Dr. Hall,

A substantial amount of tooth structure was removed during the procedure of 3 fillings in my molars. Those teeth were not painful, so I do not understand why it was necessary. The edge of one tooth was removed with the filling overflowing on that part to replace it. A little bit disintegrated, thus a bit of gum is exposed. Food gets stuck there fairly easily.
I am curious as to what type of filling material was used. I think it might be amalgam glass ionomer. It is a lighter colour than traditional amalgam fillings, and different in texture.
Also, how long should those fillings approximately last before they need to be replaced? I am only 20 years old, so I don’t know how what options I have to make those teeth more functional and aesthetically pleasing. I am distraught.

– anonrocker in the U.K.

Dear anonrocker,

I can only guess at the type of fillings you got. It would help to know on what basis you are saying these were amalgam glass ionomers. Kind of sounds like they told you something about it for you to use this term “glass ionomer.” And you don’t say what was different about the texture.
I’ll take your word that it was indeed a glass ionomer restorative and guess from there. There is a product called Miracle Mix that is a glass ionomer mixed with a silver alloy, so it has a grayish color to it. It is used usually as a buildup material for a large cavity when the tooth needs a crown, and the crown is then done over this restorative. I also used it as temporary fillings when a person had a lot of decay that needed to be arrested quickly and economically. Then we would either go back and drill off the surface of the Miracle Mix and do a composite filling on top of it, or we would do a crown over it.
Miracle Mix comes packaged in little capsules similar to the way amalgam is packaged, and it mixes in an amalgamator, also the same as amalgam. It is very quick and easy to use (i.e. cheap). There is no mercury in it
A nice feature of this restorative is that it has a high fluoride release, so it resists any recurrent decay on the tooth. Another nice feature is that it has a moderate chemical bond to tooth structure, so the tooth is unlikely to break around it. A not-so-nice feature is that it isn’t very wear resistant. It has kind of a gritty texture to the surface, and it will both wear off and dissolve over time, so that it will likely last only 2-3 years.
The good news is that your teeth are probably just fine for right now, except for the place where the food gets stuck. That should really be fixed because it will promote decay and gum disease in that spot. The bad news is that you’re going to have to have all these fillings fixed later. You shouldn’t need to have the fillings replaced–just re-surfaced with something more wear resistant. Go back to the dentist and ask if this was indeed Miracle Mix or some other similar glass ionomer restorative, and then go from there.
About the amount of drilling. While it could be that the dentist drilled away too much, a tooth with a large cavity can easily be asymptomatic. In fact they usually don’t hurt. So it’s also entirely possible that the dentist didn’t drill away too much.
If you want quality dental care in the UK, my advice would be to get away from the government program. It’s nice that so many people are getting dental care. But there is little incentive in your government-covered dental care for excellence in treatment–all the incentive is to run the patients through and take care of what they need in the easiest, quickest way possible.

– Dr. Hall

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