Should I replace my old silver (amalgam) fillings?

This is another question I get asked frequently. What is an amalgam filling? It’s basically a combination of different metals, including about 50% mercury. Studies have shown that that over time, fillings lose their mercury content. The longer the fillings are in your mouth, the higher the amount of mercury will be released from the fillings. Studies also have shown that mercury vapor is released every time you chew and subsequently, concentrations of mercury levels do indeed increase in your bodies’ tissues.

The American Dental Association’s stance is that amalgams are safe, and that the amount of mercury released into the body is too minute to be harmful. The ADA does not believe dentists should remove amalgam fillings unless there is existing decay around the filling. However, several states, including New Jersey where I practice, now require dentists to separate the amalgam waste out of the water before it reaches the sewer line. So, common sense dictates that amalgam fillings may be harmful and toxic to the human body. Amalgam fillings also fracture and crumble at the edges, and cause teeth to fracture due to the expansion and contraction of the mercury in the filling. On a personal note, when I remove an old amalgam filling, there is a 90% chance there is recurrent decay under the filling. This is due to the microscopic leakage that occurs along the edges of the filling.

So, should you let your dentist put in an amalgam filling? My personal feeling is no. In my practice, we have not placed mercury fillings in the last 15 years. There are many options, like composite bonded restorations that are chemically attached to the teeth, and contain no toxic metals.

Should you replace your existing amalgam fillings? My advice would be to remove old amalgam fillings that your dentist discovers to have cracks, leakage or decay. Also, if you suffer from an autoimmune disease, such as Multiple Sclerosis, studies have shown that mercury and other toxic metals in your bloodstream may exacerbate your disease. So you may want to remove existing amalgams if you suffer from these types of diseases.

There are also some over the counter products that claim to block the absorption of mercury into your body. These are usually mouthwashes that claim to have a chelating agent, or chemical that attaches to the mercury so it can’t be absorbed. If you don’t want to have the amalgam fillings replaced by a dentist, these mouthwashes may be an option. However, the evidence is inconclusive as to the efficacy of these products. 

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