A silver mercury amalgam filling is creating cracks in this tooth

A silver mercury amalgam filling is creating cracks in this tooth

Mercury fillings in dentistry are a very hot, controversial topic, and every dentist has her or his own views.

So on one hand, there are people who want their amalgams removed because they feel, for whatever reason, the mercury is making them sick, and on the other hand, the official spokesman for dentistry says amalgams are extremely safe.

So, who is right and who is wrong?

Let’s look at some of the realities. On a national level, the American Dental Association feels that amalgams have proven their safety for more than 100 years. Dental insurance companies like amalgams because they are usually the cheapest and fastest way to fill a decayed tooth.

The Food and Drug Administration is taking a closer look at the safety of these fillings due to the fact they are composed of 50 percent mercury and because the public is wanting answers.

The FDA considers amalgam fillings a Class II (moderate risk) medical device and, therefore, controlled by the FDA.

Here are the latest FDA positions when it comes to placing mercury fillings in the mouth:

  • The FDA has reviewed the best available scientific evidence to determine whether the low levels of mercury vapor associated with dental amalgam fillings are a cause for concern. Based on this evidence, FDA considers dental amalgam fillings safe for adults and children ages 6 and above.
  • A warning that dental professionals use adequate ventilation when handling dental amalgam.
  • A statement discussing the scientific evidence on the benefits and risk of dental amalgams, including the risks of inhaled mercury vapor. The statement will help dentists and patients make informed decisions about the use of dental amalgam.
  • A warning against the use of dental amalgams in patients with mercury allergy.

The Environmental Protection Agency also states that amalgam fillings are safe for people but not so safe for the environment. Here is what the EPA says:

“If improperly managed by dental offices, dental amalgam waste can be released into the environment. Dentists should use dental amalgam separators to catch and hold the excess amalgam waste coming from office spittoons,” according to the EPA’s website. “Without dental amalgam separators, the excess amalgam waste will be released to the sewers via drains in the dental offices.”

In my mind…if we dentists are being forced to use special machinery to control the disposal of amalgam, why is it ok to have it in our mouths?

In summary

There is no solid, scientific information that shows amalgams to be safe or dangerous to the average person.  Since so many dentists still use amalgam and have forever, it makes sense that the ADA would support its use.

The FDA and EPA are a lot more concerned about its use, but they do seem to listen to the political powerhouse ADA.

It is against the law for a dentist to tell a patient they can be cured of diseases by removing all mercury/silver fillings.

There is no universally accepted scientific evidence that says removing amalgams will make people well.

There are people who are allergic to amalgam fillings and its components as they can be to other dental materials.

My personal opinion

I have not done an amalgam filling in more than 10 years because I think they are ugly, and I think they harm teeth over time. I certainly think they are inferior in their ability to protect teeth compared to the newest materials. I can’t see anyone wanting a black, mercury, silver material in his or her mouth that is ugly. I will remove these black, ugly fillings for my patients because I think they are harmful for teeth in the long run, and I have yet to remove one that does not have some amount of mold and decay underneath. Many dentists in the Ottawa area feel as I do, so please discuss this issue with your dentist.

Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!