It has come to our attention that some insurance companies are not paying for tooth colored composite restorations. Instead, they have been paying for the less expensive silver amalgam restorations and balance billing you the difference. Generally, this has resulted in a 15-20% increase in the cost of the procedure to you our patients. For the following reasons we have not offered silver amalgam restorations for the last 20+ years within our dental practices.
Silver amalgam restorations require us to create mechanical retention in a tooth in order to make them stay in place. After the decay is removed from a cavity we then remove sound tooth structure to create undercuts in the tooth allowing for the retention of the material once it has hardened. With composite filling materials, we need only to remove the decayed tooth structure and then use bonding agents to hold the filling in place. With our current bonding agents, we can restore a tooth to nearly its’ original strength and minimize the removal of healthy tooth structure.
Silver amalgam is a cold condensed metal and neurotoxin. All cold condensed metals expand over time. Expansion of the filling can lead to fracturing of an otherwise healthy tooth structure. At certain levels, this neurotoxin can also cause neurological issues, autoimmune disease, chronic illnesses and mental disorders. Composite restorations exhibit no expansion over time and thus cause no increased risk of tooth fracturing.
Third and most concerning to me is the presence of mercury in silver fillings. Currently there is a bill before Congress, which would require the phasing out of the material over the next five years due to the mercury in the fillings. According to the Center for Disease Control, there is no health risk associated with the silver mercury fillings. According to the EPA, removal of silver fillings from patient’s mouths causes a release of the mercury in the fillings and has made dental offices the third largest producers of mercury waste in our water supply.
It doesn’t seem logical to me that the mouth is a safe area to store this material. A licensed hazardous waste carrier must take any leftover silver amalgam material from a dental procedure away from the office. All silver being removed from the mouth must also be recaptured by special filters and hauled by the hazardous waste carrier.
Finally, the silver amalgam restorations turn black and unsightly in a short amount of time. The composite tooth materials can be made to match your teeth and create a healthy smile for many years.
When silver amalgam fillings were invented in 1866, they represented a great advance in dentistry. We now have many safer alternatives to offer our patients. In fact, Scandinavian countries took action back in 2008 and banned the use of amalgam fillings for environmental and health reasons. It is unfortunate that insurance companies do not have your best interest in mind when they decide what they will pay for. As is typical of corporate America, the bottom line drives decisions. If we can answer any questions regarding this issue, please feel free to ask any of our staff members.