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Did This Direct Pulp Cap Work?

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I had a direct pulp cap done. It was needed because the pulp was exposed while trying to remove some tooth decay. Any bleeding was controlled with a cotton palette, which my dentist said was a good sign. He had to leave some of the decay because it was so close to the pulp. Then he lined the exposed area with calcium hydroxide and placed a glass isomer on top. Then he placed an amalgam filling. It’s been fine, but I live in fear that this is going to go south. When will I know I’m safe and this was a successful procedure? If I am going to need a root canal treatment, will there be any signs? Sometimes I think I feel something, but I don’t actually know what   I should be feeling.

Emma

Dear Emma,

before and after mercury free fillings

 

Doing a direct pulp cap can work well if it is done right and usually has a high success rate. The good news is, when there are problems, they usually show up right away. That being said, there are a couple of things about the way yours was done that complicates things just a bit. First, it is important that all the decay is removed. Any decay left, especially when you use an amalgam filling will continue to grow and will eventually infect the tooth.

He did a great job with the  next steps. He checked for viability of the pulp. The bleeding was controlled so the pulp is fine. The two materials he used next were good choices as well. The calcium hydroxide will release a small amount of fluoride which will help keep some of the decay at bay. I am concerned he used an amalgam filling instead of a composite filling. Composite bonds directly to the tooth, which seals it. Amalgam fillings tend to weaken the tooth.

Don’t spend all your time worrying about this. I would wait a year or so and have your dentist x-ray the tooth again to check the health of the tooth. If the root is still healthy, have him go back and remove the rest of the decay then place a new filling on the tooth. The amalgam filling will need to be removed using a sanitary amalgam removal.   Then replaced using a composite filling.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Is it Safe to Remove Amalgam Fillings?

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I want to remove my silver fillings. It makes me nervous to have them. Yet, my dentist insists removing them isn’t safe. How can it be safe to keep them in but dangerous to remove them?

Laurie

Dear Laurie,

before and after silver amalgam fillings

Removing amalgam fillings requires special knowledge and equipment. Without that, you risk inhaling mercury vapors or swallowing some bits of mercury. As this is a known toxin, that is not what you want to do. There is a specific procedure known as a sanitary amalgam removal. This can safely remove your silver fillings and allow your dentist to place them with mercury-free composite fillings.

It doesn’t sound like your dentist knows this procedure. It wouldn’t be safe for you to have him remove them. Instead, I’m going to suggest you look for a dentist who promotes themselves as mercury-free dentists. They will know the procedure.

You don’t have to switch dentists to do this. You can just get your fillings switched and then go back to your normal dentist. However, to me, it doesn’t sound like your dentist is keeping up with his industry very well. You may want to explore your options when it comes to your dental care.

A Cosmetic Consideration

If any of your fillings are in a visible place on your teeth, you may want to consider getting teeth whitening before you remove your old fillings. Once your white composite fillings are made the color won’t change. If you want them to match your teeth, you’ll want to get your teeth the color you want to stay with.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.