Silver fillings, also referred to as amalgam fillings, are used to treat cavities, and have been one of the most common dental restorations over the last century. However, silver fillings contain mercury particles, and as such, have also been at the center of a long running debate related to patient safety. Some dentists have recommended that their patients remove all of their silver filling to avoid possible health risks. This is more common in certain parts of the US than others, so what is the right answer?
Let’s start with the benefits of amalgam restorations. They are strong, user-friendly, and cost-effective, with a proven history of long-term success. Many of these fillings can last upwards of 50 years without the need for replacement. The primary alternative to a silver filling is a tooth-colored (composite) filling, which requires a very careful technique, is more expensive, and has a much lower longevity. Amalgam has a metallic look, which may not be acceptable to some patients; however, there is no sound scientific evidence to indicate that silver fillings pose any health risk to patients.
The World Health Organization defined 50 ug/mm3 as the maximum amount of mercury vapor that can be in the air for an employee to safely work 40 hours/week. Insertion or removal of an amalgam filling generates about 2ug of mercury, and a patient would require 450-500 silver restorations before even subtle symptoms of mercury poisoning would be found in even the most susceptible patients (Mackert 1997). In comparison, a diet high in certain types of seafood can contribute 10-20 ug of mercury per day, which is also well below the daily limit. In 2002, the New England Journal of Medicine reported that there are no known connections between silver dental fillings and any neuro-degenerative diseases, such as Alzheimer’s or Multiple Sclerosis.
That said, there might be valid reasons to remove your existing silver fillings, such as recurrent decay or fracture, but the vast majority of the research available indicates that removal of silver fillings due to mercury content is unnecessary. Further, choosing to remove silver filling and replace them with some alternative does come at a cost. It is expensive, time consuming, and may lead to a greater risk of tooth loss.
If you have been told to remove your silver fillings and replace them with tooth colored restorations, and would like to discuss the risks and benefits of doing so with Dr. Bryan Limmer, please contact us to schedule a consultation.