Patients don't realize that they can get whatever composition they want, as long as it is workable by the lab. Heck, most patients don't even know (or care) what other metals are in the "gold" fillings their dentist chooses for them. There are lots of combinations available, so what drives the dentist's choice? Cost and convenience for them. That extra $200 for a crown doesn't likely increase the dentist's profit, but it costs more to the patient, so likely less business for the dentist.

Again, people see the extra $200 cost and **don't realize the benefit of the purer gold that that extra $200 gives them**. How many people even know about palladium and nickel being unhealthy? Less than those who knew that silver fillings are mostly mercury. People are just ignorant because they aren't informed. They just see that this dentist wants an extra $200 for a crown, and since the dentist doesn't (or can't) say that palladium / nickel / mercury is bad, why would the patient even bother spending hundreds of dollars more if they don't realize the benefit? They'll go to another cheaper dentist who can do the job for less money. And most dentists are DRILL FILL AND BILL and they don't give a crap about the patient if they aren't competitive among other dentists and making profit. Does a dentist have an extra 20 minutes to explain to each patient the hazards of palladium / nickel / mercury / bisphenol-a? No. Time is money! Plus with the ADA placing "gag orders" on dentists...

I contacted some dental labs a while back and had a few long conversations with some people in the dental lab industry. They can customize nearly any gold mix. The trick is to contact the lab directly instead of going through the dentist. Most dentists won't act as a liason and won't even know most of the questions about what labs can do. The dentist just doesn't have time to act as a liason for high maintenance patients who ask lots of questions. A dumb patient is a good patient for a dentist - quick, easy, low maintenance... next!

There are lots of labs out there. A patient can pick the alloy they want, find a lab that can create it, and have their dentist work with that lab. If the dentist won't oblige, find another dentist!

Some dentists like Dr Tucker use a "PF" (Palladium-Free) gold alloy. Usually they replace it with copper or silver and a little bit of platinum, like 10% silver and only 1% platinum. Dr Tucker stoped using palladium altogether, but I didn't have the opportunity to ask him why. I assume it is for health reasons for patients. I'll try to find out exactly.

Why is gold not being used much today like it was decades ago? It is the only filling material that must still be sent to a lab, needing two appointments for the patient, and profit shared with a lab. Amalgams, composites, and even porcelain (CEREC) can now be produced in the dentist's office. This means more profit for the dentist and sharing less profit with a lab, and more competitiveness for the dentist. Less time and appointments for the patient too sells the patient. And a dentist who is leasing a CEREC porcelain machine is NOT going to push gold fillings - he must push CEREC to pay his bills and make profit!

And... (tinfoil hat time) which makes more money for the dentist - a composite filling that lasts 5-10 years or a gold filling that lasts 50 years? Repeat business makes money. Treating symptoms makes money. Curing and healing people for good doesn't make money. Keeping repeat patients makes money, attracting new patients costs money.