Dental Amalgam

What Is Dental Amalgam?
Most people recognize dental amalgams as silver fillings. Dental amalgam is a mixture of mercury, and an alloy of silver, tin and copper. Mercury makes up about 45-50 percent of the compound. Mercury is used to bind the metals together and to provide a strong, hard durable filling. After years of research, mercury has been found to be the only element that will bind these metals together in such a way that can be easily manipulated into a tooth cavity.

Is mercury in dental amalgam safe?
Mercury in dental amalgam is not poisonous. When mercury is combined with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless. The amount released in the mouth under the pressure of chewing and grinding is extremely small and no cause for alarm. In fact, it is less than what patients are exposed to in food, air, and water.

Ongoing scientific studies conducted over the past 100 years continue to prove that amalgam is not harmful. Claims of diseases caused by mercury in amalgam are anecdotal, as are claims of miraculous cures achieved by removing amalgam. These claims have not been proven scientifically.

Why do dentists use dental amalgam?
Dental amalgam has withstood the test of time, which is why it is the material of choice. It has a 150-year proven track record and is still one of the safest, durable and least expensive materials to a fill a cavity. It is estimated that more than 1 billion amalgam restorations (fillings) are placed annually. Dentists use dental amalgams because it is easier to work with than other alternatives. Some patients prefer dental amalgam to other alternatives because of its safety, cost-effectiveness, and ability to be placed in the tooth cavity quickly.

Why don’t dentists use alternatives to amalgam?
Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins are more costly. Gold and porcelain restorations take longer to make and can require two appointments. Composite resins, or white fillings, are esthetically appealing, but require a longer time to place the restoration. It should also be known that these materials, with the exception of gold, are not as durable as amalgam.

What about patients allergic to mercury?
The incidence of allergy to mercury is far less than one percent of the population. People suspected of having an allergy to mercury should be tested by qualified physicians, and, when necessary, seek appropriate alternatives. Should patients have amalgam removed? No. To do so, without need, would result in unnecessary expense, and potential injury to teeth.

Are staff occupationally exposed?
Dentists are using pre-mixed capsules, which reduce the chance of mercury spills. And newer, more advanced dental amalgams are containing smaller amounts of mercury than before.

An interesting factor can be brought into this: Because dental staff are exposed to mercury more often, one would expect dental personnel to have higher rates of neurological diseases, such as multiple sclerosis. They, in fact, do not.

What are other sources of mercury?
Mercury can be found in air, food, fish, and water. We are exposed to higher levels of mercury from these sources than from a mouthful of amalgam.

Reprinted with permission from the Academy of General Dentistry, July 2005