Should I Remove My Amalgam Fillings?
You may be thinking of having your amalgam fillings removed because it’s time to replace your current fillings or you are concerned about the health risks of mercury exposure. There could be both benefits and risks to replacing your fillings, depending on the condition of your teeth and any other health symptoms you are experiencing.
Amalgam fillings, or silver fillings, are generally made of a combination of silver, tin, copper, and mercury. They have been used for over 150 years due to their durability and affordability. Removing amalgam fillings may reduce symptoms in people who are sensitive to mercury, but it’s important to be aware that you may be exposed to mercury vapor during the removal procedure. It’s essential to go for a personalized evaluation before making the decision and have any fillings removed by a dentist who knows how to remove and dispose of dental amalgam safely.
Quick Facts About Amalgam Fillings
Mercury is a heavy, silver-white toxic metal commonly used in dental amalgam fillings.
The mercury content of dental amalgam fillings is roughly 50%.
Amalgam fillings are shown to release small amounts of mercury vapor over time.
Amalgam fillings are the main source of inorganic mercury exposure (besides occupational exposure) for people with these kinds of fillings.
The FDA advises against replacing or removing amalgam fillings that are in good condition unless it’s deemed medically necessary.
There is still much debate about whether dental amalgam (the mercury alloy used in dental fillings) is safe.
FAQ about Amalgam Dental Fillings
If you are considering having your amalgam fillings removed or need new cavity fillings, it may be helpful to understand a bit of background about amalgam fillings and the benefits and potential risks of removing mercury fillings from the mouth.
The following are some frequently asked questions about amalgam fillings and amalgam filling removal procedures:
Why Is Mercury Used in Amalgam Fillings?
According to The Journal of the American Dental Association, dental amalgams have been used for over 150 years to restore teeth and repair cavities. Dental amalgam is a metallic alloy primarily composed of tin and silver mixed with 50% elemental mercury. Mercury remains the only element that effectively binds metals together for cavity fillings. Despite growing concerns about mercury exposure, some dentists still regard dental amalgam as a safe, long-lasting, and cost-effective way to seal cavities.
Why Is Mercury Exposure from Dental Amalgams a Concern?
Dental amalgams release small amounts of mercury vapor, which can then be inhaled or ingested. Since dental amalgams contain mercury, some studies suggest that exposure to mercury from dental amalgam fillings over time may contribute to various health issues including cognitive, endocrine, and psychological disruptions.
Meanwhile, the FDA website states that "studies on people with dental amalgam do not show conclusive evidence that dental amalgam causes harmful health effects in the general population." Today, the safety and potential health risks associated with amalgam fillings continue to be debated among dental professionals.
What Are the Potential Benefits and Risks of Amalgam Removal?
A growing number of people are seeking to have their amalgam fillings removed as they become aware of the risks associated with heavy metals. In this case, dental amalgam removal can give patients greater peace of mind knowing that potential mercury exposure is no longer a threat. Individuals who are allergic or sensitive to metal fillings may find that their symptoms improve after the fillings are removed.
There are also risks associated with removing intact amalgam fillings, including mercury vapor release and tooth damage during the procedure. Experienced dentists like Dr. Salin in Bakersfield, CA take extensive measures to minimize these risks.
How Can I Tell If My Dental Amalgams Are Causing an Issue?
Determining if dental amalgams are causing issues can be challenging, as symptoms may vary from person to person. However, according to several authoritative sources, potential signs of mercury poisoning include:
Oral symptoms: metallic taste, mouth sores, and gum inflammation
Gastrointestinal distress: nausea, bloating, and diarrhea
Vision changes: decreased visual acuity and impaired color perception
Coordination issues: reduced fine-motor control
Neurological symptoms: difficulty concentrating, increased headaches, and memory loss
Allergic reactions: oral ulcers, skin rashes, and itching
Psychological symptoms: mood swings, depression, increased anger, and anxiety
The FDA recommends that the following high-risk groups avoid getting fillings made from dental amalgam:
Children under the age of six
Women who are pregnant or plan on becoming pregnant
Women who are breastfeeding
People suffering from neurological or kidney impairment
Individuals with increased susceptibility to mercury or any of the other components of dental amalgam
What Are Some Alternatives to Dental Amalgam (Mercury) Fillings?
