I am convinced by the peer reviewed science with regards to amalgam and believe the Word Health Organization, FDA and ADA have it right when they say it isn’t a health problem. Amalgam fillings don’t leak per se, but they do release mercury vapor. The peer reviewed literature looks at the minimum dose of micrograms of mercury vapor that is released from amalgam that would be needed to cause disease/symptoms. What they’ve found is that so very little is released in even from a full mouth of amalgam fillings that it should not cause disease/symptoms. I believe this to be reasonable.
Here is something else. Amalgam fillings are very durable! They last 30 years while a white filling needs replacement several times during that period at additional expense to you.
Some may still say for any reason that they don’t want amalgam fillings and I never argue with them, but simply respect their choice and give them good care. I always listen to my patients.
I am convinced by the peer reviewed science with regards to amalgam and believe the Word Health Organization, FDA and ADA have it right when they say it isn’t a health problem. Amalgam fillings don’t leak per se, but they do release mercury vapor. The peer reviewed literature looks at the minimum dose of micrograms of mercury vapor that is released from amalgam that would be needed to cause disease/symptoms. What they’ve found is that so very little is released in even from a full mouth of amalgam fillings that it should not cause disease/symptoms. I believe this to be reasonable.
Here is something else. Amalgam fillings are very durable! They last 30 years while a white filling needs replacement several times during that period at additional expense to you.
Some may still say for any reason that they don’t want amalgam fillings and I never argue with them, but simply respect their choice and give them good care. I always listen to my patients.
Thanks for chiming-in. This is helpful. One question - why does dental insurance not cover this procedure, if it is clinically necessary for some people at some times?
You could argue that insurers lose money on anything they cover, even routine 6-month cleanings. Health insurers have doctors and specialists working for them that set policy - I assumed dental insurers have dentists and other health professionals working for them that help them set policy as well. If a procedure is medically necessary, why is it not included to be covered by their medical policy? It’s not always about the money.
At least in my case, “deep cleaning” or “root planning” is never covered each time it was offered to me over the years by several dentists with several dental insurance plans. It seems the procedure is not seen as necessary, at least by the insurers. If this is a needed thing (like fillings, extractions, and root canals), I would think the industry would have resolved it as such by now.
Whenever your health professional offers you something that is not covered by insurance, you should ask them why.
Dental insurance really isn’t insurance as we think of it. It doesn’t cover you in a calamity. It doesn’t pay for you until you are healthy, like medical insurance. It’s really a limited benefit plan that helps pay for some of your care. It’s definitely better than nothing, but not particularly good.
Scaling and root planing is absolutely necessary to avoid tooth loss. Periodontitis is a slow process that often times takes 10-15 years to cause tooth loss and symptoms but it happens sure enough if untreated. There is mountain of peer reviewed science on this subject and radiographs taken each year can actually document the bone loss that occurs with the disease. Periodontitis is the number 1 cause of tooth loss world wide, even more so than cavities. No one disputes this.
A good dentist should take time to explain the disease and answer all your questions. A good dentist should be willing to show you the x-rays, probe scores, or even let you look at a perio probe dropping 6 mm into your gum pockets by having you look in the mirror while he checks your gums.
I understand the confusion that the discord between the dentist’s recommendation and the insurance benefits causes. I don’t like how insurance companies come between the doctor- patient relationship. I will tell you that insurance companies have a financial interest in making sure they pay out as little as possible in benefits. Unlike dentists, they do not take an oath to patients, unlike dentists they are not governed ethically and clinically by a state dental board. They are in this only for the money. After you pay them your premium, anything they don’t pay out to you drops to the bottom line.
Now you could say dentists are motivated to be concerned for what is best for you health. Or you could say they are motivated to doing a procedure that makes them money. These are both true. I think money is a challenge to any person’s ethics in this world. We can’t escape these concerns and you are smart to consider them. But ultimately you need to trust your dentist for your oral health’s sake. If you don’t believe the one you have, by all means drop him/her. But then find a cool dentist you do trust.
Insurance companies do have dentists working for them to review claims, don’t know about policy making. Dentists often get a claim denied saying their reviewing dentist determined the the procedure wasn’t necessary and is therefore denied.
I just had a full gold crown denied because the insurance company’s “Dentist” said there wasn’t enough gold in it. Turns out he/she didn’t know the difference between Au and Ag on the lab slip. Of course in these cases the “Dentist” is I am sure an $8 an hour high school graduate clerk.
Sometimes when a claim is denied some insurance companies send letters to patients stating that the claim was denied because the dentist was doing an unnecessary procedure. The implication that the dentist is a cheat and the insurance company is looking out for the patient by not paying.
I hadn’t seen a dentist for an appallingly long time. Had one checkup by an obvious quack–how to find a good one? There’s a dental school near where I work with a large clinic offering low-cost dentistry. And a small clinic staffed by the faculty–which accepts my insurance!
A deep cleaning was recommended; really, it had been a long time. Since I hadn’t had one before, insurance paid all but the co-pay. No fun but I won’t need another one if I’m good about “regular” cleanings.
A filling needed replacing. The dentist asked whether I wanted “silver” (amalgam) or white. I picked amalgam & she was glad. Said it was stronger.
I have a couple amalgam fillings approaching 40 years old. They aren’t on biting surfaces, that probably accounts for some of their longevity.
The last two dentists I’ve had said that as long as the fillings are intact and stable there’s no reason to replace them. Basically, leave well enough alone.
Recently had two fillings, my first in 25 years (yeah, past 50 and everything seems to be going to hell…) The dentist said he doesn’t do amalgam fillings anymore, so I got the “white”/resin/whatever ones.
Hoping it will be just routine cleanings going forward, at least for a couple decades.
Due to a lack of money and insurance my GF has not had regular teeth cleanings in over 5 years. She went to my dentist’s office and they said she needs the deep cleaning/scaling/planing. I’ve been going to that office for over 10 years and they are honest from what I can tell. Never seen them push extra stuff for me.
Is skipping regular teeth cleanings for 5+ years mean you are more likely to need the deep cleaning, in general? She does brush well at home every day. I go for a cleaning every 6 months and never had deep cleaning.
Good friend of mine went for their first dental appt in 14 years a few months back (dental insurance was out of their reach till the ACA). They’re diligent about avoiding sugar and use a sonic toothbrush, rinses, etc.
No cavities, but the dentist said there was significant plaque in the usual hard to reach places where saliva settles. He said he removed as much as he could in the time allowed for the appt and for the friend to have a deep cleaning when they come back for their next 6 month appt. Even w/ the usual cleaning they raved about how their teeth felt.
This is what happened to me. In my early 20s I didn’t have dental insurance, so there was about a 2-3 year period where I didn’t go to the dentist. Brushed everyday, never had a cavity. First visit back to the dentist, they said my gums were in really bad shape and I had pretty bad gingivitis and that root planing was necessary.
Some people are more prone to gum disease than others. It didn’t help that I hardly ever flossed. Those 6-month visits really do wonders. Missing them hurt me a lot.
You’ve probably heard of Dr. Weston Price, the dentist who traveled the world researching indigenous hunter-gatherer people. He often found 80-year-old people with perfect teeth, because they got K2 from their diets and didn’t eat seed oils, grains, and most sugars. If someone here in the US doesn’t eat seed oils, grains, and most sugars, and supplements with D2 and K2, what would cause the bacteria and tarter to accumulate under the gum line, and why can’t antibiotics get rid of it instead of the patient having to basically go through surgery?