Ask the Dental Experts

I've heard a lot about amalgam fillings not being good. Can you tell me why? What do you recommend if you have amalgam fillings? What is an "amalgam" filling anyway?

In our opinion, the use of dental amalgam fillings (Silver-Mercury Fillings) is no longer the best or wisest choice for simple fillings.

The material was developed during the civil war, and is still widely used in most parts of this country. The filling is mainly a mix of silver and mercury. It softens when the two are mixed, and hardens in a short time. There are many reasons that we no longer offer this type of filling for our patients.

The mercury component of these fillings can be as high as 55% in a new amalgam filling. Over a period of time this mercury does leach out of the filling. On average the mercury component has dropped to 27% in 5 years, approaching zero in 15 years. We just don't feel that there is a reason to have our patients ingest this toxic material. Mercury shows up in the liver and kidneys, in mother's milk, and passes the placental barrier. There is insufficient evidence to link this mercury contamination to a host of diseases that are mentioned periodically in the media, but there is a concern.

The reasons for the continued use of amalgam is multifaceted. It continues to be taught as a technique in most dental schools. It is easy to place, and therefore cheap to do. Many insurance companies (never an advocate for optimum care), encourage the use of this material to minimize the benefits they have to pay out.

We also find it amusing that the amalgam scraps that are removed from patient's teeth have to be stored in a labeled hazardous waste container, and have a special pickup for disposal. It seems the only safe place to place this material is in the hazardous waste container, or in a patient's mouth!

The safety of the material was grandfathered when the federal government and the ADA (American Dental Association) began testing dental materials for safety. It would be highly unlikely the material, if just invented, would be approved today. The more important reason behind our decision to go "Mercury-Free", has to do with the expansive nature of the mercury itself. Mercury is placed in thermometers for a reason. It is very sensitive to temperatures. I can put a thermometer in a child's mouth and tell a two degree difference, due to the mercury expanding that much. Why would we put a filling with 55% mercury into a brittle tooth, knowing the patient will be eating ice cream, then washing it down with hot coffee? In short, these fillings are perhaps culprits in tooth fracture. We feel that these fillings are partly responsible for the amount of crowns that are placed on adult molars.

Lastly, we find that most patients actually desire their teeth to look natural. With the materials available today a properly trained dental professional can make most teeth look brand new.