Amalgam Removal
Amalgam fillings containing mercury contain toxins that should not be swallowed. If a filling is to be removed, it is recommended to apply a rubber dam. Because when drilling out the filling material, amalgam dust is created, which combines with the drilling water.
This water has to be sucked out, otherwise it flows into the throat, and one could swallow the amalgam dissolved in water. Although the amount of mercury is very small and not directly harmful, it is also not very good for the body, so at least you can try to absorb as little of it as possible. Some fillings are very brittle, so the filling breaks into large pieces that can be sucked off directly.
If it is very firm and still well intact, more dust is produced, which can get into the throat. In many practices, a rubber dam is not used for amalgam removal, because the assistants are usually very skilled at vacuuming off the amalgam residues immediately. In addition, amalgam fillings are often very deep, so that the rubber dam does not seal tightly against the tooth.
In this case a rubber dam is even bad, because the gap between the rubber band and the tooth allows more water to pass through with amalgam. It is important that amalgam is a material that lasts very long, which means that the fillings that are removed are usually already old. In the long time a lot of mercury has been dissolved from the filling, so there is not much mercury content in the filling anymore. If you swallow a little of the amalgam dust, it would not be more harmful to the body than a filling that repeatedly releases mercury vapor over several years.
Implementation
The rubber dam does not require much preparation. Usually the helper puts on the rubber band. Prior to this, a tooth cleaning may have been done, since the clasps do not hold well on the tooth if there is still tartar.In addition, the teeth should be clean before major procedures such as a filling or root canal treatment are performed.
The assistant’s preparatory work consists of selecting a suitable brace depending on the size and type of tooth. The clasp is tried on the tooth before without a clamping rubber, whether it holds well and fits tightly to the tooth. In addition, depending on the treatment, one or more holes are punched into the rubber beforehand, which allows the teeth concerned to protrude from the rubber.
There are different possibilities in which order the rubber dam is applied. What they all have in common, however, is that the rubber is put over the teeth and the rubber is held in place by the rubber dam clamps. In addition, rubber bands and dental floss are then placed around the teeth to fix the rubber.
Depending on the treatment, wooden wedges are added, which bend the teeth slightly apart. The number of holes punched in the rubber depends on how many teeth need to be treated. In the case of root canal treatment, the clasp is placed around the tooth in question.
In the case of anterior fillings, the neighboring teeth also come out of the rubber to better match the shape and color of the filling. With ceramic crowns, it is also important to expose the direct neighboring teeth to ensure contact between the crown and the neighboring teeth. There are also different clasps for different teeth.
Roughly speaking, clasps are divided into clasps for front teeth, for small and for large side teeth. The choice of different clasp shapes is important because the small molars have a smaller circumference than the large molars. Within one group there are again different shapes, because the shape of a tooth varies from patient to patient. So the dentist has the possibility to try out which clasp fits best to the respective tooth. All clasps have two small wings that prevent the rubber dam from slipping off the tooth.
