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Dr. Matt Nejad

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  1. I thought it was interesting that you mentioned that the composite restorations have less of a chance to decay because it’s more bonded with the tooth. I have a lot of metal fillings, but I have been thinking about getting them switched to this. I think that, for now, I will take extra care of my teeth so nothing drastic has to be done and get the composite fillings if I need anything new done.

    • Hi Gerty. I just wanted to clarify that this is only true when the composite restoration is well done. Unfortunately, this is not often the case. Composite restorations need to be done with good isolation, good technique, and with the right adhesives and materials. Lots of shortcuts can be taken to speed up the restoration, but they all result in poor bonding and complications.

  2. I got 3 amalgam fillings 3-4 days ago and I was chewing gum today and tiny pieces of the amalgam came out and now i am having a little bit of sensitivity. What should I do?

  3. Hi,
    Came Across this article and comments and thought I’d share my experience as well – I hope you can help. I got 3 Silver Fillings today (Insurance decided they’d only cover those) and I am having this strange burning sensation on my tongue. Its been roughly 4hours now and my tongue feels like its burning and itching a bit. Could I be allergic to the fillings because of the mercury? I have another 3-4 filling to do in the back next week and I am freaking out a bit. HELP!

  4. My dentist will not replace my old silver fillings with white fillings because there is
    No cavity. I am ready to get the silver out of my mouth, what should I do?

  5. About 8-10 years ago my dentist replaced some of my then 20+ year old fillings with new amalgam fillings. I don’t remember the reason for the replacement – I trust my dentist did a good job and for a good reason, but certainly it resulted in larger amalgam fillings. I am considering replacing my amalgam fillings but I am a little concerned that replacing my fillings will enlarge the fillings further. You say that composite fillings only replace the damaged portion of the teeth – is that also the situation when you replace old amalgam fillings or should the teeth be prepared further or differently for the composite?

    • If absolutely nothing was wrong with the teeth, and it was done conservatively. There would be negligible additional tooth removal (say 1-2%). However, if there are problems such as cavities, or cracks, then additional removal would be necessary. Also, for larger amalgams, an inlay or onlay may be a better option depending on the clinical presentation.

  6. I just had 2 amalgams replaced with composites yesterday, in the upper right back molars (#2 & #3). Upon inspection at home after the procedure, it looks like there is still some silver filling in #3 on the bite surface. It doesn’t look like a stain as it is shiny and silver. Is it possible that my dentist left behind some of the amalgam when he did the replacement?

    • Hi Ravynne- It is possible, I have seen it before. It might also be staining of the remaining tooth structure, and its pretty impossible to narrow it down without seeing it. Hope that helps. Best- Matt Nejad DDS

  7. I just got an amalgam filling today. My doctor made a mistake. It was supposed to be a composite filling. What should I do? I am very displeased at the appearance of the amalgam filling.

    • Hi Kay. I would do whatever makes you comfortable. If you don’t want the silver filling, let your dentist know or go somewhere else. If it doesn’t bother you, leave it alone. A good composite is better than a good amalgam in my opinion, but some people might disagree on that. There is a risk everytime a filling is removed, so some people would recommend not touching it. I myself, in my own mouth, would change it with very good dentistry.

  8. I had a dental hygienist state that the “blackish line are” between my old large silver fillings and teeth is decay. Does that make sense? I though silver can stain things near it? The hygienist thinks the fillings need to be taken out and the teeth crowned. I have no pain, or sensitivity in these old silver fillings. Thank you in advance.

    • It can really be either one. I can’t tell without seeing it. I would say to get a second opinion anytime you don’t trust the recommendations you are receiving.

  9. Hello Doctor. I am some large silver feelings that are maybe 20 to 40 years old, depending on the filling. They do not bother me at all and are not food, or temperature sensitive. If some of these fillings have a blackish line” area between the silver filling and the tooth, is this “black line area” a sign of tooth decay? A dental hygienist told me the black area is a sign of decay, but the fillings look fine otherwise, no cracks or decay noticeable. is the black really a sign of decay with silver fillings? They claimed the fillings should be removed and the tooth crowned? Thank you for your thoughts.

