Kevin W. Toal, DDS
St. Louis, Missouri
I have read with interest the discussion of amalgam vs. composites. However, I did not see a single mention about the potential estrogenic effort of the new composite filling materials. While it is known that the composites are estrogenic, it is not yet clear what the effects are on humans, if any.
Xenoestrogens can have long-term serious adverse health effects. Yet the proponents of the amalgam-free practices blithely promote a material that may have far more potentially dangerous effects than the Oanti-amalgamistsO ever alleged for amalgam. Remember? First do no harm!
Any restorative material that has the longevity of amalgam has to have something said for it. Extensive amalgams function for more than 30 years, and I have some well-made gold inlays and well-made composites with a far shorter function life span.
It has been noted that a Owell doneO amalgam is a technically demanding procedure and, as such, demands fair compensation. Therein lies part of the problem. Dentists themselves denigrate the service of an amalgam restoration by rushing the procedure because they are not getting fair compensation, rather than performing the best amalgam restoration at a good and fair fee.
Several mentions were made describing amalgams as black and ugly. Have these dentists been taught to polish amalgams or do they not recognize discolored composites?
In any event, while composites no doubt have a place in dentistry, it is questionable whether they should, at this time, be used as a posterior filling material where functional and non-functional forces can increase the potentially toxic load to the patient. Until we can prove, for our patients? welfare, that the material is safe for both long-term and short-term use, we should avoid amalgam-free practices unless it is going to be an all-gold or all-porcelain practice, or so it seems to me.
