Oral Care Guide for Teens

Amalgam

Amalgam has been used as a dental filling material for more than 150 years.

Composition

An alloy of mainly silver, tin, copper and mercury

Properties

Hard and durable; high wear resistance

Easy to use

Safe

Amalgam safety

The followings are some queries about amalgam:

Mercury, which is poisonous, is used in dental amalgam. Is amalgam filling safe?
Amalgam contains various metals such as silver, copper and tin, as well as mercury. When mercury is combined with these metals, it becomes an inactive stable substance. Only under unusually great pressure or abrasion will the amalgam release a minute amount of mercury vapour. As compared to the daily dosage of mercury being absorbed from the environment, such as food, water and air, the minuscule amount of mercury released from the amalgam fillings is insignificant.

Should people have the amalgam fillings in their mouths removed in order to prevent certain serious illnesses such as Alzheimer's disease?
There is no scientific literature or evidence which shows that the removal of amalgam fillings helps patients recover from their illnesses, nor is there any evidence which suggests such a relationship. Unless there is an allergic reaction, it is not advisable to have amalgam fillings replaced because of the following reasons:

Replacement of filling materials will lead to further loss of tooth structure.

Amalgam is still the most preferred filling material owing to its safety and effectiveness. Tooth-coloured filling material such as composite is not as resistant to stress as amalgam and is not suitable for large cavities. Gold is an effective material, but it is expensive.

Are some people allergic to amalgam?
Allergic reaction to amalgam is very rare. Within 150 years of usage, there were only 100 documented cases. This type of patients should use other filling materials.

Disadvantage

The greyish-silver colour of amalgam is not aesthetically appealing.

Application

It's mainly used for restoring back teeth where stress load is high.

Procedures for amalgam filling

First remove decayed tooth substances.

Amalgam is placed into the tooth cavity.

The filling is shaped, excessive material is trimmed off and the filling is polished.

Before filling

After filling

Composite

It has been in use for over 40 years and has been undergoing improvement in the past 10 years.

Composition

A substance made up of acrylic resin filled with inorganic substances such as glass, quartz as additives to enhance the strength

Properties

Aesthetic; colour is similar to natural tooth, but will be stained by food after having been in use for a period of time

Disadvantage

Not as hard as amalgam

Application

To restore decayed teeth

Before filling

After filling

To restore the aesthetics of the teeth, such as to modify the shape, size and colour of the teeth

Procedures for composite filling

Decayed or weakened portion of the tooth is removed.

Tooth surface is etched with diluted acid (for example, 30% phosphoric acid).

Tooth adhesive is applied on the prepared tooth.

Composite is placed onto the prepared tooth and the restoration is shaped.

Filling is hardened by using a light curing instrument

Excessive material is trimmed off and the restoration is polished.

Glass Ionomer Cement

It has been in use for over 20 years and has been improved in recent years.

Composite

A substance made up of aluminosilicate glass powder and a liquid polyacrylic acid

Properties

Aesthetic; colour is similar to natural tooth, but lack of translucency

Bonds to the tooth

Fluoride releasing---prevents recurrent Dental Caries around the filling material

Disadvantage

Inadequate strength, low wear resistance, not durable

Application

To restore abraded teeth

Because it is not durable, it serves as a transitional filling for deciduous teeth

Procedures for Glass Ionomer Cement filling

Decay is removed.

Glass ionomer cement is placed onto the prepared tooth and the restoration is shaped.

Filling is hardened by a light curing instrument.

Excessive material is trimmed off and the restoration is polished.

Compomer


A newly developed material in recent years
Composition
It is a mixture of composite and glass ionomer cement.
Properties
	It possesses the properties of both composite and glass ionomer cement.
	Improved aesthetics and better wear resistance than glass ionomer cement but not as good as composite.
	Easy manipulation—as easy as glass ionomer cement but not as critical as composite.
Application
Used as transitional filling for deciduous dentition
Procedures for Compomer filling
	Decay is removed.
	Tooth adhesive is placed on the prepared tooth.
	Compomer is placed onto the prepared tooth and the restoration is shaped.
	Filling is hardened by using a light curing instrument.
	Excessive material is trimmed off and the restoration is polished.

Stainless steel crown

Silver in colour, fixed sizes, and usually used for molars of deciduous teeth

Procedures for stainless steel crown