Should I have my amalgam fillings removed?Ethical Dental
Amalgam (otherwise known as metal or silver filling material) has been commonly used for dental fillings throughout the 20th century. One of the most common questions we get asked as dentists is about amalgam removal. So should you get your amalgam fillings removed?
One of the main concerns that people raise about amalgam fillings is that they contain mercury. Amalgam can be made of different metals, but tends to be a combination of about 50% mercury and 50% other metals (such as silver, tin, copper and zinc).
The World Health Organization lists the following key facts about mercury:
- Mercury is a naturally occurring element that is found in air, water and soil.
- Exposure to mercury – even small amounts – may cause serious health problems, and is a threat to the development of the child in uteroand early in life.
- Mercury may have toxic effects on the nervous, digestive and immune systems, and on lungs, kidneys, skin and eyes.
- Mercury is considered by WHO as one of the top ten chemicals or groups of chemicals of major public health concern.
- People are mainly exposed to methylmercury, an organic compound, when they eat fish and shellfish that contain the compound.
We generally recommend amalgam removal when:
- An amalgam filling shows signs of deterioration
- When a metal filling breaks
- When there is a crack in the tooth adjacent to a metal filling
- When there are health concerns relating to mercury levels (often by referral from the GP or naturopath)
We respect patient autonomy (freedom of health choices) and some patients elect to have their amalgam restorations removed and replaced with white fillings. When this is requested, we will discuss the procedure and any risks associated with elective filling replacement.
The protocols used for safe removal of amalgam used in our clinic include:
- The use of Rubber Dam isolation
- High volume air evacuation
- Use of special burs and equipment to minimize aerosols
Often a white (composite resin) filling can be used to replace a metal filling. However, if amalgam fillings are large or there is not much remaining strong tooth structure, other options may need to be considered including fillings made of ceramic or crowns that cover and protect the entire tooth.
The process of removing amalgam fillings needs to be planned appropriately. We will not usually replace all metal fillings in one visit as we aim to minimize the exposure load to the patient. For this reason, a consultation is the first step in planning for amalgam filling removal to enable a safe strategy for this process.
For more information on dental amalgam, visit the World Health Organisation website by clicking here.