Will I Need Dental Implants if I Have Metal Fillings Removed?

My doctor told me I’d need to have dental implants if I had my mercury fillings replaced with tooth-colored ones. I went in for a consult because I’ve been worried about my overall health and read that some of the problems I’m physically having could be related to high levels of mercury. I thought it would be a smaller thing. I have six metal fillings altogether, but they’ve never given me any trouble. He said that the ones on my premolars were small enough that he could probably swap out the fillings, but that the ones in my molars are too large for replacement—that the only option is to pull the teeth and have dental implants done instead. That presents two problems. 1) Isn’t that overkill? I don’t see how that is necessary since the teeth are fine now. 2) I really wanted to be metal-free. It’s my understanding that dental implants use metal posts of some sort. So, how would that even help? I don’t know if he’s giving me sound advice, trying to scare me out of replacing my fillings because he thinks I’m some kook, or if he’s just trying to gouge me.

Thanks,

Andrea

Dear Andrea,

You should get a second opinion before you do anything else, but let’s break down the basics.

Amalgam Fillings Can’t Always Be Replaced with Composite Fillings

The tooth-colored fillings you referenced are called composite fillings. They actually bond to the tooth itself, so the process is pretty straightforward. The dentist just removes the decay or damage, prepares the tooth to receive the composite, places it, and then cures and adjusts it for a perfect fit. Amalgam fillings, also called mercury fillings or metal fillings, don’t bond to the tooth. The dentist has to cut out a small notch of tooth structure to ensure the filling is retained. That also means they sometimes leak, especially when they’re old. It’s common for dentists to remove an old amalgam and find decay under it. Oftentimes, once everything is cleaned up, there’s often not enough tooth structure left for a filling to provide adequate support.

The Common Replacement for Large Amalgam Fillings is Crowns

The idea of extracting those teeth is extreme though. Crowns are usually the ideal fix. The dentist will build the tooth back up using filling material and then place a restoration that covers the full tooth for maximum support. Sometimes, it’s a full porcelain crown while other times the porcelain has metal below it for more strength. Some dentists also do CEREC crowns or similar, which is a crown made in the office from a block of ceramic. This would be a metal-free option as well.

Dental Implants Usually Have Titanium

You are correct in that most dental implants have metal. However, it’s usually titanium and they’re mercury-free. If it comes down to it, you might be able to find someone who is willing to use ceramic or similar, but titanium is the metal used throughout the body and is incredibly safe.

Get a Second Opinion

It’s odd that your dentist jumped from fillings to dental implants when there is a whole lot of middle ground between. Get a second opinion from another dentist before you have any treatment done.

This blog is sponsored by Dr. Steve Sirin, an Elgin dental implant provider and mercury-free dentist.