One of the most frequently asked question in our practice relates to the question of silver amalgam as a restorative material. Should it still be used? Should all my existing amalgam restorations be replaced? Are my existing filling safe and is it affecting my general health?
Personally, Silver Amalgam restorations have very limited use in our practice. Not only do traditional silver amalgam restorations appear unaesthetic, they also eventually damage teeth that they are supposed to protect. Metal fillings expands and contracts with temperature changes. These movements, combined with the wedging action of the unbonded metal restoration places internal pressure to the remaining tooth structure eventually resulting in cracks and breakages.
I believe it is simply an inferior material to a well-placed bonded tooth coloured restorations in the form of direct composite or indirect ceramic restorations. Not only are these modern materials as durable (if not more durable) than the traditional metal amalgam fillings, but they are also more natural in appearance.
Silver amalgam starts off as a fine metal powder composed of silver, copper, and other metals which is mixed with a droplet of mercury. This forms a sort of paste which quickly hardens into a solid amalgam. Once hardened, the components are chemically locked together.
The concern is about the possibility of mercury release from those fillings in your mouth over time. There has been a LOT of controversy about this over literally 150 years. To date, no recognized scientific entity has determined that there are any negative health issues with amalgam fillings. And, I am inclined (so far) to believe that there are no real health issues with the mercury that is locked up in amalgam fillings. However, I am open to REAL scientific evidence to the contrary.
A far bigger source of mercury in our environment is from coal-burning electric plants that put tons of mercury in the atmosphere. That mercury ends up in the ground and water. You’ve probably heard about mercury concerns when it comes to eating fish.
Oddly enough, the government or regulatory bodies have deemed scrap amalgam as a hazardous waste. Meanwhile, some other government entities assure us it is safe for use in dentistry. So, it’s against the law to put it in the garbage or landfills in some places. But, it’s safe to put in your mouth?
Another thing that will make you go, “Hmmmm” is that the goverment in the U.S. is banning incandescent (traditional) light bulbs in favor of the so-called “green” compact fluorescent bulbs. Those are the “curly-cue” bulbs. And, they contain mercury. The EPA protocol, should one of these bulbs break, is extensive due to the mercury content within the bulb.This is a clear illustration of the contradictory agendas we see, and it should definitely make one question the “lines” presented by differing bodies.
Some countries around the world have restricted the use of amalgam. And, every so often, the notion of banning it in comes up. And, so here we are again. I believe it will be banned eventually – possibly for the wrong reasons – But, it will be banned some day.
Although there are biomechanics advantages in electively replacing metal amalgam restorations to prevent fractures of the supporting tooth structure, I do not advocate the wholesale replacement of amalgams in order to prevent or treat any medical condition. And, I won’t until credible scientific evidence supports the notion. However, I do understand that some patients do not want them in their mouths for a variety of reasons, including cosmetic concerns. “Silver” fillings are really BLACK fillings. And, who wants that?