Many people know us as a mercury free dental practice, we get asked many times about amalgam fillings and their use within dentistry, we thought the best way to go through many of these things is to create a blog post.
What is an amalgam filling?
A filling is simply your dentist replacing decayed tooth structure with a new material. In days gone by the best material to use to replace this decayed structure was amalgam.
Amalgam consists of silver, tin, copper and approximately 50% by weight of mercury.
Why are dentists still using mercury in fillings?
As a simple to use, manageable, malleable and long-lasting filling material amalgam fits all of the criteria. However, in our opinion, with more health conscious individuals it does not fit the criteria of being the healthiest option for a patient, the dentist or the environment.
How safe is a dental amalgam?
A dental filling releases low levels of mercury, particularly during removal. The information on this website is available to help you understand the potential toxicity or safety of dental amalgam fillings.
The UK Department of Health advises all dentists not to remove or replace amalgam fillings in pregnant women.
Here you can find several documents that can be accessed directly by clicking on the buttons and research articles that you can find online.
- American Dental Association Literature review on Dental Amalgam Safety
- International Academy of Oral Medicine and Toxicology: The Case Against Amalgam
- The safety of dental amalgam and alternative dental restoration materials for patients and users
- World Health Organisation – Fact sheet 361: Mercury and Health
- World Health Organisation: Guidance for Identifying Populations at Risk From Mercury Exposure
- World Health Organisation – Exposure To Mercury: A Major Public Health Concern
- World Health Organisation welcomes international treaty on mercury
How difficult is it to have mercury dental fillings removed?
The actual technique of getting amalgam fillings removed is quite simple, however the safe and holistic way to remove them is to use extensive suction, filters and special burs.
Can an amalgam filling be replaced?
Yes, however it is best removed under very tight control procedures, including, but not limited to:
- High-quality ventilation during the removal procedure.
- Filters in place to cover your nose and eyes to protect you from daybreak and mercury vapours.
- Rubber dam* in place around the tooth to ensure we catch any daybreak and stop it going into your mouth.
- High-volume suction to ensure that the mercury vapour is kept to a minimum.
- Safe storage of anything which goes into the dental suction chamber.
- Continuous water irrigation to keep your feeling cool as it has been shown that more vapour is released with heat.
- Specially designed burs which efficiently remove the amalgam was keeping the heat low.
*This is controversial for some people as they believe that the amalgam vapour built up behind the rubber dam, however studies have also shown that treatment with a rubber dam reduces the overall exposure to amalgam during the whole procedure
Why is mercury in dental amalgams?
Mercury was historically used in dental amalgams as it was very pliable at low temperatures meaning that the metal did not need to be heated in order to be placed into the dental cavity, you can imagine how painful it might be having molten metal poured in!
Should I get my silver fillings removed?
The general advice is that if your silver amalgam fillings are working well, not breaking down and the tooth structure around them is sound then leave them as they are. If, however the fillings are beginning to break down then they could either be removed and replaced or, if the breakdown is severe, a dental crown placed over the top.
Why don’t dentists make a silver filling that has no mercury?
Indeed there are many materials which have no mercury including:
- Dental composite.
Composite tends to be the cheapest option, is most aesthetic and is amongst one of the easiest materials for the dentist to use. In dental terms it is a relatively modern material which is why amalgam was used historically.
Gold fillings and ceramic inlays have also been used in latter years, gold is falling out of favour due to its cost but ceramic inlays are still used frequently.
Are Composite Resin fillings better than Amalgam fillings?
As with many questions, it depends on who you ask. In our opinion composite resin fillings are indeed better than amalgam fillings for the following reasons:
- They look better and blend in with the natural teeth.
- They are simple and easy to repair if they break. Composite can be treated so that it bonds to itself, this means a dentist can easily add more if some chips off.
- They bond to the tooth structure, this means that your dentist may not need to remove additional tooth structure (After removing the tooth decay) in order to create an undercut that the amalgam would sit in. Composite resin fillings are therefore less destructive on the whole.
- In very small quantities composite resins can also release fluoride which have a positive effect on the re-mineralisation of your enamel as it is attacked throughout the day.
There has however been research which shows that amalgam has a slightly lower wear rate compared to composite, this could mean that in time composite fillings may need to be replaced more frequently as they wear. In our opinion this slight disadvantage is far outweighed by all of the other advantages of composite resin.
Do holistic dentists help people get healthier? If so, how?
All dentistry can be considered holistic. Links have been found between dental disease and heart disease, diabetes and even erectile dysfunction. The same bacteria has been found in heart disease as is present in those people with gingivitis. The same is true for many other conditions. Looking after your mouth is a very good holistic way to begin looking after your whole body.
Dr Lage has a special interest in Implant Dentistry, Mercury free Dentistry, Root Canal Treatments (Endodontics), and Cosmetic Dentistry (crowns, bridges, veneers, teeth whitening).
He is very calm and very good with children and nervous patients.
Jose speaks English, Portuguese and Spanish and is trying to improve his Italian and French.