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Teeth Whitening or Fillings First?

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I have a canine tooth that needs to have a dental crown on it. My teeth are kind of yellow so my dentist told me if I wanted to get them whitened I should do it before I have the dental crown made because the color for that cannot be changed once it is done. Something I am wondering about, though, is all the fillings I have. They are silver and probably need to be replaced anyway. Some of them are visible when I smile. Should I replace the fillings first with those white ones and then bleach my teeth to match them or should I whiten the teeth and then get the fillings done?

Bridgette

Dear Bridgette,

Teeth Whitening trays

 

I would start with the teeth whitening. It is nearly impossible to get teeth whitening to an exact match to a color. But, you can whiten your teeth to a color you love and then the composite fillings as well as the canine dental crown can be made to match.

I want to give you a couple of precautions. The teeth whitening itself is easy and just about any dentist can do it. The canine you want to be more careful with. First, make sure that your dentist uses a porcelain crown. These are much more natural looking. A metal-based crown will be too opaque and, eventually, will give you quite an unsightly gray line at the gumline. In order to ensure your dentist is able to properly match your dental crown, make certain that he or she uses a temporary try-in paste and then allows you to look at it in several different types of lighting. If you don’t like the crown, your dentist should send it right back to the lab in order to make any changes that you need.

Replacing Amalgam Fillings

One other very important piece of information. Silver fillings are made mostly of mercury. You want to be certain that whoever switches out your fillings knows how to do a sanitary amalgam removal. This will prevent you from inhaling any mercury vapors or swallowing any pieces of mercury. As you know mercury is a toxin and people have serious health repercussions from mercury poisoning.  This is actually why so many patients are anxious about their silver fillings and want to replace them, though the American Dental Association still considers them safe.

I recommend seeing a mercury-free dentist in order to have them removed and then ask him if they know how to do a sanitary amalgam removal.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Are Amalgam Fillings Stronger than Composite Ones?

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My dentist has always done amalgam fillings. When I went in this time, though, he gave me one of those white fillings. He told me that he was trying to go “mercury-free” whatever that means. I was excited about the white fillings at first because they would not be so obvious as all my silver ones are in my mouth. The problem is that a week later the new white filling came out. I went back and he replaced it. Then, a couple of weeks after that the stupid thing fell out again. He went ahead and did the regular amalgam filling after that and it is doing just fine. Does this mean the newer composite fillings are not as strong?

Jeff

Dear Jeff,

Before and After Mercury Free Fillings

It sounds like your dentist is striving to improve his skills and catch up with the advancements in his field. This is admirable. Trying to go mercury-free is admirable too. Your amalgam (silver) fillings are made of a mixture of materials, hence the name amalgam. However, the main ingredient is mercury. This is a known toxin. While the American Dental Society assures patients that these are safe, you can understand the concern of patients.

Amalgam Versus Composite Fillings

The truth is that the composite fillings are actually stronger than their amalgam predecessors. This is because the bond directly to your tooth and require less removal of tooth structure. If that is the case, why in the world is yours not staying put? The problem likely lies in your dentist’s placement technique.

Composite fillings are placed differently than the old amalgam ones. It sounds like he has not mastered this yet. One thing he needs to be aware of is that there needs to be zero moisture during placement or the bond will weaken. You have a couple of options here moving forward. You can give him time and opportunity to learn or you can find a dentist who has already mastered the technique. This process has been around a while, so there are plenty of dentists who are already mercury-free dentists and can do a great job for you.

Whoa! Mercury?

This may have been the first time you’ve heard about the mercury content in your silver fillings. Don’t panic. You’ve had them this long and unless they are leaking or cracked you probably won’t have any issues. However, if the new knowledge will keep you anxious, there is a sanitary removal process. It requires special knowledge and equipment that I can almost guarantee your dentist does not have. If you decide you want to switch them out for white fillings, than I would highly suggest you look for an experience metal-free dentist or mercury-free dentist.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.