Patients often ask us about whether they should replace their amalgam fillings. This type of filling material is called amalgam, and it is made of silver, mercury, tin and copper. Most fillings were made of amalgam until around 15 years ago, when safety concerns about the mercury in amalgam fillings began to be widely publicized. The mercury in amalgam fillings leaks out very, very slowly into our bodies, and there is a debate as to whether this small amount of leaking mercury is safe. In this article, we will discuss the best courses of action if you have old amalgam fillings and are concerned about your mercury exposure.
To make an amalgam filling, the dentist prepares the tooth, an amalgam paste is placed in the tooth, and then the paste hardens to a metallic solid. The filling precisely fits into the tooth and is supported by the tooth itself. There is no chemical attachment between the filling and the tooth.
Amalgam fillings have been in widespread use since the 1830s. There are good reasons why they have been used for so long: they are reasonably inexpensive and long-lasting. The drawbacks, of course, are that amalgam fillings can be much more noticeable than tooth-colored fillings, and that mercury exposure continues to be a concern.
The unknown health effects mercury could cause are the primary reason amalgam is a concern. Although the mercury exposure from a filling is very low, these low levels might still affect a sensitive patient.
The mercury in dental fillings continues to be a concern even after it has been removed from your mouth. In fact, the number one source of mercury pollution into the environment is from the dental industry. Sweden, Norway, and Denmark have all outlawed amalgam more for their environmental concerns than for their health implications.
Approximately half of dental offices in the United States, including our office, no longer use amalgam fillings. With the vast variety of materials that we have in modern day dentistry, we no longer think amalgam fillings are necessary.
However, we do NOT advocate removing amalgam fillings for health concerns. If the fillings are in good condition, and if the silver color doesn’t bother you, we would recommend leaving them alone. On the other hand, if they are showing signs of breaking down and leaking, which occasionally happens with old fillings, then we would suggest replacing them with another type of material.
If you are unsure about the current state of your old fillings or have more questions about amalgam fillings, it is best to make an appointment with your dentist.