Amalgam and its position in modern dentistry
In modern dentistry amalgam is considered an out of date material, which always has better substitutions (except a few exceptions).
The main advantages of amalgam are low sensitivity to moisture during placement in the mouth and some antibacterial effect in the immediate closeness. If under the amalgam filling is created a new decay, it will spread slowly than under photo-composite filling. Tolerance to errors also allows, that amalgams “on the assurance company” were done for 5-10 minutes.
The main disadvantage of amalgam from the patient's perspective is clearly aesthetics. Visible is not only filling, but as amalgam grows old, metal ions are released out of its and can colour tissue of tooth around amalgam filling.
The main disadvantage of amalgam from the doctor's perspective is the absent bond on dental tissues. It is always necessary to ensure, that the bottom part of filling was wider than upper and so that amalgam have stayed after solidification wedged in the tooth. This wedging is only one mechanism, which holds teeth. In order to creation of this shape, it is necessary to drilling more than is the extent of tooth decay. Simply said, amalgam packs out the hole in the tooth. The teeth practically remain firm, as if they do not contain a filling and they often cracks. In contrast, modern photo-composite fillings are strongly weighted on the tooth and can hold weak parts of teeth together and prolong their vitality.
Disadvantages of amalgam are allergies to metal. Amalgam contains metals (silver, mercury, copper, tin...) which may cause allergic reactions such as burning sensations, tingling, various rashes on the gums and mucous membranes of the oral cavity.
A separate chapter is the issue of mercury toxicity, which is dedicated to another article.