“Dr. xxxx has developed a sound technique for bone in the jaw to be preserved especially after an extraction. Extractions done with these various types of grafting material has now been able to maintain your natural healthy bone. With the grafting incorporated with the extractions, we at xxxxx have eliminated the painful side effect from the traditional extractions called DRY SOCKET.”
I might, and I say “might”, meaning less than 1% of the time, use a bone graft on LOWER 3rd molar extractions when teeth have been impacted and need to be cut out. Again, yours is upper left so the quote above does not apply in your case. Your body regenerates bone naturally. No need (in the case of #16) to bone graft. If it were in the front or maybe any tooth not a 3rd molar then I would say think about it. Your bone will fill it in naturally. I know Oral Surgeons who do not use bone grafts for 3rd molars.
Amalgam fillings are another story. If silver fillings are more than 15-20 years old I usually recommend replacing them. Great material, last a long time, but they are metal (silver, copper, mercury contents), which expands and contracts over time when fluids, whether hot or cold (water, coffee, juice etc) interact w/the filling. This expansion and contraction is microscopic. Over a period of years it can and does leak. It’s extremely hard to tell if the filling is leaking and has a cavity underneath it until it is too late and you need a root canal. Silver fillings are not bonded to the tooth. Composite or tooth colored fillings are bonded chemically, but they too have to be replaced. Remember this stuff is man made. You have to change the oil in your car right? Also if the silver fillings take up more than two/thirds of the chewing surface of your tooth, I usually recommend a crown. The large silver fillings tend to act as a wedge in your tooth and can split them. Imagine a metal wedge in a tree and you using a hammer to hammer it in…it splits the tree. Thats why large fillings turn into cracked teeth.
Recap: 1) is the filling more than 15 – 20 years old. 2) Is the filling large. 3) Are you unhappy w/the look and feel of the metal?. 4) Will insurance pay for the replacement. If you answered yes to these, then replace them. If these are a no, then just tell your dentist you would like to just watch and wait for signs or symptoms of a cavity/recurrent decay. In other words, I trust your dentist’s judgement, but if you just got these fillings done 5 years ago, I’d get some more milage out of the ones you have. If it’s cracked or poor margins where the filling meets the tooth, definitely replace it.