If you are wary about getting dental amalgam fillings or belong to a high-risk population that should avoid getting mercury fillings, you're in luck. A few popular alternatives to amalgam fillings are both biocompatible and can be matched to your natural tooth color. Also, most modern tooth fillings are preferred by dentists as they provide a durable and non-toxic option for teeth restoration. Some of the best alternatives to amalgam include:
Composite resin. Sometimes called white fillings, composite resin fillings are made of a resin-based matrix with an inorganic filler like silica. Composite fillings can be customized to match the color of your teeth.
Porcelain. Porcelain fillings (inlays and onlays) are typically made of a combination of kaolin, quartz, and feldspar. Like composite resin fillings, they can be customized to match the color of your teeth.
Glass ionomer cement. Self-adhesive glass ionomer cement (GIC) is made from an acidic water-soluble powder combined with fine glass powder. Although GIC isn’t as strong as porcelain or composite resin, it can sometimes be used for small fillings.
Dental crowns. When regular fillings, inlays, or onlays are not able to restore your tooth structure, dental crowns may be a better option. Dental crowns are typically made from porcelain and completely encase the tooth, restoring its natural size and shape.
Dental implants. Porcelain-capped dental implants may be a better option than a filling or a crown if you have severe tooth decay or a missing tooth. The dental implant root is typically made from titanium. However, zirconia can be used for patients who prefer a metal-free option.
When determining which kind of restoration may be most appropriate, it is best to see a dentist for an evaluation and to discuss your treatment options with him or her. When the time comes to fill the cavity (if another filling is sufficient), your dentist will clean out the decayed portion of the tooth to make the area ready for the filling. The filling will then be placed, compacted, set, and polished.
Weighing the Risks versus Benefits of Amalgam Removal
It’s important to weigh up the potential risks and benefits before removing amalgam fillings. Removal may be a reasonable consideration if you have specific health concerns, allergies, or aesthetic preferences. However, if your existing amalgam fillings are in good condition and your dentist does not raise any concerns, leaving them in place may be a safer and more cost-effective option.
Arguments for the Removal of Dental Amalgam
Mercury exposure. The primary concern with amalgam fillings is the potential for mercury exposure. Mercury is a toxic substance that can accumulate in the body over time. Although the amount of mercury exposure caused by amalgam fillings is debatable, some people still prefer to remove their mercury fillings for peace of mind.
Allergic reaction. Some people may develop allergic reactions to the metals used in amalgam fillings. These reactions can range from minor skin irritation to more severe symptoms like those mentioned earlier on.
Aesthetics. Some patients may consider having their silver fillings removed because they prefer tooth-colored fillings for a more natural appearance.
Arguments Against the Removal of Dental Amalgam
Safety. A higher amount of mercury vapor is released during amalgam removal than occurs on a daily basis. In addition, amalgam removal could lead to the needless loss of healthy tooth structure. Both of these problems can be minimized by working with an experienced dentist.
Cost. Removing amalgam fillings can be costly. Insurance may only cover part of the procedure and patients may need multiple dental visits to complete the process.
Lack of conclusive evidence. Even though some researchers think amalgam fillings expose the body to mercury, others say there isn't enough data to confirm or deny any adverse effects connected to amalgam fillings.
Make an Informed Choice
If you are considering the removal of amalgam fillings, it’s essential to go for an evaluation with an experienced dentist who knows how to remove and dispose of these kinds of fillings safely. He or she will also be able to advise you on the most appropriate material for the replacement restorations.
Remember that factors such as the condition of your teeth, the extent of the decay, and your overall health will influence the final decision. Amalgam filling removal may be more suitable (and necessary) for some patients than for others, and an experienced dentist can help you work through the options and make an informed decision.