The Dental Amalgam Debate

What is Dental Amalgam?

Dental Amalgam was invented in 1819 and is largely an alloy of silver, tin, copper, zinc and mercury which is hardens in the tooth once it is placed. Amalgam is still used extensively around the world as an inexpensive alternative to other materials. Its use has been banned in Sweden, Norway and Denmark.

The mercury toxicity question

The main issue with amalgam is mercury. Controversy still remains about the safety and health implications of amalgam. Many chronic illnesses have been attributed to amalgam and although there is plenty of evidence to support amalgam toxicity, there is also a lot of data that shows the opposite. The World Health Organisation states that the data does not support mercury toxicity.

Environmental concerns

When amalgam fillings are removed, the mercury finds its way into the sewage and contributes significantly to environmental pollution. Apple Dental uses an amalgam separator to remove the vast majority of mercury from suctioned water. They are, unfortunately, not mandatory.

Structural issues

Although amalgam itself is very long-lasting, its effect on the surrounding tooth is often less than desirable. Cracks are common in amalgam-filled teeth, often leading to recurrent tooth decay and split teeth. At best, larger fillings or crowns are needed to treat cracked teeth. At worst, root canal treatment or even extraction becomes the only treatment.

Alternatives

The main alternative is composite resin, which is a white synthetic material. It may not be as long-lasting, but it is more conservative and not as structurally damaging to teeth.

CAD/CAM ceramic, such as the CEREC system, is now recognised as the longest-lasting filling method in dentistry today, while serving to strengthen rather than weaken the tooth being restored.

A personal opinion from Dr Mark Casiglia

I made the decision to stop placing amalgam fillings in 1995. Without buying into the debate, I know that mercury is released from amalgam fillings during teeth grinding, and that there is no safe level of mercury exposure. Personally, I would not allow amalgam to be placed in my teeth. After all, who wants a black filling that can break your tooth and may be harmful to your health?