You probably don’t give much thought to a filling once it’s been placed in your tooth. But there are some who question the safety of silver fillings, also known as dental amalgam.
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Currently, there are millions of amalgam dental fillings in use, and they continue to be placed in dental schools, clinics and hospitals all over the world. They are considered safe and stable, yet their use continues to be debated.
Hadie Rifai, DDS, says that dentists have used these fillings for more than 150 years all over the world. And, he says, they have a proven track record as a safe, durable, low-cost material that dentists can place easily to fill cavities that tooth decay causes.
“Neither the scientific evidence nor my own experience in my practice leads me to find any logical dangers related to amalgam restorations. I have no qualms about using them to treat my patients,” Dr. Rifai says.
What is dental amalgam?
Dental amalgam is a mixture of liquid (elemental) mercury and a powdered alloy composed of silver, tin and copper.
Elemental mercury makes up about 50 percent of dental amalgam by weight. Elemental mercury reacts with and binds together the other metal particles to form the strong amalgam.
What are the primary fears about mercury?
There are instruments so sensitive that they can detect very miniscule amounts of mercury vapor in people’s mouths. But studies find that the amount of mercury a person’s body absorbs is far below anything that could cause an adverse health effect.
One study compared ten symptomatic patients and eight patients who reported no health complaints. The symptom group did not have a higher estimated daily uptake of inhaled mercury vapor, nor did this group have a higher mercury concentration in blood and urine than in the control group. The amounts of mercury detected by the tests were trivial.
Other research has shown that the problems patients believe are caused by amalgam restorations are related to their anxiety about them rather than to the fillings themselves. When researchers tested the blood, they found no signs of mercury intoxication. Still, they found that removing fillings in patients with such anxiety was important for people’s mental health.
Some people claim that mercury has been linked to Alzheimer’s disease. However, a host of organizations, including the American Dental Association, Food and Drug Administration, and the World Health Organization, cite current evidence that finds no relationship between amalgam dental fillings and Alzheimer’s.
Additionally, the Alzheimer’s Association website states, “According to the best available scientific evidence, there is no relationship between silver dental fillings and Alzheimer’s.”
“This has been studied extensively,” Dr. Rifai says. “To my knowledge, there is no study as of yet that has proven a direct relationship of dental amalgams to Alzheimer’s.”
Should you have existing amalgam fillings removed?
Currently, there is no scientific evidence that supports the removal of dental amalgams as curative, according to Dr. Rifai.
He adds that, if you already have amalgam fillings, it can be more harmful to remove them. This is because of the mercury vapor released upon removal.
“However, if the amalgam needs to be removed due to secondary caries or failure of the restorative material, you should not delay replacing that individual filling,” Dr. Rifai says. “Fortunately, today there are a wide variety of alternatives patients can choose from, such as composites, ceramic or gold.”
If you’re concerned about amalgam fillings, Dr. Rifai suggests that you talk to your dentist about it. He says it’s important to have an open dialogue with your dentist and to address any concerns.