  10. I had one of my baby teeth updated with the new white composite and the silver filling removed since I chose to and later found out it was leaking. Now my tooth is a grayish color on the tooth itself and in the back. Is this common? My dentist said the last time I was in that we will have to pay close attention to that particular tooth. I don’t have pain but I feel like the tooth is weak like it gets tired from eating. Does that make sense?

    • Dear Heather,

      It is impossible to evaluate this without seeing it. It is not uncommon for a silver filling to impart a grayish hue on the tooth which does not necessarily mean anything besides stain. If it is a baby tooth, there is a lot of possible things that could cause it to be weak: the roots could be resorbed, it could have a crack, it could be slightly loose, etc. I would just talk to your dentist and tell him about your symptoms and go from there. I hope everything works out.

      Best,
      Matt Nejad

  11. hey, doctor! I’m currently thinking about replacing my silver fillings to color fillings. Recently one of my tooth that has a silver filling is getting discolored. could this be a possibility of recurrent decay? i feel no pain.

    • Hello Jessica,

      Yes, staining around silver fillings could be anything from simple staining or recurrent decay. Because these metal fillings don’t actually bond to the tooth like a biomimetic restoration does, there is always a gap for bacteria and stain to enter. On smaller metal fillings that have no staining or cracks around the restoration, we usually ignore these and only monitor them over time to make sure everything is ok. However, if the metal filling shows staining, cracks, chips, or the patient has pain, we always chose to remove the metal filling under a very specific protocol utilizing rubber dam and high volume suction. We can then replace these with biomimetic stress-reduced fillings or inlays and onlays that look and function like natural teeth. Thank you for your question and I hope this helps!
      Dr. Kyle Stanley

    • Dear Jessica,

      It could be corrosion, cavity, or just marginal breakdown as Dr. Stanley mentioned. Please keep in mind that replacing the fillings does not guarantee improvement in this regard. It is not the filling itself, but how well it is done and how it is done that helps address issues like this. I would have it evaluated and maybe even get a second opinion if you are unsure because sometimes the best thing is to leave a restoration alone if there is no major problem.
      Dr. Matt Nejad

    • Is there any way to bleach the stain before putting in the new composite filling?? I have two teeth next to front teeth that need the composite redone and I would like the stain from the old mercury filling to not show!

  12. I am getting my mercury fillings removed soon due to some health issues and my dentist has given me the option of replacing with composite or ceramic. The ceramics are much more expensive but he says composite leaks a BPA derivative and the ceramics are guaranteed for life and made of safer ingredients. I am trying to find a second opinion on this! Thanks so much

  13. Just switched to a new dentist because of insurance reasons. I have 7 silver fillings from when i got them put in between the ages of 15-30. I’m 36 right now and the new dentist recommended to switch to composite as it will bond better to the tooth and it won’t decay like the silver fillings and less likely to needing a crown in the future. He didn’t say anything was wrong with my current silver fillings. I’m trying to find some answers online to figure out what to do, what should i do?

    • Hey Mike, if the silver fillings are ok and intact and none of the tooth structure around it is in jeopardy, we would probably recommend just keeping an eye on it. Larger silver fillings, however, should usually be changed as the teeth around them can fracture since the tooth structure isn’t supported well. In these cases, a porcelain inlay or onlay is the treatment of choice to keep it minimally invasive and get a great bond. If any of the fillings have recurrent decay around them or are fractured then we would definitely change them out for well done composite fillings or bonded porcelain restorations.

  14. I got amalgam filling 15 days ago now on three molar .. Now I wanted to change it because of excess of Mercury in it. I wanted to change it … So should I go for change it with composite ..will it save..????

    • Hello Trahul, it is hard to say if you should change it or not without seeing the restoration. Often times, on old amalgam fillings there are cracks in the surrounding tooth or recurrent decay in which case these should be changed. However, if the filling is pretty small with no problems, we would probably leave it. If it is a large filling, doing a large composite filling isn’t a great idea and it should be evaluated for an inlay or onlay made of porcelain. Good luck and thanks for the question.

  15. After removing my silver fillings and getting the tooth colored ones, my tooth is very sensitive. will it go away? i bit into a cracker and it hurt so badly. i had the fillings replaced about 6 hours ago.

