Monday, February 22, 2010

Dentistry's Workhorse

Although I would like to think that as a missionary dentist I'm always doing something dramatic like fixing a broken mandible, doing extractions in the Bush, or rescuing a teenager who avulsed a central incisor; the majority of my time is doing the same thing I would be doing back in the United States; good old fashioned class II amalgam fillings (dentistry's workhorse) to treat inter-proximal decay.

Amalgam fillings have a longer and seemingly more derogatory rap sheet than Mike Tyson, Dental Amalgams have been blamed for almost everything including Autism, Alzheimer's disease, Meniere's Disease, Multiple Sclerosis, Arthritis, Alopecia, Tennis Elbow, and probably even Athlete's Foot. It doesn't really matter how many studies have shown that Amalgam is safe, junk science seems to predominate. It doesn't matter how many case studies show that after removing dental amalgams neurological disorders fail to improve (there is always one vocal person who swears by this treatment). It doesn't matter how many materials experiments show that the mercury in amalgam form is inert, OSHA is making it more difficult on our profession to use this material (even though the risk of mercury is much greater from eating fresh Tuna Fish than from amalgam fillings.)

Now I'm first to admit these fillings are neither sexy, fashionable, and/or state of the art. I completely understand that many who have the time and budget are going to prefer white fillings on there back teeth. But dental Amalgam has been our profession's workhorse for the last 150 years. There benefits are many including strength (withhold chewing forces), long lasting, self sealing, easy placement (able to be placed in a wet field), relatively quick placement allowed (good for children), and lastly are relatively cheap. In the end in Africa these restorations are appropriate, cost effective, and serve the community at large very well. I have amalgam restorations in my mouth and they will remain. And, after a quick polish they don't look too bad.

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