Amalgam Filling Safety: Benefits and Facts About Silver Fillings

If you need a cavity filled, you may be considering your material options. Dental amalgam is a durable and cost-effective choice that has been used for over 150 years. The short answer is yes: dental amalgam is considered safe for adults and children aged six and older by the FDA. While it contains mercury, it is chemically bound to other metals, making it stable and safe for use in your mouth. As you navigate your oral health journey, we encourage you to find resources, products, and information to give your patients a healthier future.

What Is Amalgam?

Amalgam is a mixture of metals, typically including silver, mercury, tin, and copper, sometimes with trace amounts of zinc, indium, or palladium. Mercury is used because it allows the material to be mixed into a pliable state that can be easily packed into a tooth before hardening quickly. This makes it exceptionally durable for teeth that endure heavy chewing pressure, often outlasting composite alternatives in high-stress areas of the mouth.

Why Is Mercury Used?

Mercury acts as a binding agent. It allows the alloy powder to become a soft, moldable compound that your dentist can precisely shape to your tooth. Once set, it forms a strong, long-lasting restoration that resists wear and tear better than many alternatives. The chemical reaction creates a stable metallic compound that prevents the mercury from remaining in its free, elemental state.

Safety and Precautions

While dentists take specific safety precautions when handling amalgam—such as using protective gear to avoid inhaling vapors during the mixing process—this is to protect the professional from chronic, high-level exposure. Once the filling is placed in your tooth, the mercury is no longer in a state that poses a toxic risk to you. Research indicates that the low levels of mercury exposure from these fillings are well below the threshold for causing adverse health effects, and are comparable to levels found in common dietary sources.

When to Consider Alternatives

You may wish to discuss alternatives like composite resin, porcelain, or gold if you have a known mercury allergy, are pregnant, or have specific concerns about your health history. Additionally, if you prefer a tooth-colored restoration for aesthetic reasons, composite resin is a common alternative, though it may wear faster than amalgam. Red flag: If you notice a metallic taste, persistent sensitivity, or visible cracks around an existing filling, consult your dentist to rule out structural failure or leakage.

Should You Replace Existing Fillings?

It is generally not recommended to remove intact amalgam fillings. The removal process can result in the unnecessary loss of healthy tooth structure and may release more mercury vapor than leaving the filling in place. Replacement is typically only advised if the filling is broken, shows signs of marginal leakage, or if there is new decay beneath it.

Frequently Asked Questions

Are amalgam fillings still commonly used?

They are used less frequently today due to the popularity of tooth-colored materials, but they remain a versatile and budget-friendly option for many patients.

Is the mercury in fillings toxic?

No. Research shows that the low levels of mercury released from fillings are well below the threshold for causing adverse health effects.

How do I know if I need a replacement?

You should only consider replacing a filling if it is fractured, leaking, or if your dentist detects decay underneath it during a routine exam.

Are there different types of amalgam?

Yes, some modern amalgams contain indium to help retain mercury, while high-copper amalgams are designed to be more stable and durable.