It is a common myth that silver amalgam fillings last forever. They are very durable but are not indestructible. There are several reasons why a silver filling can fail. Fillings have to endure an incredible amount of biting force and over time, they become worn and turn black, and their edges wear away. Moisture and temperature changes can also cause the filling to expand and contract. This expansion can create a wedging effect in the tooth, which can fracture or break off tooth structure. The expansion can also lift the surface of the filling slightly creating a gap where the filling meets the tooth and allow bacteria into the tooth.



Jamie had begun to have sensitivity when flossing in her lower right molar, which had a large silver amalgam filling. Dr. Adler, dentist in boulder, diagnosed recurrent decay in the tooth and recommended that a dental inlay be placed.

An inlay is similar to a filling and lies in between the cusps of the tooth. They are custom-made to fit the prepared cavity and are then cemented into place. A dental onlay is a more extensive reconstruction that replaces one or more cusps of a tooth. Onlays are indicated in situations where a substantial reconstruction is required. However, more of the tooth structure can be conserved compared to the placement of a crown.To repair damage to the tooth's biting surface, rather than using a simple filling, or a crown, Dr. Adler will often use an inlay, or a dental onlay. Inlays and onlays are made from porcelain because of its strength and ability to match the natural color of the tooth.

Dr. Adler prepared Jamie's tooth by removing the old amalgam filling and the underlying decay. He then painted a reflective powder over the prepared tooth. Using a special camera, he took an accurate picture of the tooth which was then displayed on a computer screen, where he designed the inlay. Then CEREC took over and automatically fabricated and shaped the restoration. CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics. With CEREC there was no need for us to make an impression and send it to a lab. The inlay was then permanently bonded to Jamie's tooth. The whole process took about an hour and Jamie was able to leave with a beautiful and healthy white tooth verses the discolored and decayed one that she came in with.

About Dr. Adler

Dr. Michael Adler, Boulder Cosmetic Dentist, brings the power & wisdom of scientific research, and diverse life experience to his practice. A graduate of: the University of Michigan, Dr. Adler was a research biochemist at Stanford University prior to completing his dental degree at Georgetown University. Serving as a Lieutenant in the United States Public Health Service, he provided dental care and patient education. Dr. Adler was awarded a prestigious commission by Surgeon General Dr. C. Everett Koop. Dr. Adler has been in private practice since 1990.

Dr. Adler is committed to lifelong ongoing training, assuring his patients the best dental care available on the planet. His postgraduate training has been extensive, including studies on the topics of neuromuscular dentistry and smile design at the nationally renowned Las Vegas Institute for Advanced Dental Studies. Dr. Adler is certified to provide Invisalign? (invisible braces) orthodontics to his patients, as well.