplements, like Vitamin C and some multivitamins, can decrease the effectiveness of LA. Please do not take any supplements within 24 hours of your appointment.
- Being Informed: Ask any questions you have to ensure you are totally informed and relaxed, as being calm raises your pain threshold.
- Pain Management Options: We offer headphones with music (classical or popular) or you may bring your own. If LA is not sufficient, we offer alternatives such as sedation (sleep dentistry), general anaesthetic, or Penthrox.
The Coward's Promise
Please be a 'Total Coward.' If you feel uncomfortable in any way—no matter how small the concern—put your hand up to stop us. We will immediately address your concerns.
Choosing Anaesthesia Level
During treatment, you have choices regarding pain relief:
- No Local Anaesthetic: A reasonable option only for small cavities. Not suggested for nervous patients or those with a history of painful visits. You may change your mind at any time and request numbing.
- Local Anaesthetic: We always apply topical anaesthetic to the gum first to make the injection comfortable before placing the LA needle beside the tooth.
3. Safe Mercury Amalgam Removal (SMART Protocol)
Your safety during the removal process is paramount. We take significant steps to minimise mercury vapour exposure:
- Rubber Dam: A rubber dam is placed over your tooth, ensuring the tooth is isolated outside the mouth to prevent you from swallowing any filling material debris.
- Oxygen Mask: An oxygen mask is placed over your nose to prevent the inhalation of mercury vapour.
- Bite Block: We provide a bite block to allow your jaw joint and muscles to relax throughout the procedure.
- Efficiency: Highly trained staff and effective systems allow us to work efficiently and precisely to complete the procedure as quickly as possible.
Body Protection and Supplementation
We have a specific list of supplements and chelation agents that can be used to protect you from any mercury release during the process. Please inquire about these during your consultation.
4. Post-Removal: Restoration and Bite Check
After the mercury amalgam filling is removed, the remaining tooth structure must be properly restored and protected.
Restorative Material Options
We offer various filling materials to place in the cavity, including:
- Composites (BPA-releasing or non-releasing options)
- Gold
- Porcelain
Please discuss the different filling materials with us to determine what is safest and best for your needs.
Reinforcement and Fracture Prevention
Silver amalgam fillings (50% mercury) are known for causing cracks and splits in teeth. The mercury expands when heated and contracts when cooled (like when consuming hot and cold foods/drinks), stressing the tooth structure.
- If the tooth is brittle or heavily compromised, it may require reinforcing to try and prevent future splitting caused by normal chewing forces.
- A crack or split is often indicated by sharp pain when biting hard, grainy foods, seeds, or pips. If a tooth is confirmed to be cracked, the current treatment to save the tooth is usually a crown.
The Critical Importance of the Bite Check
Teeth are incredibly sensitive, able to feel differences as small as 7 microns (one-third the thickness of a human hair). If we leave a new filling even slightly "high" (e.g., 14 microns), you will not be able to detect it while the tooth is numb.
If the bite feels strange in ANY way when the anaesthesia wears off, you must call us immediately to have the bite adjusted and the filling polished.
- Warning: If a high filling is ignored, your tooth will try to grind it down while you sleep, bruising the end of the tooth. This will lead to sensitivity to hot and cold that worsens, potentially causing the nerve to die. A quick, five-minute polishing visit can prevent this issue.
5. Understanding Post-Treatment Symptoms
While most people are pleasantly surprised by how little discomfort they experience, it is important to know which symptoms are normal and which are warning signs. When we drill, we inevitably inflame the nerve inside the dentine, which is rich in nerve endings.
Normal Symptoms That Will Improve
- Sensitivity to Hot or Cold
- Sore to Bite Due to High Filling
Warning Symptoms That Require Immediate Attention
- Aching Pain
- Sharp Pain on Biting
Contact Lifetime Dental Today!
If you have any queries about your treatment plan, the safety process or post-operative care, please give Lifetime Holistic Dental a ring on (03) 9510 1644.
