What is Dental Amalgam? Is it safe?


Dental amalgam is a filling material which has been used in dentistry for more than 150 years to fill cavities caused by tooth decay. It is used because it is a strong, cheap, and effective filling material. Amalgams have been surrounded with controversy recently due to ''health and environmental concerns''.

Amalgam contains mercury, which is a volatile liquid metal (volatile means it releases vapor). Low levels of this vapor are released by dental amalgam, especially when it is being mixed and placed or removed in a tooth. When solid and set in the mouth, much lower levels of vapor are released. The short answer is that dental amalgam fillings are safe for adults and children ages 6 and above.

Rarely, some people may be allergic or sensitive to amalgam and may develop contact reactions or allergies within the mouth. This is similar to nickel allergy from jewellry and if the person is allergic they should avoid amalgam fillings.

''Should I get my amalgam fillings replaced for health reasons other than direct allergy''

Unless you have allergy to amalgam, you should not get your amalgam fillings replaced for health reasons for several reasons:

1. Each time a filing is removed, some healthy tooth structure is lost, weakening your tooth.

2. When amalgam fillings are set and in the mouth they release small amounts vapor. When being removed, more vapor is released. This can be controlled by using high suction and isolation on the dentists part. In essence, if you are concerned about the effects of mercury vapor, you are exposing yourself to higher levels over a short period by removing those fillings than if you did not.

3. Overwhelming evidence exists that amalgam causes no health issues.

When should I replace my amalgam fillings?

You can however, get amalgams replaced for aesthetic reasons, or if there is decay or a defect in the filling. This would be the route I would recommend for anyone considering this procedure. Finally, at Gentle Dental we currently do not provide amalgam fillings as we prefer using white composite fillings.

Further reading

I would highly recommend any patient curious about possible healthcare effects to read the following literature:

The American FDA view on amalgam use: They reviewed 200 scientific articles and an additional 70 relevant abstracts. FDA stated that “dental amalgam is a commonly used device with a low risk of adverse events reported to the agency”.

The World Health Organisation view: “dental amalgam restorations are considered safe…”

Not a science article, but an overview of the story of amalgam which I found a fascinating read.A history of dental amalgams and controversy. Was the controversy around amalgams a business ploy to to drive an amalgam replacement business?

Dr Hayley Brahm and Dr John Bresnan

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