First, let's talk about tooth decay.
Why does tooth decay occur?
We ingest food containing sugar through our mouths (sugars in the form of carbohydrates are contained in a completely normal diet, including flour products such as bread or rolls).
Bacteria are naturally present in the oral cavity, and we cannot eliminate them completely (we can only limit them with mouthwash). Bacteria feed on sugars and produce lactic acid as their waste product. Bacteria convert sugars in the mouth into lactic acid. The acidic environment in the mouth attacks tooth enamel, thus forming cavities. The formation of cavities is called demineralization. There is also a defense mechanism of teeth, which is remineralization, i.e., the re-mineralization of teeth. It can happen that a smaller cavity can disappear again and the tooth heals. The process of demineralization and remineralization is constantly taking place on the teeth. The only question is which of these two is faster.
Dental enamel is chemically composed of calcium hydroxyphosphate. Calcium and phosphorus intake is very important for dental health. For natural phosphorus intake, meat is best, as every single animal cell membrane contains a lot of phosphorus.
An important factor in tooth decay is the ability to salivate. A person with a salivary disorder who has a dry mouth (this can also be a side effect of some medications) gets cavities more easily because lactic acid is found in the mouth in higher concentrations, and therefore there is a more acidic environment in the mouth, which demineralizes the teeth more.
What happens if I have a toothache?
It's very bad. It means that the decay has progressed so far that it has reached the dental nerves. Bacteria attack the dental nerve, which causes pain. If the tooth then stops hurting, it's even worse because it means the nerve has already died. Of course, you should visit the dentist as soon as possible.
Fillings
Amalgam is an alloy of mercury with the powder of other metals. Mercury is slowly released and is harmful to health, mainly damaging nerve cells (thus adversely affecting the brain). Humans primarily absorb mercury in its gaseous state through breathing.
Also, the presence of metal in the mouth is not entirely natural – for example, when we make phone calls, the metal amalgam can theoretically multiply the harmfulness of radio waves.
Mercury is released particularly intensively when drilling into amalgam if a cavity is formed. I don't know about Slovakia, but in some countries, the profession of a dentist is considered a high-risk profession for this very reason. A dentist inhales a lot of mercury during the day when drilling.
In Sweden, amalgam has been completely banned since 2009!!! On the contrary, in most countries, amalgam is highly supported, mainly by being reimbursed by insurance companies. When amalgam is reimbursed by the insurance company and another type of filling is not, then logically amalgam comes out cheaper and that is why people have it done more often.
So-called white fillings are called composites. Composites have no health risks (only myths exist). When you ask for a composite, the dentist has no reason to refuse to give it to you. However, applying a composite is significantly more demanding in terms of the dentist's skill and intelligence than applying amalgam. With a composite, the dentist must ensure complete dryness at the application site (this is not necessary with amalgam), which is not that easy. Some less skilled dentists may not be enthusiastic about your request for a composite – there may be only one reason – their poor skill – but in the vast majority of cases, there should be no problem.
Overall, the lifespan of the composite is highly dependent on the specific dentist, the methodological procedure they choose for application, and how diligently they perform it. In principle, a male dentist is better than a female dentist for composite, because a man has more intelligence and logical thinking skills for the highest quality and best attachment of the composite.
The price difference between composite and amalgam is about 5 EUR (so instead of 20 EUR you will pay 25 EUR – this is the average price at Slovak dentists), for larger multi-surface fillings the difference is about 8 EUR. The price difference is not that dramatic – either way, the insurance company reimburses patients very poorly.
It is true that composite lasts for a shorter time, but be careful not to be fooled. The difference in durability is not dramatic – composite lasts only about 20% less time than amalgam. In some cases, in certain places, composite can even last longer than amalgam.
The composite also has the advantage of extending the life of your teeth. With amalgam, the dentist has to gradually widen the hole as the depth increases when drilling so that the amalgam does not fall out. The composite is glued to the tooth and does not require this gradual widening. With composite, the dentist saves a lot of tooth enamel – they will have to drill much less into the tooth and damage it less. Moreover, if they drill less, it will be more pleasant for you.
Furthermore, if a cavity forms around the composite, there is no need to drill out the entire filling. In contrast, with amalgam, it is necessary to drill out the entire filling, and thus with amalgam, the entire tooth is unnecessarily drilled out again, shortening its lifespan.
With larger amalgam fillings, the entire tooth can crack under chewing pressure. Amalgam is to blame for all of this. In contrast, composite can beautifully bond even a severely damaged tooth and strengthen it.
Also, many people are very allergic to amalgam. You can read more here.
http://www.dentonet.sk/verejnost/zubna-poradna/337/biele-plomby-vs-amalgan-pre-a-proti
(by the way, that dentist is a really retarded extremist, maybe she's gone crazy from breathing so much mercury)
There are also glass ionomer and ceramic fillings
Interesting link about composites http://www.studio32.cz/newsletter-leden-2013/
Glass ionomer filling
Even more advantageous than composite fillings are glass ionomer fillings – they do not contain metals, are white in color and, according to the latest studies, last much longer than amalgam. It is also not necessary to gradually widen the hole, i.e. excessively remove dental tissue.
Methodologically and in terms of time, these fillings are very undemanding for the dentist; the filling is completed very quickly. The price for this filling is either the same as for composite, or, for example, my dentist has a significant price advantage for this filling. I think it comes out either the same or even less than amalgam – the low price is, of course, justified due to the time-saving and labor-saving procedures.
The disadvantage of glass ionomer fillings is that they contain aluminum oxide powder (with a hardness of 9), which is almost as hard as diamond (with a hardness of 10). If the dentist had to drill into such a filling, it could dull their drills considerably. However, there are also diamond drills on the market, so that's not a problem. In fact, diamond drills/cutters are much cheaper than steel ones. Glass ionomer fillings are also very good; they are also white and do not contain mercury. In the past, I read all available scientific studies on the durability, quality, and lifespan of these types of fillings. https://en.wikipedia.org/wiki/Glass_ionomer_cement
Links
https://en.wikipedia.org/wiki/Amalgam
https://en.wikipedia.org/wiki/Dental_composite
https://en.wikipedia.org/wiki/Dental_restoration
https://en.wikipedia.org/wiki/Dental_material