    • Hi Hanan,

      Usually, that is not a good sign. A number of different things could be going on, but it is not normal for the tooth to be sensitive, especially when biting into something. I would have this evaluated as soon as possible. I hope it works out well! Best- Matt Nejad

  16. Hi
    I have loads of mercury fillings. I’ve just starting getting a bit of a sensation in a huge mercury filling, NOT pain just my tongue touching the side of the tooth it feels strange.
    My new Dr says the mercury is leaking and wants to replace it, but can only do so with a crown as the the filling is so big.

    He says there’s two teeth leaking, which is hard to accept with having no pain. I don’t want dental work done for no reason, it can cause problems.

    Also I’m worried I’ve read there is toxic fumes when removing the old filling.

    Hope you can advice

  17. Hi, I don’t see it mentioned, but do you have any comments about the risks of mercury exposure during the process of removing amalgam fillings? I have read that removal has a high risk of significant mercury exposure, and that strict precautions must be taken to minimize exposure to patient and staff.

    • Hi Gabe- great question. There is definitely a process that can be used to minimize exposure and we are actually about ready to publish another blog article on this exact subject! Please stay tuned!

  18. Hi

    I have had a silver filling placed into my tooth about 2 years ago the filling isn’t particularly large but I get a funny sensation from it from time to time. I have had an X Ray and been to many dentists snd all of them have said there’s nothing wrong with it but I am confused as I get a metal Taste in my mouth . Please advise one dentist the NHS one said he could replace it and Treat it but they have all said they couldn’t find any evidence of decay ? Please help me!!! I feel like I’m going mad!!

    • Hey Jay- I am really sorry to hear about your predicament. The thing is, you might not have a cavity but there are other things that can cause a tooth to have symptoms including cracks, bad bite, clenching, periodontal disease, or even a leaky restoration/bad seal. From what you are describing, I would wonder if there is an un-diagnosed crack that isn’t visible under the restoration or perhaps the sensation arises from saliva being under the restoration and applying pressure to the dentinal tubules. The point is, its not always easy to diagnose but sometimes the restoration just needs to be removed and the situation re-evaluated. I hope you can find someone to take care of this well for you. We are always here, just on the other side of the pond if you want to come out here =). Wish you all the best my friend.

  19. I got my composite filling about 5 years ago and there is a huge swoop dent thing in the center of my molar. Do i need to get it replace?

    • Hi Liz! I would recommend getting that checked out by your dentist. Without seeing the restoration you’re referring to, it is impossible to say whether or not it needs to be replaced, but it does sound like it needs to be checked out for sure. It might be chipped or have a void in it. I hope this helps!

  20. I have some amalgam fillings from the early 1980s. Though they don’t look at all nice when I smile, they are still functional and there is no pain or discomfort with them. Did consider having a couple of crowns fitted to replace some of the larger fillings which are more noticeable nearer the front of my mouth. These show through the teeth and look awful. Implants would be ideal, but costly; or I could go the whole hog and have a good set of injection moulded dentures fitted for £1,000. I would really love to have beautiful teeth for just once in my life.

    • Hi Sue, I can definitely relate to what you are saying, but please please please don’t resort to dentures if you can avoid it. The quality of life is not comparable! If you have no symptoms such as pain or sensitivity, just monitor these fillings and replace them as needed. The mercury in these fillings is a cause for concern for some and not for others. Currently, there is no research that indicates that this mercury exposure can cause systemic adverse systemic effects but it somewhat a controversy among providers. My opinion is that any silver filling with defects such as chips, cracks, cavities, symptoms, etc should be replaced. I think if you can find a good provider near you, you can start replacing them as needed one by one and maintain these teeth for years and years. Try to find a really good Biomimetic dentist you can work with. There is no reason you would absolutely have to have them all replaced at once. If it helps you to do it little by little, then this would be a great solution. Give us a call if you would consider coming to our office.

    • “Currently, there is no research that indicates that this mercury exposure can cause systemic adverse systemic effects but it somewhat a controversy among providers”

      What an absolute load of lies. I am shocked this guy said that! There are thousands of sources of information which clearly show toxicity from mercury exposure due to amalgam fillings.

