Safe Amalgam Filling Removal with Tooth Grinding and Clenching:
Amalgam filling removal in patients who brux and grind their teeth can be challenging cases. Clenching teeth will accelerate the rate of mercury release from the amalgam fillings and also cause the mercury containing fillings to break-down faster. Tooth wear or specifically wear of the enamel including cracking, chipping and abrading of the enamel will predispose teeth to decay and will prematurely break down existing filling materials. In the picture below, the yellow area adjacent to the amalgam filling is where all of the white enamel has been worn away, exposing the underlying Dentin. The amalgam filling is also crumbling and separating from the tooth. All of this damage was caused by a TMJ problem. TMJ or TMD is defined as a misalignment between the best fit of the teeth and the path of closure of the jaw. It is also typically complicated by an upper airway problems and general complaints from the patient about head and neck pain. The “TMJ” causes tooth clenching and grinding or bruxism among many other symptoms. Temporomandibular joint problems can be diagnosed and cured by a specially trained dentist using dental appliances for sleep apnea and TMJ.
Amalgam fillings Release More Mercury and Break Down Faster When There is Teeth Clenching
In the case below, the amalgam filling was removed using the IAOMT.org safe amalgam filling material protocol. Additionally the TMJ problem was improved with a bite adjustment and the exposed dentin was sealed (as was the original amalgam filling material) with a BPA-free tooth colored composite filling material. Tooth colored composites can out perform silver fillings in many ways, but not having mercury sure makes them a less concerning chioce.