Hello. I have a gold onlay on a molar. I have had it for 28 years and the gold on the top surface of the tooth is worn out. My dentist says he can cut the top off and fill in with amalgam, keeping the gold around the sides of the tooth. I was wondering if composite filling could be used for this to improve the look. I also don’t like amalgam.
Thank you
- Penny from New York
Penny,
Part of your question is simple, and part is a little complicated.
A gold onlay is like a crown that covers the entire tooth, except that it covers just the chewing surface and goes down the sides partway. They can last a long time if they’re done well, and it looks like yours was done well.
Yes, I would much prefer in my own tooth or in a patient’s tooth, to have the hole repaired with white composite rather than amalgam.
Another issue with plugging the hole with amalgam is that you would then have two dissimilar metals in the same tooth. This creates a slight electric current, which would accelerate the corrosion of the amalgam. Plus, a little of the mercury gets absorbed in the surface of the gold.
The complication is that, if your dentist prefers using amalgam here, he is not one I would ask to do the composite repair. Dentists who know how to do the composite repair well almost universally prefer that technique. It is very risky to try to nudge a dentist out of his or her comfort zone. They will not want to reveal their discomfort with a procedure, and it’s a recipe for disaster. These composite fillings are very technique sensitive, and many dentists don’t know how to do them well.
Bottom line – if you want to have your dentist do this, let him do it the way he wants. If you have a problem with that, seek out a dentist who does composites on back teeth routinely. A good way to find such a dentist is to call the office and ask if the dentist does very many silver fillings (as if that is what you wanted). If they tell you the dentist doesn’t do many silver fillings or doesn’t recommend silver fillings, then you can be fairly sure he or she is very comfortable doing composites on back teeth.
Link: See our page explaining that Dr. Kagan is a mercury-free Boca Raton dentist.