Can you believe that those silver-coloured fillings called ‘amalgam’ have been around since 1812? They were created by the British chemist, Joseph Bell, more than 200 years ago! Amalgam is a specific mixture of metals. It consists of liquid mercury and a powdered alloy of silver, tin, and copper. They bind together to form a putty, which quickly sets. After being positioned in the cavity, it’s quickly set to form a strong filling.
These days, many clients request to have their old mercury fillings replaced with white fillings, mainly for aesthetic reasons but sometimes for perceived health reasons. I have personally stopped using amalgam for fillings about a decade ago. My decision was mainly due to aesthetic concerns. Not because of any health risk.
The issue that concerns many people is the health risk of leaking mercury from the silver fillings. However, the mercury of the amalgam is bound together to the tin and copper, so once it’s set, there’s no liquid mercury present anymore. Amalgam doesn’t pose a health risk. It’s safe for adults, as well as children who are six and over.
The weight of evidence doesn’t establish any association between amalgam and adverse health effects. In my opinion, everything’s been blown out of proportion. If the old fillings are in good condition with no decay beneath them, I do not recommend removal. Otherwise, the client may end up with an unnecessary loss of tooth structure.
Having said that, there are many who argue that the mercury should be removed. I respect their opinions and concerns and often carefully replace these fillings.
Many have their silver fillings replaced because the white fillings are more aesthetically appealing. It’s not attractive to have black fillings in your teeth. But there are other reasons why silver mercury fillings are not used anymore.
With advancements in technology, dentists have more aesthetic materials on offer, such as composite resin and porcelain, which now last as long if done properly.
In the EU, silver mercury fillings are not being manufactured anymore because the process causes pollution. I expect that Australia would follow suit in time.
For many clients, their silver fillings are starting to break down as they come to the end of their longevity. This simply means that the interface between the filling and the tooth is starting to separate. There are gaps occurring, and this allows bacteria to get into that space and create a potential cavity.
So it’s not the mercury that’s leaking — it’s just the fillings breaking down. I don’t suggest replacing amalgam due to the fear of mercury poisoning but if the client wishes to replace them for aesthetic reasons then I’m happy to do so.
There’s no real urgency in getting the old amalgam’s filling replaced unless the silver filling is not doing the job it was designed to do. Most importantly, it’s safe to know that you’re not going to be poisoned by them.
So the take-home message here is that the best filling is no filling at all! That’s what we should all be working towards.
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