The seal

Definition

As a seal (Tooth seal) is called colloquial a tooth filling made of amalgam, a mercury alloy (Silver amalgam).

The individual components of this filling material are:

• Silver (40%)
• Tin (32%)
• Copper (30%)
• Indium (5%)
• Mercury (3%) and
• Zinc (2%).

Discussions about the seal

To this day, dental fillings made from amalgam spark a wide variety of discussions. Critics are of the opinion that the mercury content has a damaging influence on the organism.

However, various studies have shown that this damaging effect only occurs at a mercury concentration of around 50%. In addition, it was found that an intact seal does not release any mercury.
Nevertheless, it is advisable to check amalgam fillings at regular intervals and to have defective seals replaced quickly.

As a general rule, patients who have several different heavy metals in their oral cavity (e.g. amalgam, gold and silver) usually have a higher mercury value.

This fact can be explained by the fact that, due to the interactions of the different materials, so-called electrochemical corrosion takes place, i.e. mercury particles are released from the seal.

The stress during the chewing process can also lead to abrasion and the associated release of copper and / or tin particles.

In healthy organisms, mercury is excreted in the urine, i.e. via the kidneys, but certain amounts of mercury can also be deposited in various organs and tissues of the body. Since the nerve tissue in particular is surrounded by fat cells, the nerve cells are often damaged. For these reasons, seals should not be used on pregnant women and kidney patients.

However, a health hazard from seals has not yet been properly proven. A large number of studies even show that a seal has absolutely no harmful effects.

Only the occurrence of pigment disorders (so-called Amalgam tattoos) of the oral mucosa is due to the presence of a seal.

application

Amalgam is still widely used in German dental practices and is also quite easy to insert into the tooth.

After applying a local anesthetic, the caries is completely removed and the tooth is prepared in a box shape.
This preparation ensures the highest possible adhesion between the tooth substance and the filling material. In the case of very deep caries, a so-called underfill made of a drug containing calcium hydroxide must first be placed under the seal.

On the one hand, this medication has a calming effect on the nerve fibers of the tooth and, on the other hand, is intended to stimulate the formation of the dentinDentine) stimulate.
In dentistry, this procedure is known as capping.

Before the filling material is introduced, a shaping matrix is ​​placed around the tooth to be treated and fixed with small wedges.
Then the treating dentist puts freshly mixed amalgam into the tooth.
Before the seal can be polished, the material must cure for a period of at least 24 hours; an amalgam filling requires at least two sessions.

The polishing of the seal serves not only to beautify the surface of the filling, but above all to reduce the release of mercury. Patients are increasingly opting for a plastic filling instead of a seal, which is mainly due to the fact that plastic tooth fillings are almost invisible in the tooth.

The statutory health insurance companies only cover the cost of a tooth filling if amalgam is used as the filling material, plastic fillings are only worn in the anterior region.

During pregnancy and people with proven kidney dysfunction (renal insufficiency) are the exception here, because the health insurance companies also cover plastic fillings in the posterior area for them.

Seal fell out

Even with a carefully made seal, it is possible that it will come off the tooth after a certain period of time.

A fallen seal causes no pain in most cases, but is perceived by the affected patients as uncomfortable and very annoying. Nevertheless, a prompt visit to a dentist is urgently necessary, otherwise there is a risk of toothache after a period of a few days to weeks. In addition, permanent damage to the tooth and / or the nerve fibers within the dental pulp can occur.

In many cases, tooth decay that forms under the filling material (so-called secondary caries) for the seal to fall out.

In fact, this is by far the most common reason for loosening the filling material introduced into the tooth. If treatment is not carried out quickly, there is often a risk of root inflammation and, in the worst case, removal of the tooth (extraction). See pulling a tooth.

Breaking through an outer wall of the treated tooth can also lead to the loss of the seal. Damage to the outer wall of the tooth can result from excessive or excessive stress on the natural tooth substance.

In the affected patients, re-inserting a seal may not be enough to restore the tooth over the long term - a so-called inlay is necessary.

Other reasons are so-called filling fractures, i.e. broken seals, and the loss of the bond between the tooth substance and the actual filling material.

The actual filling also breaks through as a rule, when individual tooth surfaces are overloaded, which makes the filling material porous in the long term. Particularly with very old tooth fillings, there are signs of wear and tear and an associated loss of the layer thickness of the filling material, which ultimately leads to breakout.

In the area of ​​the incisors and canines, dental fillings that have fallen out are the result of a loss of adhesive strength between the tooth substance and the actual filling material in many of those affected.

Patients who have lost a seal should make an appointment with their treating dentist as soon as possible.

What should I do if I swallowed a seal?

If a seal has fallen out and you swallowed it, don't worry. In most cases, the seal is excreted naturally from the body.

However, you should visit a dentist as soon as possible to have the now exposed tooth surfaces restored. Often there is a reason why the seal fell out. This can, for example carious lesion have been under the seal or one broken tooth surface.

What to do if a seal has broken?

If the seal has broken, this does not necessarily have to affect the entire seal. It is also possible that only a piece of the filling has broken out. This can usually be felt with the tongue. In this case, the filling just needs to be rebuilt.

In many cases, however, the tooth with the broken seal causes toothache. Mostly it is also sensitive to hot or cold dishes. This is an indication that the filling needs to be renewed. In any case, a dentist must be consulted to have the defect repaired.

Read more about this at: Broken tooth - what to do?

The cost of a seal

The cost of a seal, i.e. a tooth filling, depends on the material chosen for the filling. In most cases there is the option of a plastic or amalgam filling.

Each of these materials has its own advantages and disadvantages. The most popular seal is made of plastic. The disadvantage of this, however, is that the patient has to make a private additional payment.

The statutory health insurance only takes on amalgam fillings in the posterior area and plastic fillings in the anterior and canine area.

The cost of the plastic filling in the posterior region depends on the size of the filling and is calculated by area.Depending on the number of areas, the costs can be approx. 50 to 300 € amount.

Learn more at: Tooth filling with plastic

Pain under the seal

Pain under a seal is in many cases a sign of tooth decay under the filling. If, in addition to the existing pain, the tooth is particularly sensitive to temperature or irritation, this supports the fact that there is existing caries underneath the seal. If the symptoms persist, a dentist must be visited to find out the cause of the pain.

You can also find out more here: Toothache under a crown