Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break

Hello,

I’m the director of Seoul Bardi Dental Clinic.

"It was filled with amalgam before,

so if it doesn’t hurt, can I just keep using it?"

This is one of the most common questions we hear during checkups.

The silver-colored "amalgam," which looks different from tooth color,

is such a long-used material that many people leave it alone if there seems to be no major issue.

I also often tell patients,

"If there’s no problem, there’s no need to replace it in advance."

But if secondary decay is quietly spreading inside an amalgam that looks fine on the surface,

the story changes.

Today, through a painful case in which a natural tooth that we wanted to save ultimately could not be preserved,

I’d like to once again emphasize the importance of regular checkups.

1. Is amalgam automatically a bad material? Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break

Amalgam is a material made by mixing metal powders such as silver and copper with mercury,

and it has been used in dentistry for more than 100 years.

It is covered by health insurance, so it is inexpensive, and it has the clear advantage of being durable.

However, because it is not bonded directly to the tooth but packed into the cavity,

small gaps can easily form between the tooth and the material over time.

Since it is metal, corrosion can also cause the tooth to become darkly discolored.

In fact, if it is well maintained, it can last comfortably for more than 10 years,

but it is important not to miss the signs that it is nearing the end of its lifespan.

2. When is it best to replace amalgam? Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break If there is no problem, there is no need to replace it in advance.

But in the following cases, you should look more carefully.

• If a black line is visible around the amalgam or a gap has opened up

• If part of the amalgam has broken off or fallen out

• If you feel sensitivity to cold water or discomfort when chewing

This is because once a gap forms, bacteria can enter through it and cause secondary decay that eats away at the inside of the tooth.

Even if it looks fine on the outside, the inside may already be damaged.

3. The danger of painless secondary decay, and why the patient came in with a broken tooth Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break

Recently, a patient who came to our clinic had a broken lower left premolar.

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The amalgam that had been treated long ago had gradually come apart,

but because there was no pain, the patient kept using it as is.

However, when we performed a detailed examination, the situation was more serious than expected.

Secondary decay had progressed very deeply under the amalgam.

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It was similar to a worm leaving the outside of an apple and eating only the inside.

As the soft tissue inside the tooth had become hollow from decay,

it eventually could not withstand chewing force,

and half the tooth broke off..ㅜㅜ

4. We tried to preserve the tooth, but why extraction was decided Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break

As someone who values natural teeth above all else,

I desperately wanted to save the patient’s tooth if at all possible.

Fortunately, there was no sign of inflammation around the root,

so we discussed the possibility of root canal treatment and placing a crown

so the tooth could be used strongly again.

However, because of the impact when the tooth broke, there was also a possibility of an invisible

"fine crack" in the root area, so I explained that carefully.

I also cautiously explained in advance that if pain remained even after the treatment was completed with great care,

extraction might be unavoidable at that point.

Since the patient also wanted to keep the tooth rather than remove it right away,

I continued the treatment with great care and a sincere desire to save it.

But unfortunately, even after treatment, the throbbing pain every time the patient ate would not go away.ㅜㅜ

In the end, we judged that the suspected crack in the root area was the cause,

and after discussion, we decided on extraction so the patient would not have to suffer more.

5. Implant treatment process and completion of the final prosthesis Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break Fortunately, there was no inflammation spreading around the root,

so we performed immediate implant placement on the same day as the extraction.

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We confirmed that it was placed in the most ideal position while maintaining sufficient distance from the nerve canal.

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Five months later, after confirming that the implant had firmly integrated with the bone, we moved on to the final prosthetic stage.

For implants, minimizing the margin of error and making an accurate prosthesis is the most important thing.

We use an intraoral scanner to precisely capture the oral structure as digital data,

which helps minimize the minor distortions that can occur when taking impressions with rubber material.

Based on this detailed data, we fabricated a custom prosthesis for this patient in our in-house lab.

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I personally checked and finely adjusted it so that it would fit well with the surrounding teeth,

and now the patient is eating comfortably again, just like before. ^^

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As a doctor, the most difficult moments are when I have to let go of a tooth that I believed could be saved.

But rather than forcing treatment to continue without knowing the cause,

I believe making the right decision at the right time is the way to protect the patient’s health.

Before (231004) After (251121)

If anything seems even slightly off around an amalgam,

or if it has been more than 10 years since treatment, please be sure to get a regular checkup.

Just because there is no pain does not mean everything inside the tooth is fine.

I will always think with you so we can protect the lifespan of your precious teeth.

Thank you. ^^

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Amalgam Fracture: It Broke a Little, but a Secondary Cavity Caused Half the Tooth to Break

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| This post was written directly by Seoul Bardi Dental Clinic for the purpose of providing medical information, in compliance with Article 56, Paragraph 1 of the Medical Advertising Act. We recommend that the information provided be used for reference only, and that symptoms and accurate management methods be obtained through a visit to a medical institution and consultation with medical staff. All procedures / surgeries performed at the dental clinic may involve possible side effects depending on the individual (inflammation, bleeding, swelling, etc.). Please decide after sufficient consultation with medical staff in advance. The treatment cases in this post were photographed with the consent of patients who completed treatment at our clinic, and the before-and-after photos were taken under the same conditions. |