No more amalgam!

Oct 20, 2009

Editor's note: Helaine Smith's column, The Mouth Physician, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

During a recent congressional review of Medicare and Medicaid services, Rep. Diane Watson (D-CA) suggested that dentists should be discouraged from using amalgam because "you have gas constantly escaping," a health concern she thought should overshadow any savings in cost.

Finally a politician talking some sense! (Even if it is about amalgam.) Although I do not believe that gases are constantly escaping from ugly black amalgam fillings, I firmly believe amalgam should not be the restorative material of choice in children or adults. With all the advances in composite resin materials, there just is no need to use it anymore.

I do not understand why dentists stubbornly hang on to a material that is part of dental history. Even in an insurance-driven practice or a Medicaid practice, cavity preps can be economically restored with composite, and it is better for the patient.

My practice has been metal free for more than 12 years. I can assure you there is no need to use amalgam or porcelain-fused-to-metal (PFM) crowns. If you take the time to learn about composite resins and how to use them according to what is recommended by the manufacturer, these materials work very well.

I can understand why people debate political issues such as Roe versus Wade and capital punishment, but the fact that we have not thrown away amalgamators is a debate I will never understand.

If anesthesiologists followed this same path, they would still be using ether. Yes, it worked, but there are so many other options that work better and improve the outcome for the patient. We need to be mouth physicians and keep up with the times and technology.

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