Dental amalgam, or ‘silver filling’, as it’s perhaps better known, has been around for over 150 years.  Now, before I lay into amalgam (which I will) I should confess that there may be a slight conflict of interest on two counts:

1. I got some amalgam fillings in my early teens which have subsequently caused me no end of problems.
2. I’m a dentist. I’m a private dentist who doesn’t use amalgam.

So, now I’ve confessed you might want to read on…

Amalgam is a mixture of metals that chemically react together to produce a compound.  The main metal involved in this intimate exchange of electrons is mercury.  Mercury accounts for 50% of the metal in amalgam; and pure mercury is highly poisonous.

According to the FDA (the American Food and Drug Administration), amalgam “releases low levels of mercury in the form of a vapor that can be inhaled and absorbed by the lungs. High levels of mercury vapor exposure are associated with adverse effects in the brain and the kidneys”.  Nice.  But don’t worry, they also state “Based on this evidence, FDA considers dental amalgam fillings safe for adults and children ages 6 and above”.  Great! That’s helpful!!

So which is it?  Is it safe? Or is it NOT safe?  Well, the debate has gone on for decades and up to now there is no conclusive evidence that dental amalgam is in any way harmful to health.  However, the use of dental amalgam has recently been banned in the UK in children under 15.  In Sweden, the use of mercury was banned in 2009 – that’s TEN years ago.

Anyway, so there’s no proof that amalgam is harmful to your health, but is it harmful to your teeth?  In a word, yes.  In my opinion.  Which I did say might be slightly biased.

Putting aside my now obvious dislike of the stuff, let’s just look at some FACTS about amalgam as a restorative dental material:

1. Dental amalgam doesn’t stick to anything – there is no chemical or mechanical ‘bond’ between amalgam and tooth. In order for an amalgam filling to stay in the tooth, a cavity has to be prepared that is wider at the base than it is at the opening.  This means acute internal angles which causes micro cracks in the tooth.
2. Dental amalgam can last for AGES! It’s metal after-all.  Problem is, as the pictures above show, the tooth around the filling eventually develops cracks which can result in part of the tooth breaking off, root canal infections, or worse, loss of the whole tooth.
3. Amalgam can discolour teeth – the metal atoms leach into the tooth causing it to go grey or even black.
4. Dental amalgam is still widely used in the UK and indeed is the standard choice of filling material in most situations.
5. It’s damn ugly! Ok, maybe I’m getting personal again, but aside from the functional benefits of replacing amalgam fillings safely with a better alternative (if done properly), a tooth with a lump of metal in it looks like, well, a tooth with a lump of metal in it – we can do better.
6. Amalgam tarnishes. Just like our beloved copper coins that quickly go brown and dirty looking, amalgam does too.  The metals oxidise when they are in contact with moisture – this means the metals leak out into the environment (or your mouth in the case of amalgam).
7. It’s cheap. Yep, we all like a bargain, but as the old saying goes ‘only a rich man can afford cheap shoes’.  Unlike the cheap shoes, amalgam can last for decades but can eventually cause the loss of a tooth, and the cost of replacing it can be significant.  Amalgam is a cheap material and it’s easy and quick to use.  The alternatives cost more because the materials and the technology costs more, and they take longer to do.

So it’s been a while since my last blog, but this case (photographed) highlights the dramatic improvements in both the protection of the damaged teeth and the aesthetic improvements replacing amalgam fillings can achieve.  And all this was done in a single day with our advanced digital CADCAM technology.

Until my next rant 🙂