Dental Amalgam Fillings

Dental amalgam (silver fillings) came into use in 1830. Dental amalgam is a metal alloy consisting of approximately 50% mercury, 40% silver and the remaining 10% is a combination of tin, copper and zinc.

In 1840 the American Society of Dental Surgeons prohibited its members from using amalgam because of the dangerous mercury content (Mercury being highly toxic). This prohibition directly led to the formation of the American Dental Association, which promoted this new cheap and easily-used material to the mass population. Prior to amalgam fillings, only wealthy people could afford the traditional gold fillings, which resulted in most people going without dental treatment.

Until recently, the official position has been that mercury within an amalgam filling cannot escape after the material has hardened. However, the opposite has been indisputably and scientifically demonstrated. Mercury vapour does escape from amalgam fillings in measurable and significant quantities whenever one chews or has a hot drink. Also if a person grinds their teeth, which is a very common involuntary action during sleep, called bruxism, then the level of mercury released can be much higher.

In addition, the quality of amalgam can vary greatly. High grade amalgam has a high silver content and low mercury content, whilst poor quality amalgam has low silver content and high mercury content. The low grade material tends to corrode easily and release more mercury, more easily. Low grade amalgam is predominantly used in the NHS system in the United Kingdom , due to low cost of the material. One very commonly sees very poor quality amalgam indeed which has very low silver content and quickly corrodes and disintegrates.

The World Health Organisation (WHO) has stated that the greatest exposure to mercury in the general population is from dental amalgam. The WHO has also stated that there is no accepted safe level of mercury in the body.

Mercury vapour released from amalgam fillings is inhaled into the lungs and then absorbed into the blood stream. It then accumulates in the brain, central nervous system and major organs. Mercury is a heavy metal ( like Lead and Cadmium ) and is not easily eliminated from the body.

The two levels of mercury poisoning are "Acute" and "Chronic".

Acute poisoning develops from a single significant exposure to a relatively large quantity of mercury, such as a fractured thermometer or industrial spillage. The Victorians were well aware of the effect of prolonged exposure to significant levels of mercury because of their large hat making industry. Hence, the origin of the phrase "mad as a hatter", due to mercury poisoning causing massive deterioration of the brain and central nervous system of the hat makers, who were continually exposed to mercury used in the hat making process. This is classic "heavy metal" poisoning.

Chronic mercury poisoning is due to sustained exposure to very low levels of mercury which can have a range of physical and mental symptoms. There is considerable variation between individuals regarding "sensitivity" to mercury and its potential effects at low levels. It is for this reason that many health practitioners of varying kinds consider it best avoided, though the official line of the dental community is that at such low levels it is completely safe. For many people it is safe, though for many it might not be and for some people it may be really quite dangerous. One simply cannot be certain of the potential effects of this material, hence in my view it is best avoided.

It is curious that it is against the law to paint your house with a paint containing higher than a certain level of mercury, or a factory may be immediately shut down for exceeding a certain level of mercury vapour in the air, yet it is considered perfectly fine for a dentist to place a material in your teeth that can create potentially far greater mercury levels in your mouth!

Dental Amalgam waste in a dental practice is a major health and safety concern and by law has to be clearly labelled as "highly toxic" and handled and stored with extreme care and very strict safety precautions, yet , it is deemed completely safe when it is placed in someone's teeth. Because prevention is better than cure, many dentists would consider it is best not to have amalgam fillings placed.

One can be tested for mercury levels within the body and also for individual sensitivity to mercury. One needs to get the right type of very specific test i.e. a Mercury Challenge Test.

In removing amalgam fillings, the dentist needs to be very careful not to expose the person to increased levels of mercury. This happens if fillings are drilled into, as the heat causes the release of mercury vapour. Therefore, any dentist removing amalgams should take precautions against this. Dentists use several different methods to protect patients and staff against mercury exposure.

It is best that copious amounts of water aerosol from the dental drill are used to ensure cooling and to absorb any vapours. Also, it is advisable to use high volume aspiration to suck away any vapour and debris. As a further precaution, a barrier can also be placed in the form of a rubber dam, which is a piece of rubber in which holes are punched and which is then pulled over teeth to isolate them and also provide a barrier at the back of the mouth to any debris and vapours. Some dentists may also provide alternative air supply for patients to breathe.

Basically, the dentist should be aware of the dangers of the material and the procedure and ensure as a far as possible there is no exposure to mercury to the patient and themselves and their assistants. Ideally, if having amalgam fillings removed, one should visit a dentist who is knowledgeable and experienced with the procedure.

Removal of amalgam fillings will prevent a person from having further exposure to mercury, however, one ideally needs to deal with accumulated mercury in the body by eliminating it from the body tissues. This is best done with Chelation Therapy, which is basically administering a substance into the body which binds to mercury , and then both are eliminated from the body.

Once amalgam has been removed from teeth, the materials for replacing the fillings should be as bio-compatible as possible. Most commonly used materials are Composite Resins (which are plastics) and Glass Ionomers. Other materials include gold and porcelain. Porcelain is the most bio-compatible material and also provides a very durable and generally much longer lasting tooth restoration.

It is important that one also have good quality dentistry and the best long-term restorations placed to minimize the amount of times teeth are "drilled and filled", as this potentially quite traumatic to teeth ( particularly with large or deep fillings ) and increases the chances of negative consequences to these teeth. Teeth can only withstand a certain amount of trauma before nerve problems etc. start to occur.

Video showing mercury vapour leaking from amalgam fillings

To make an appointment for a free consultation or any other enquiries, please call Luton Dental Practice on 01582 - 726853