Until recently, dental “silver fillings” made of a compound called amalgam have been a standard material for use in reconstructive procedures such as cavities. What many people do not know is that amalgam is made in large part (up to 55 percent) of mercury, a highly toxic liquid metal. As this information has become disseminated, patients are rightfully asking for safe ways to remove and replace silver fillings.

Amalgam is a mixture of a silver alloy (silver, copper, tin and zinc) mixed with 45-55 percent mercury that is packed into the filling area before it sets to form a durable filler. Although considered safe by major health and professional organizations, major concerns remain as to whether or not the mercury in amalgam could have lasting health consequences. An organization, the IAOMT (International Association of Oral Medical Toxicology) has spearheaded the reaction to mercury exposure from silver fillings.

Consider this. In 1996, the United States passed the Mercury-Containing and Rechargeable Battery Management Act, which eliminated the use of mercury in batteries due to concerns over environmental pollution. In 2013, 140 countries agreed to the ideas outlined in the Minamata Convention on Mercury. Named after a devastating humanitarian disaster caused by environmental mercury poisoning in the Japanese city of Minamata, the convention was convened to propose steps to eliminate emission of mercury into the environment. Given the efforts to eliminate the use of mercury where possible in other industries, what are the concerns with amalgam fillings?

Mercury vapor that is absorbed through the lungs is the largest risk to patients with amalgam fillings. In addition, removal of the problematic amalgam exposes the patient to additional mercury vapor.  Certainly, many patients have silver fillings and are doing “fine”.  But some people have lower tolerances and higher susceptibility to the dangers of mercury…and they may benefit from the removal of this potentially toxic element. So what is the solution?

Why has amalgam been used for so long?

Amalgam is documented to have been used as far back as the first part of the Tang Dynasty in China (AD 618–907). The compound was brought to the United States in 1833 by Edward Crawcour and by 1844, amalgam was use in upwards of fifty percent of all restorations in NY state. Did you know thatat that the American Society of Dental Surgeons stepped in declared the use of mercury fillings as malpractice!  It forced all members to sign a pledge to refrain from using those types of compounds in restorative procedures. This created a rift in the dental professional’s community that lead to the disbanding of the ASDS and the founding of the American Dental Association in 1859. Oh, and did I mention that the ADA holds patents on amalgam?

The debate over toxicity of amalgam fillings rages to this day. One camp calls the other camp alarmists whereas the anti-amalgam group sees conflicts of interest and convenient “looking the other way” by proponents.

When in doubt, follow the money

Charles Brown, president of Consumers for Dental Choice has been the most vocal critic of the ADA and its defense of amalgam. Viewed as somewhat strident by his critics, he has led the movement for mercury-free dentistry since the 1990s. According to him, a combination of efforts by the FDA, the state Dental Boards and the ADA have conspired to lock in the use of amalgam. You are welcome to read details if you care to by searching for his name and amalgam in your favorite search engine.

When you understand how mercury poisoning can occur over time, and how some people may react to repeated exposure,  it is easy to understand why mercury filling removal makes sense. Mercury accumulates in the body as it is absorbed, much like lead or other heavy metals like arsenic.

Although amalgam has never been linked to a disaster like Minamata, I believe that removal of amalgam fillings is wise. There is no sense in risking one’s health with such potentially dangerous compounds.