Hello!
There's some controversy about whether or not amalgams which
are perfectly serviceable should be replaced with composites.
I say, "Generally no." Here's why.
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[Since I wrote this, I decided to modify - highly qualified dentists
can and do replace amalgam with composite with no bad effects! -
10/19/98]
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PATIENT A: He presents with the lower left side containing
several amalgams and a gold crown. The lower right has some
rather extensive composites that are well done and a
porcelain/metal crown with root c{*filter*}therapy performed.
He is over here because he had a series of problems after his
last dentist convinced him to replace the amalgams on the
lower right. He eventually needed the root c{*filter*}therapy and
the crown and decided not to pursue the "amalgam replacement
policy" any more. This is how he was referred over here.
(Minimally invasive dentistry!)
I have encountered the same "patient reports" in social
situations and I hear this from time to time at
sci.med.dentistry. In fact, my original post was in reply to
a patient who inquired about this exact situation.
Now lots of dentists' claim very good success with composites
but I think that it depends on case selection. If you are a
"take it or leave it" dentist and you tell your patient that
he/she needs 3 crowns and 2 composites, you may have a bit
more success in avoiding the problems, if you stand firm with
your treatment plan.
Unfortunately, too much of the American population (patients)
are of the "leave it" variety, what with other priorities and
lack of motivation to invest in their dentition. Some
colleagues may say, "You, the dentist did not do your job in
convincing the patient," but just look around at the poor
condition of many people's mouths. Its hardly endemic.
For many of these folks, leaving well enough alone when
looking at the amalgams may be more appropriate.
Cheers,
Joel
Joel M. Eichen, D.D.S.
Replacing amalgams