Are amalgam fillings safe?
Dental amalgams (silver fillings) were first used in the 1800’s. For decades, amalgam was considered the only appropriate choice of filling material for posterior teeth. Amalgam fillings had a number of positive characteristics that made it the best material for use in these difficult and challenging parts of the mouth. These included:
- long-term success
- relative ease of placement and
- tolerance for success in difficult working conditions
In the last decade however, it has been demonised by the public and some in the profession as a horrible, unhealthy material.
The scientific information on the subject is well known, and it does not condemn dental amalgam. However, the alleged problems with amalgam are expressed on the Internet by many anti-amalgam groups. The result is continuing uncertainty on the part of the lay public about the safety of dental amalgam.
However, there are times when some dentists feel amalgam is a better restorative material than resin in a given situation. Numerous studies show amalgam to last twice as long as white fillings in posterior teeth. Many of the problems we see with white fillings are the result of poor technique and material application. Composite resin requires greater attention to detail in placement to include the need for excellent isolation that is free of contamination during placement. Poor placement will lead to premature failure and possibly greater problems down the track. If you are going to replace your metal fillings with white fillings you must be prepared for longer appointments and therefore higher costs.
Some European countries, like Switzerland, have banned the use dental amalgam, THis is often used to suggest that dental amalgam is indeed a health risk. The truth of the situation is that Mercury in all industrial applications was banned and therefore the decision was an industrial one based on environmental issues and not due to any specific dental health concerns. The dental profession had no choice but to comply.
Today, in general dental practice, amalgam use has diminished significantly with some reporting a drop to around 35% use in dental procedures. With aesthetics, the dominant reason patients seek treatment, the use of amalgam has further declined and replaced with tooth coloured restorative materials.