    • Hi John,- I have nothing to lie about and I was sharing a quote from the World Health Organization. I have also researched this myself and I still don’t see anything that shows CAUSE. I don’t use Amalgam and I have never placed one. I do think that it’s common sense that we should not do anything to increase the levels of mercury we are exposed to, however there is no research to show that the level of mercury from silver amalgam fillings actually CAUSES systemic adverse effects. It is very difficult to prove causation and all the research you are referring to shows association or correlation. There is numerous studies that show that mercury fillings cause increases in the level of mercury in blood, tissues, urine, etc but none of it proves causation of systemic adverse effects. If you find one article on pubmed that proves causation please let me know and I will update the blog article, but in the meanwhile the emphasis of this blog is on facts. Fact is Amalgam does raise your levels of mercury and if you are concerned about that, you have the right and the ability to have it removed and I would agree that it is better to have no extra mercury exposure. Best- Matt Nejad

  21. I had no problems with my silver fillings. My dentist in NJ never said anything about ever needing to replace them for any reason. Some of them have been in my teeth for forty years.
    I moved to Washington and had to get a new dentist. I made an appointment for an annual cleaning and check with a dentist in my insurance plan. I left the appointment with them telling me I needed nine fillings replaced. They said it was to prevent cracking and decaying which.
    After having six fillings replaced two visits later, I am so sorry I was talked into doing it. Where I once had no problems with my teeth, they are now sensitive and sore. They actually replaced one filling twice and are now telling me I probably need a root canal in that tooth! I feel like my whole mouth is messed up from doing this.
    I feel coating from the fillings on the sides of my teeth. I’m wondering if this is going to cause decay?
    While I will not be going back to this dental practice, I feel damage is done and am skeptical of trusting any dentist at this point.
    I take care of my teeth and am very upset over this.
    If it’s not broke, do not fix it!!!!!!
    Laura Coolack

    • Difficult to comment on the work without seeing it but I am sorry you are having problems. That is never the goal and really shouldn’t be happening. I definitely agree that less is more. We never replace restorations that look intact and functional.

      Sometimes there are problems with silver fillings causing cracks, recurrent decay, etc that may not currently be causing pain. So it is important to distinguish between a silver filling that has problems vs a silver filling that has no pain symptoms. Cracks and recurrent decay are problems and should be taken care of before the problem becomes larger such as fracture, larger decay or even root canal. This would not be called preventative treatment.

      It sounds like you had silver fillings replaced to prevent cracks and decay, but that is not to say you already had cracks and decay. In my opinion, that would be excessive treatment if there was no problems with the silver fillings.

      Again really sorry to hear about your experience with your dentist. Let us know if we can do anything.

    • I have SEVERAL amalgam fillings that were plac d in my mouth 14-15 years ago (most of which replacing composite fillings that I’d had since childhood), a year later, I was diagnosed with MS. Since then, I have had significant health issues that have all been blamed on MS. The symptoms and timing all coincidence with Mercury Toxicity. I’d like to remove all of the Mercury from my body; it is poison! Can you help me?

    • I feel exactly the same as Laura Coolack, your experience you posted above. My teeth are in so much pain and its only been two weeks and I hurt more than I did the day after. At first I thought it was just my nerves in my teeth from the shock of being drilled and the removal of the silver fillings. But its more difficult to even sleep not to mention I can’t even chew food on the left side of my mouth. I feel like my teeth are so messed up that there is no hope of them ever feeling normal again, and even worse I’m afraid to even go back to my dentist as I’m afraid he will do something awful to me if i say anything negative about his work on the white composite fillings he did. I think I’m just going to have to live this way forever 🙁

    • Hi Mary! My heart goes out to you. I am very sorry you had this experience and it’s definitely not how it should be. This is not something that happens in my practice. There are so many reasons why this could be happening but please please please go to a dentist that you can trust. You need someone to help you get this under control. Please look for someone. I highly recommend a biomimetic dentist. I am in the process of adding all the dentists I have trained so the list is growing but take a look at: http://www.biomimeticdentistryce.com/trained-dentists/ . There should be another 10-20 dentists going up over the next few months. I am wishing you relief and peace and hope that you will not endure pain any longer.

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