What is dental amalgam?

Most people recognize dental amalgam as silver fillings. Dental amalgam is a mixture of mercury, and an alloy of silver, tin and copper. Mercury makes up about 40-50 percent of the compound. Mercury is used to bind the metals together and to provide a strong, hard durable filling. After years of research, mercury has been found to be the only element that will bind these metals together in such a way that can be easily manipulated into a tooth cavity.

Is mercury in dental amalgam safe?

NO! It is poisonous but its release is extremely small. Some studies say dental mercury is harmless while others say it is harmful. Dr. Miller's feeling is that it is relatively harmless however, for the past 7 years Dr. Miller has not done silver fillings - based on reasons other than whether mercury is harmless or not. Dr. Miller feels that although amalgam was the best material for filling teeth for hundreds of years, it is not the best any longer given that silver fillings require the dentist to remove more tooth structure to "lock in" the amalgam, since silver does not "stick" to teeth. Amalgams are also more likely to cause fractures in teeth rather than composite resins..

Why do dentists use dental amalgam?

Dental amalgam has withstood the test of time, which is why it is the material of choice. Amalgam is a very durable material and has been used safely for more than 150 years. It is estimated that well over 1 billion amalgam restorations (fillings) are placed annually. Dentists appreciate using dental amalgam because it is easier to work with than other alternatives. Dentists also believe that patients prefer dental amalgam to other alternatives because of its safety, cost-effectiveness, and ability to be placed in the tooth cavity quickly.

Why don't dentists use alternatives to amalgam?

Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins are more costly. Gold restorations take longer to make, and porcelain and composite resins are esthetically appealing, but are more technique sensitive (harder for the dentist to do).

What about patients allergic to mercury?

Patients are better served if we know what they're allergic to. The trouble is, a lot of people don't know what they are allergic to. The incidence of allergy to mercury is far less than one percent of the population. People suspected of having an allergy to mercury should receive tests by qualified physicians, and, when necessary, seek appropriate alternatives.

Should patients have amalgam removed?

No. To do so, without need, would result in unnecessary expense, and potential injury to teeth.

Are staff occupationally exposed?

Dental staff are more occupationally exposed than patients. Necessary precautions should be taken, such as having open air ventilation, and being careful not to spill mercury. Dental personnel have been shown to excrete three to four times more mercury in their urine than the average patient. Studies have shown that dentists have not suffered from more mercury-related disorders than the general population. In the few instances when dentists have shown evidence of mercury disorders, these cases have been associated with poor mercury management in the dental office, especially mercury spills that have not been cleaned up properly. More dentists also are using pre-mixed capsules, which reduce the chance of mercury spills. And newer, more advanced dental amalgams are containing smaller amounts of mercury than before.
An interesting factor can be brought into this: Because dental staff are exposed to mercury more often, one would expect dental personnel to have higher rates of neurological diseases, such as multiple sclerosis. They do not.

What are other sources of mercury?

Mercury can be found in air, food, and water. We are exposed to higher levels of mercury from these sources than from a mouthful of amalgam.

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