I am sure I will ruffle some feathers with this blog, but so be it. 

One of the benefits of having had a long career is the ability to observe dentistry prior to titanium roots, scanning, lasers, printing crowns and the shift from preserving the natural dentition in a state of health to an emphasis on cosmetics. 

I am presenting two patients with very different outcomes. The first case goes back 45 years and the second is a 4-year disaster. 

Mr. Bpresented in my office 45 years ago, just having completed restorations following periodontal treatment. In the mandible you can see these large amalgams, well-placed 45 years ago, that still remain in tact after four and a half decades. 

In the maxilla gold on lays were places similarly at the same time. 

Note the amount of recession in the palate. The patient had 10-millimeter pockets upon presentation and came because he was told to have his teeth removed. Now 4+ decades after periodontal treatment, his dentition remains healthy and the restorations that were placed 45 years ago remain intact.

Patient #2, 4 years prior at the age of 61, had shallow composite restorations on teeth #30 and #31.

Subsequently the patient was told these restorations could break and crowns were fabricated. 4 years later they have had two crowns, two root canals and a fractured molar, soon to be extracted. 

One of the great frauds perpetuated on dentistry is the belief that amalgam restorations were harmful to patients’ health. If there ever was fake news, this was it.

My practice is blessed with 600 people over the age of 80 and 110 over 90. Many of these patients have had amalgam restoration for 70 plus years. 

The wear of amalgam and the slight creep that occurs seems to result in less open contacts and less decay. 

It is rare, if ever, that I’ve removed fractured teeth that have gold restorations. However, on a weekly basis, I am removing teeth that had endodontics and ceramic crowns. 

This is not to obviate the value of well done aesthetic restorative dentistry, but if longevity of an intact dentition in a healthy state is the objective of dentistry, then it’s time we revisit and go back to the future. 

As always, I appreciate your feedback 

Yours truly, 

Dr. Victor M. Sternberg 

By Westchester Center for Periodontal & Implant Excellence

December 31, 2023