Posts for tag: Metal Free Fillings

May 28, 2013
Category: Uncategorized

Are Sealants Good for Adult Teeth?

 I receive many questions about sealants about what they are for and whether or not they can benefit adults(not only children). Before I discuss this, I think it’s important to understand what they are and when/where they are used.

A sealant is a noninvasive/drill-free filling that is placed on the biting surfaces of teeth(typically back teeth) to prevent decay. I emphasize “PREVENT” decay not “TREAT” decay. It is made a material similar to composite(aka tooth colored white fillings) in that the material is typically white in color and is bonded to tooth.  It does not require drilling as it more less a “covering” that is placed on the top(biting surface of the tooth.

The purpose of the sealant is to “Seal” off the grooves and channels are that are often times on the biting edges of the tooth.  I like to call it “Dorito-proofing”. If you have ever eaten a chip or Dorito and find yourself picking at half of the chip out of your tooth, it is because the grooves and channels trap the food and make it very difficult to remove. Those areas that trap food are much more prone to decay.  A sealant is placed over the grooves to minimize food impaction and furthermore decreasing the chance of decay.  They are often placed in children’s permanent molars to help with hygiene and decrease the chances of decay(i.e. needing a filling). A sealant is cheaper and quicker and more comfortable as anesthetic and drilling is not necessary.

Can they be used on adults? Absolutely.  I personally have them on all my back teeth as I like the additional protection from decay. I am not crazy about being numb and drilled on if I can have a noninvasive filling placed instead. There are limitations about sealants such as:

  1. Insurance does NOT typically cover them on adults.
  2. They are only typically placed on teeth that have never had fillings.
  3. The cannot protect the surfaces in between teeth(i.e. the areas you floss).

Talk to your dentist about how sealants can benefit you!

Is it necessary to replace silver fillings that are not bothering me?


Absolutely not. I kind of like the "If it's not broke, don't fix it" attitude. But I will try and explain further. There are many dentists who are urging patients to replace all the silver fillings in their mouth without a reasonable explanation why. There is a lot of controversy and literature that suggests the harmful effects of silver fillings can cause multiple health problems. More specifically, critics state the small amounts of mercury in the silver restorations can be potentially harmful leading to neuropathies.


Neuropathies are nonspecific disorders that can affect the nervous system and brain which alter things such as vision, memory, sense of smell and taste, etc. While mercury has been shown to demonstrate potentially harmful effects if exposed in large amounts, there is not enough conclusive evidence to deter dentists from still routinely placing silver fillings. If in doubt, you can consult the American Dental Association and the FDA as they still support the use of silver fillings as an acceptable restoration in dentistry.


So why should silver fillings be replaced?


Silver fillings should be replaced if they develop cavities around them. If the silver fillings(amalgams) chip, fracture, break, or develop symptoms such as cold/biting sensitivity, then it is acceptable to replace the fillings. In these cases, a tooth colored filling (aka "composite") would typically be used to restore the tooth back to function.


Is there any harm in replacing my silver fillings if they don't bother me?


Depending on the size of the filling and location, there is always a chance of sensitivity developing following replacement of the filling as with any other filling. This should be discussed at detail with your dentist prior to replacements. If the filling is more than 50% of the tooth, then a crown may be necessary to restore the tooth back to function as well as recreating an esthetic appearance.


If silver fillings are safe then why do you not do them on a regular basis?


Two simple reasons:


1. There are environmental hazards associated with disposing of silver filling material in the garbage. This is one of the few dental materials that has specific instructions for disposal requiring special filters/traps as well as pickup services that is not only expensive but time consuming.


2. Most patients simply do not want them! Less than 5% of the general public prefer silver fillings or the tooth colored kind. It becomes a supply and demand issue where there is no demand.


What happens if I whiten my teeth following my white fillings being placed?


Tooth colored fillings, much like crowns, dentures, bridges and veneers will not respond to teeth whitening like natural teeth. It is for this reason that tooth colored fillings that will be placed on the front teeth will typically follow teeth whitening so that the fillings will not have to be redone. Back teeth have less issues with esthetics simply because of their position, therefore not as critical.

Question: What is a bridge?


Answer: A bridge is a permanent dental restoration that replaces one or more teeth. It is permanent in that it is permanently glued in and cannot be taken in and out of the mouth like a denture. It often follows after a hopeless tooth has been extracted(removed). To put in a bridge, I have to prepare and reshape the teeth on both sides of the missing tooth. The bridge consists of the replacement tooth and two crowns (caps) on each side. The crowns will fit over the prepared teeth to support the replacement tooth. This typically requires two appointments and you will be placed in temporaries at the end of the first appointment until the lab fabricates your bridge. While this is one way to replace missing teeth, there are other ways to replace missing teeth such as removable partial dentures and implants.