Amalgam restorations - our most vexatious topic - a silver material that is paid for 100% by the German public health insurances.
Amalgam restorations - our most vexatious topic - a silver material that is paid for 100% by the German public health insurances.
When Cerec, technology that allowed ceramic fillings to be made chairside in only one appointment and the patient could go home with the finished porcelain restauration at the end of the appointment, was introduced into the surgery in the mid-nineties, we thought that we could turn our backs on amalgam. The material had become unpopular over the years and white fillings became more and more favourable. It was also said that Amalgam was the cause for many disease patterns and allergies. Especially the natural health practitioners promised the patient that many illnesses and problems could only be healed by removing all amalgam fillings in the course of a so called amalgam rehabilitation and a therapeutic detoxification.
After more than three decades we did not see one patient in our surgery where the existing medical problems disappeared after the removal of the amalgam fillings!!!
We are no amalgam devotees and would prefer to provide all out patients with porcelain restaurations (inlays or crowns). But unfortunatley this type of treatment is fairly expensive and it is not supported by most of the insurances or the subsidy is very low. According to our observations up to now composite fillings (plastic) in molars (back teeth) are not a long-term solution as they come with a number of disadvantages (see also the article: why are large composite restaurations in back teeth a catastrophe?)
Many young people are students and don't have the financial capabilities to pay for expensive dental treatment.
The amalgam has changed ompletely over the course of many decades and has served many generations of patients well by keeping their teeth functional for many decades. For this reason, because the health insurances pay for amalgam to 100% and because there are many patients without the financial possibilities to restore their teeth properly, we decided a few years ago to reintroduce amalgam into our surgery. This way these patients can stabalize their oral health and if have the possibility to get high-end treatment at a later stage.
The decision pro amalgam is purely based on rationality and was not taken lightly.
What we regret the most ist that our health care system has become so ridgid. We have the knowledge, capabilities and the equipment to practice high end dentistry, but the system reduces us to practise the most basic dentistry. It allows us to do the bare minimum of treatment with little foresight, unless the patient is in the lucky position to e able to pay the treatment out of their own pocket.
This is for both, the dentist and the patient, extremly dissatisfying.
Mabybe some patients have the foresight like us and see amalgam as a cheap/free temporary solution and can live with the decision to have amalgam fillings.