Gold Inlays: The Best Alternative to Silver-Mercury Amalgam Restorations

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.
 
Not many 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.
 
Gold inlays 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 dental adhesive.
 

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In 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.
 
Gold inlays 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.
 
For over 27 years, Dr. Kurpis has practiced cosmetic, implant, and Gold Inlay Dentistry. He can be reached at 545 Rt. 17 South, Ridgewood, New Jersey 07450, Telephone: 201 447-9700, e-mail: drkurpis@cosmeticdentist.com. For more info about Dr. Kurpis, Click Here
 

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