We Need To Stop Teaching Amalgam Restorations

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When was the last time you placed an amalgam? When was the last time you placed a pin?

Back in dental school, the first thing we were taught was how to prepare teeth for amalgam restorations and how to place them. But with the advent of new composites and bonding systems as well as increasing patient awareness of modern dentistry, amalgams simply have no place in clinical care in 2017 (and beyond).

Patient’s don’t want it

 

Let’s face it. Amalgam restorations are damn ugly. Even if you carve anatomy into them. Patients prefer something that looks natural in their mouths. Also with increasing concerns about mercury (whether they are unfounded or not) most patients will try to avoid them. If there were no price differences between composite and amalgam, there would be no market for amalgam.

Catastrophic failure

 

 

How many cracks have you seen around amalgam restorations during your practice? It makes sense –  given that teeth have been prepared with undercuts. Although it may take years for catastrophic failures to occur (vertical root fractures), why risk it in the first place?

Extension for retention

 

 

We no longer need to create undercuts or dovetails to retain restorations. But since we teach amalgam like its an entry step into placing restorations, aren’t we promoting a more aggressive form of dentistry from the get-go?

More time on learning how to place composites correctly

 

 

Instead of teaching students amalgams during their course, we should focus more time on how to place composites correctly. This would most likely improve the longevity of these restorations in the long run, improve patient outcomes, and really promote the concept of conservative dentistry we’re so used to saying.

 

What do you think? Do dental schools need to catch up and meet market demands for their students when they graduate?

Dr Kevin Ho
Dr Kevin Ho
Dr Kevin Ho is Cosmetic Dentist, Clinical Professor and Entrepreneur based out of Australia and Canada.

2 Comments

  1. dr.Nuha Elkadiki says:

    I think composite is now patient demands but still complain of disadvantage that make it less popular

  2. Dr M.S says:

    I think the schools should still teach about amalgam restorations not primarily so that the dentists could do them after graduating but to understand why those amalgams used in the past are causing complications nowadays like cracks and fractures, and be able to provide correct diagnosis with knowledge.

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