Amalgam or Composite

A recent dental school graduate (Dr. A) accepts a position with an older experienced dentist (Dr. X). Part of their agreement is that Dr. X does all examinations, diagnoses, and treatment planning and that Dr. A is to adhere strictly to the plan of treatment.

Dr. A is assigned a new patient with a treatment plan developed by Dr. X. The patient is a 46-year-old female factory worker with dental insurance. She complains of frequent headaches. Numerous visits to physicians have not solved this problem. A friend suggested her problem might be dental in origin. The patient had no caries and no missing teeth. She had numerous amalgam restorations that had integrity of margins, adequate contour and were serviceable.

Dr. X recommended removal of all "mercury-containing" silver fillings and replacement with composite restorations. A notation in the patient's chart read: "possible mercury poisoning contributing to unmanageable headaches." Dr. A did not agree with the treatment plan but because of their agreement, acted on the recommendations of Dr. X—all amalgams were removed and replaced with composite resin.