The Disadvantages Of Amalgam As A Filling Material

Amalgam Fillings

Colour

The first obvious disadvantage of amalgam is its colour. In the past, it was acceptable to have a mesial-occlusal cavity in first premolars, second premolars or first molars. Nowadays patients are much more conscious and they might find this unacceptable.

Having said this, I know many dentists who still prefer to have an amalgam as their dental filling material of choice. Also, amalgam can still be used in class V buccal or palatal cavities due to the other advantages it has as aesthetics are not that important in this region of the mouth.

Does Not Bond To Enamel

Amalgam does not inherently bond to enamel or dentine and although this is a disadvantage, as already stated above, amalgam does produce its own seal due to the way the material sets and reacts.

Crown Cannot Be Prepared At The Same Visit

Amalgam can be used as a core build up material under crowns but then that crown cannot be prepared at the same visit. This is because amalgam takes several hours to achieve a final set and any dentist who has tried to prepare an amalgam core for a crown soon realises what a horrible mess it makes. Amalgam dust just goes absolutely everywhere.

Potential Errors

For large cavities, amalgam requires extra retention in the form of pins and posts. Unfortunately, dentine pins do require considerable skill and it is easy to accidentally drill into the dental pulp or into the periodontal ligament. Dentine pins can also sometimes weaken tooth structure. However, when a core is required after a tooth has been treated, the amalgam can be packed into the root creating a post. These posts are extremely effective and you can ensure a good margin of adaptation.

Health Scares

The health scares around amalgam are largely unfounded and have no scientific basis whatsoever. They are driven by consumerism. In addition, it is disposal of the amount of amalgam waste that has also created problems. However, most of the mercury waste is created by the use of hairdressing products. In any case, dentists now need to have amalgam separators attached to their suction units so that the mercury does not go into the water supply inadvertently.