Concerns About Silver Filling Surface Irregularities in Dental Care

Q: Concerns About Silver Filling Surface Irregularities in Dental Care

Hello： If you have already had an X-ray and confirmed that there are no cavities and no particular discomfort, it is recommended to simply monitor the situation regularly. <br>The indentation in the old silver filling may be due to occlusal wear, and placing material directly on

Inquiry about Silver Powder Fillers

Dear Dr.
Lin,
Happy New Year! I recently noticed that the surface of the silver amalgam filling on my lower left first molar is somewhat uneven, with a small area that is slightly recessed.
The affected area is not large and not very deep.
This filling has been in place for about twenty years (or longer), and I am unsure whether it was originally like this or if the surface irregularity is due to the amalgam "wearing down" over time.
I have had an X-ray taken of this tooth, which confirmed that there are no cavities and I do not experience any discomfort; the issue is purely the uneven surface of the filling.
I would like to ask Dr.
Lin for advice on whether I should: 1.
Visit the dentist to have the recessed area of the amalgam filling smoothed out, or 2.
Leave it as is, as the tooth may naturally wear down and the uneven area may become smoother over time due to chewing and eating.
Which approach would be more advisable? Thank you for your guidance, Dr.
Lin.

Axiang, 30~39 year old female. Ask Date: 2022/02/16

Dr. Lin Jiayong reply Dentistry

Hello: If you have already had an X-ray and confirmed that there are no cavities and no particular discomfort, it is recommended to simply monitor the situation regularly.
The indentation in the old silver filling may be due to occlusal wear, and placing material directly on it will likely result in it being bitten off again, causing you unnecessary concern.
It is advisable to have regular check-ups every six months and to intervene promptly if any symptoms arise.

Reply Date: 2022/02/16

More Info

Hello! Thank you for your inquiry regarding the concerns about silver fillings, particularly the surface irregularities you've noticed on your dental restoration. It's great that you are being proactive about your dental health, especially considering that the silver filling has been in place for around twenty years.
To address your concerns, let's break down the issues related to silver fillings, also known as dental amalgams, and their potential surface irregularities.

1. Understanding Silver Fillings: Silver fillings are primarily made of a mixture of metals, including silver, mercury, tin, and copper. They are known for their durability and strength, making them a popular choice for restoring teeth that bear significant chewing pressure, such as molars. However, over time, these fillings can undergo changes due to wear and tear, corrosion, or even the natural expansion and contraction of the materials in response to temperature changes in the mouth.

2. Surface Irregularities: The irregularities you are observing, such as the slight depression on the surface of the filling, could be attributed to several factors:
- Wear and Tear: Over the years, the constant pressure from chewing and grinding can lead to wear on the filling surface. This is especially true if you have a habit of grinding your teeth (bruxism).

- Corrosion: Although dental amalgams are quite stable, they can still corrode over time, especially in a moist environment like the mouth. This corrosion can lead to changes in the surface texture of the filling.

- Marginal Breakdown: The interface between the filling and the tooth structure can degrade, leading to gaps or irregularities. This can sometimes be mistaken for the filling itself being uneven.

3. Should You Seek Treatment?: Given that your X-ray has shown no signs of decay and you are not experiencing any discomfort, you have a couple of options:
- Observation: If the irregularity is minor and not causing any issues, you might choose to monitor the situation. Over time, it is possible that the irregularity could smooth out naturally due to the wear from chewing. However, this is not guaranteed, and it may take a long time.

- Dental Consultation: It would be prudent to consult with your dentist. They can assess the filling more closely and determine if any treatment is necessary. If the irregularity is significant enough to warrant concern, they may recommend smoothing it out or even replacing the filling if there are signs of deterioration.

4. Potential Risks of Leaving It Untreated: While minor surface irregularities may not pose an immediate risk, they can sometimes lead to complications. For instance, if the filling is compromised, it could allow bacteria to enter and potentially lead to decay underneath the filling. Additionally, if the irregularity affects your bite, it could lead to discomfort or further dental issues.

5. Conclusion: In summary, while it may be tempting to leave the filling as is, a consultation with your dentist is advisable. They can provide a thorough examination and determine the best course of action based on the condition of the filling and your overall dental health. Regular dental check-ups are essential, especially for older restorations, to ensure that they remain functional and do not lead to further complications.

Thank you for your question, and I hope this information helps you make an informed decision regarding your dental care!

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