This 65 year old female patient presented to my office with a chief complaint of vague,  generalized discomfort from the left posterior region. Other than old and deteriorated amalgam restorations I did not see an obvious etiology. It was decided that we would replace her amalgams with composite restorations. Whether the deteriorated amalgam leaking margins were the cause of her discomfort is questionable however, bacteria having access to these areas can only have negative consequences.

Following administration of local anesthesia (topical plus carbocaine 3 %) the amalgam from the upper left first molar was removed. The stained, dark remaining tooth structure was the result of the amalgam but there was no soft or decayed tooth structure remaining. Rather than subject the patient to a more time consuming and expensive procedure, a flowable composite restoration was placed. As long as the occlusion was adjusted to avoid trauma and the contacts were established, this type of conservative restoration should last.

In terms of  improper diagnosis,  please note the radiographic cervical burnout (an artifact) on the distal surface of the first bicuspid. This is not decay.