Dental Amalgam Fillings
Please note that we are a mercury free office. Although we do not perform this procedure, this information is provided for informational and educational purposes.
What is a dental amalgam or a silver filling?
A dental amalgam is a commonly used dental filling that has been used for over 150 years. It is a mixture of mercury with at least one other metal. If you are between the ages of 24 to 65, chances are good that if you had a cavity, your filling was made of amalgam, which is visible in your mouth when you smile or laugh. For many years these silver fillings were the standard and treatment of choice. They were the only option available besides extracting the decayed tooth.
What are the advantages of dental amalgams?
Amalgam has many advantages over other restorative materials, such as low cost, strength, durability, and bacteriostatic effects. Amalgams can serve for 10-12 years.
Why replace amalgam fillings?
At our office we no longer offer metal amalgam fillings, partly due to potential health risks associated with them, but also because tooth fillings look and function better. While we use these white fillings now for patients who have new cavities, we often get requests from patients to replace their old, amalgam silver fillings with these newer composite fillings. Here are 5 reasons to replace your silver fillings:
- Silver Fillings Have a Limited Lifespan – Unlike composite fillings which are chemically bonded to your teeth, an amalgam filling is packed into an area of your tooth, much like filling in a pothole. With time all fillings wear away and allow leakage. This on-going process exposes areas where bacteria can start cause tooth decay. Because you will not see or feel when a filling wears out, the decay may continue unabated and you may end up needing to get a crown instead of just another filling. At your regular hygiene exam, Dr. Chan will check your old fillings to see if they are due for a replacement due to corrosion, leakage or staining of your teeth and/or gums.
- Amalgam Contains Mercury– Approximately 50% of an amalgam filling is made up of mercury, which can potentially be a health risk to some patients. While on-going research and debate continues regarding the potential dangers of amalgam, peace of mind may be a consideration for some patients.
- Amalgam Fillings React to Temperature Changes– Metal expands and contracts with temperature changes. Since an amalgam filling is made of around 50% mercury, a metal, which is used in thermometers, it adjusts to the temperature. When you drink something hot, the amalgam filling will expand and place a lot of extra strain on your tooth, which can eventually lead to cracks and fractures. And when you eat something cold, like ice cream, these fillings contract, creating a gap around the filling and your tooth. These on-going expansions and contractions eventually will weaken your tooth.
- Composite/Bonded Fillings Strengthen Your Tooth– Because amalgam fillings act like a pot-hole filling, there is no attachment of filling to the tooth. Composite fillings not only fill the cavity but are also designed to chemically bond directly to your tooth, so that the filling and tooth work together, not against each other, as can happen with amalgam fillings. When a tooth with a filling gives under force, the amalgam does not (it’s a solid and immovable pothole) and this creates an uneven distribution of force that can damage the non-filled areas of your tooth resulting in tooth cracks and fractures.
- Composite/Bonded Fillings Are Esthetically Pleasing– When you smile or laugh, those amalgam fillings are noticeable. Not only can they be seen but they show how many fillings you have had. Because composite fillings are tooth colored, and are made to match the look of your teeth, they are virtually invisible.
Switching out your old amalgam fillings is a personal decision which comes down to how you feel about aesthetics, comfort, functionality and possibly your peace of mind.
In September 2020 the FDA’s updated recommendations said dental amalgam is safe for most, but there are some who should avoid the material, including pregnant women and their developing fetuses; women who plan to become pregnant; women who are nursing; children, especially those that are under the age of six; people with kidney problems; and people with pre-existing neurological conditions like multiple sclerosis, Parkinson’s or Alzheimer’s.