Gold Inlays: The Best Alternative to Silver-Mercury
By Albert J. Kurpis, D.D.S.
Gold inlays are the best, safest, oldest and longest lasting dental
restorations. They are usually indicated for use in the back part of
the mouth, the bicuspids and molars. If these statements are true,
why are so few patients offered gold inlays as a dental restorative
alternative? The answer is simple…economics.
Doctors in the dental profession will dispute the fact that gold
inlays, where properly indicated are the longest lasting dental
restorations for teeth. So what are the barriers preventing us from
receiving these great restorations? One is the initial cost. Gold
inlays cost 4-5 times that of a silver-mercury amalgam for the same
tooth. However, when you consider that many silver-mercury amalgams
are replaced over time possible followed by root canals and crowns,
the long term investment of a gold inlay may in fact be superior. A
major influence on dental care is the insurance industry. Many
insurance companies simply do not cover these superior restorations.
If you go to an insurance driven dental office you may not be
offered this alternative. You can test this hypothesis by asking
your dentist about these restorations at your next visit. If your
dentist offers these restorations, consider yourself fortunate.
Another disturbing fact is that many dental schools no longer
require gold inlay proficiency for graduation.
|Why is gold
superior to silver-mercury amalgam? First of all, gold is relatively
stable and inert in our bodies. A tooth containing gold inlays never
discolors over time. Yet if you look at teeth containing
silver-mercury amalgam, you can see the discoloration of the tooth
structure as the silver-mercury corrodes and the by products enter
the surrounding tissues. Traces of dental mercury in the body is
presently a controversial issue within the dental profession.
Another reason is that gold shares expansion contraction properties
similar to natural tooth structure. This is called the coefficient
of thermal expansion. It results in less tooth cracking and damage
over time. Gold has wear resistance similar to natural tooth
structure maintaining a good biting surface over time without
damaging the opposing teeth. Gold does not corrode and is highly
polishable leaving a pleasant feeling in the mouth over time. Cast
gold restorations don’t just fill the tooth, they support the tooth
from the crushing forces if chewing. When a cusp of a tooth is
damaged, it can easily be replaced with a variation of the gold
inlay called the gold onlay. In many circumstances, this can avoid
the necessary over reduction of healthy tooth structure by
conventional crowns and caps.
are made during two dental visits. On the first visit, the
preparation is made, an impression is made of the tooth and a
temporary if placed in the tooth. In the laboratory, a wax pattern
is fabricated and cast into gold by the lost was casting technique.
It is finished and polished and returned to the dentist. At the
second visit, the final casting is permanently cemented with a
the past 27 years I have observed gold inlays verses silver-mercury
amalgams in many comparable tooth situations. I have observed less
tooth breakage, less recurrent decay and less root canals necessary.
Thus those individuals who have had gold inlays placed have had less
dental services performed on those teeth over time. Over time is
when you see the return on the gold inlay investment.
are the indisputable premier dental restoration where indicated. As
a dental consumer, you owe it to yourself to find out more about
these fantastic time tested restorations.