How Safe Are Amalgam Fillings and Should You Replace Them?

For quite some time now, there has been an ongoing discussion concerning mercury poisoning and ways people get exposed to this dangerous neurotoxin, and I’ve mentioned it in my article on how to detox from heavy metals. Consequently, some took fish off their menu, while others put the blame on amalgam fillings, also known as silver fillings. Many, including several official bodies, claim that routine mercury exposure does not present a health problem. However, too many doubts and conflicting study results exist to ignore the issue.

Could your amalgam fillings be slowly damaging your health? Should they be removed or are they safe as they are? This article aims to provide some information to help with the decision about your dental work.

What is amalgam?

Every year, about a billion amalgam fillings are fitted. They have been used for over 150 years and are popular due to their durability, affordability and ease of manipulation. They are a preferred choice for many dentists and patients, especially when fixing back teeth that need strength for chewing and are not visible when we smile, so their appearance is often less of a priority.

Amalgam is a mixture of mercury, copper, tin and silver. 50% of amalgam filling is mercury, which is used to bind the other elements together. To this day, no alternative to mercury has been discovered, so it continues to be used.

This is where the problem with silver fillings starts. Many people are not even aware that their dental work contains mercury that produces potentially dangerous vapor in their mouth. The vapor levels are particularly high when inserting and removing the fillings, so possible extraction needs to be completed with great care.

Conflicting information about mercury vapor

According to different studies, the level of mercury you get exposed if you were fitted with amalgam fillings ranges from 1 microgram a day to 27 micrograms a day. The World Health Organization (WHO) also states that the exposure significantly increases – up to 5 times – with certain practices and habits such as grinding your teeth, chewing gum and drinking carbonated drinks.

If we consider the higher numbers from these studies, the WHO’s statement, and continuous exposure, mercury vapor from amalgams should be deemed unhealthy as per standards set by the Occupational Safety and Health Administration (OSHA).

However, the American Dental Association (ADA) doesn’t consider amalgam to be unsafe. The US Food and Drug Administration (FDA) also advises against the removal of amalgam and warns that this could cause more harm to the patient compared to leaving the fillings as they are. Not only that, the FDA brands the removal of amalgam for fear of mercury vapor unethical, and dentists performing the procedure risks losing their license. Yet, in 2009, the FDA itself moved the use of amalgams to Class II (moderate risk) from the previous Class I (low risk), which is slightly contradictory to their position on the safety of amalgam.

Health risks of amalgam fillings

Again, the studies don’t provide us with a clear and unquestionable answer.

When exposure to mercury reaches a certain level, this powerful neurotoxin can cause neurological damage, mental health problems, chronic diseases and autoimmune conditions. A study performed in Sweden revealed that 78% of people who had pre-existing neurological and health issues (for example, chronic fatigue syndrome) reported an improvement in their health after they had their fillings removed. In 2008, Scandinavian countries banned the use of amalgam in dentistry.

Reports from the US contradict the above decision. Studies funded by the FDA found insufficient evidence that would link mercury from amalgams to various health complaints. They explain that when mercury is linked with other materials, its chemical composition changes and it becomes non-toxic. Furthermore, the FDA and the ADA believe that the amount of mercury that gets released from amalgam fillings is too small to be harmful to humans.

Environmental risks of amalgam

Mercury presents a great threat to the environment, too. The WHO established that 53% of mercury emissions could be attributed to amalgam and laboratory devices. That is why a correct removal technique that can decrease the release of mercury into the sewer system is so important. Amalgam separators can mitigate the negative impact, but they are not mandatory in many countries, including the US.

To remove or not to remove?

This is not an easy and straightforward decision to make and should be carefully discussed with your dental team. As mentioned before, during removal, more mercury vapor gets released, which can worsen your health situation.

Generally speaking, a non-amalgam restoration is usually recommended if the fillings are older than 20 years, cause gum inflammation and prevent you from keeping good dental hygiene.

How much mercury might be leaking into your body also depends on the number of fillings and your diet. For example, if you like to indulge in carbonated drinks, this will increase the mercury levels as the bubbly drink erodes amalgam.

If you do decide to remove your old amalgam fillings, make sure that your dentist uses a dental rubber dam that will isolate the tooth and minimize mercury vapor.

What are the alternatives?

Instead of amalgams, resin composite fillings can be used. They mimic the appearance of your teeth and are usually used for front teeth. They used to be considered not durable enough for back molars, but the techniques and materials have improved now, so they can also be used for high-pressure grinding and chewing. Still, many dental plans don’t cover them.

Other, more expensive alternatives include laboratory-fabricated porcelain and gold.

Final thoughts

It is still not clear if mercury in amalgam presents a health risk. More research by independent bodies is required and the results need to be made available to the patients.

Don’t just rush into removing your existing amalgams as most mercury vapor is released during placement and removal.

Scandinavian countries banned or restricted amalgams due to health and environmental reasons. When you are deciding about your future fillings, consider the alternatives that are available and might be safer and healthier.

How Safe Are Amalgam Fillings and Should You Replace Them?

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