Amalgam is still used in the dental practice of health insurance companies. The reason: it is above all socially acceptable! From a health point of view, however, it is questionable (see amalgam restoration), which is why very conscientious dentists refuse to process this material.
But is plastic filling a cheap alternative?
The plastics used in dentistry are the so-called composites. The word composite comes from Latin (compositum) and means “composed”.
In fact, they consist of an organic matrix (the plastic) and inorganic fillers. A composite phase of silanes provides the intimate bond between the plastic matrix (resin) and the fillers (quartz and glass). Depending on the make, the filler content is between 65 and 85 percent by weight or 55 to 75 percent by volume. The plastic used (organic matrix) is almost exclusively the “Bowen resin”, bisphenol A glycidyl methacrylate (Bis-GMA).
Bisphenol A is a xenoestrogen with an estrogen-like effect and is suspected of being harmful to health and genetic material. It not only interferes with sexual development, but also with brain development in mice and birds. According to current American studies, obesity, which is widespread today, could also have one of its causes.
When heated and exposed to acidic pH, individual BPA molecules may detach from the filling. In the organism, BPA works similarly to the female sex hormone estrogen. In animal experiments, it interfered with embryonic and brain development, caused infertility, cancer and behavioural disorders. Studies by Frederick vom Saal have shown that women with high concentrations of bisphenol in the blood are on average heavier than women with low levels. Children of highly BPA-loaded women are clearly fatter than those of unloaded women.
Conclusion: Those who exchange amalgam for plastic for biological reasons are doing their patients a disservice!
Further arguments against plastic fillings:
- In a chemical equilibrium reaction with a change in volume, polymers change to the solid state. However, this reaction always leaves liquid monomer components, which on the one hand are toxic to the pulp and damage the nerves, and on the other hand lead to stress states due to the change in volume and thus to the formation of gaps due to tears in the adhesive joint. This gap formation leads to an increased caries risk, especially in the interdental areas which are difficult to control.
- Polymer fillings suffer a renewed change in volume in the cavity as a result of aging and the absorption of fluids. As they age, they become vulnerable to bacteria and possibly to digestive enzymes in the oral cavity. The very specific bacterial spectrum under leaky polymer fillings is frightening in its composition and aggressive potency. If one compares this with amalgam fillings, then plastic cuts off extremely badly.
- Polymers still do not have sufficient deformation and abrasion resistance in the posterior region.
“From a scientific point of view, it is currently unacceptable to ban amalgam as a filling material. Current research shows that substitute materials, such as those based on plastics, are far from being able to cover all the indications for amalgam fillings. The biological problems of such plastic materials are largely unexplained and therefore require intensive bio-medical research”. With these words, the President of the German Society of Dentistry, Oral Medicine and Maxillofacial Surgery (DGZMK), Prof. Dr. Georg Meyer, University of Greifswald, addressed the German EU parliamentarians at the beginning of 2006 in order to avert an imminent ban on amalgam. (DZW 12/2006, S.2).
The composites contain substances such as the monomers triethylene glycol methacrylate (TEGDMA) and hydroxypropyl methacrylate (HEMA), which can trigger allergic reactions. In a Danish study, for example, contact eczema was detected in 2% of participating dentists using these materials.
Plastic fillings are therefore no alternative to amalgam.
According to the current state of science, it is therefore premature to describe composites as a more compatible amalgam alternative. An increase in allergies to these plastics due to the displacement of amalgam is to be expected (Brehler et al. 1993). They in no way meet the requirements that should be placed on a biologically compatible long-term filling material. The adhesives necessary for this change constantly, the compositions can be even the dental material trained or interested expert chemically or toxicologically hardly assign. Micro-gap formation at the edges, plastic ageing products as bacterial substrate, undeclared ingredients, these materials have absolutely nothing to do with a “holistic view”, if “holistic” should not mean exclusively the purse of the patient. Because for this type of filling, a private portion has to be paid in addition to the health insurance fee almost everywhere.
The use of stone cements (translite) is recommended as a short-term solution.
Only gold inlays and ceramic inlays are available as long-term filling materials.
Forum for Dentistry
Do you have questions, criticism or suggestions to this article? Feedback to: The nervous tooth you can post these in our forum for dentistry: Plastic fillings – an alternative to amalgam?