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What is Dental Amalgam? Here are the Basics

One of the most common materials used to fill cavities is dental amalgam. They are also known as silver fillings. Over the years, there have been rising concerns over the use of dental amalgam fillings. These concerns stem from the fact that amalgam contains mercury. As you might know, high levels of mercury can cause long-term damage to the human body. 

Artistic image of dental fillings or dental amalgam fillings

You might have heard about the side effects of dental amalgam fillings and wondered whether you should consider amalgam removal. Some concerned patients even ask whether they will be poisoned if they leave their amalgam fillings in. 

In most cases, amalgam fillings are removed only when broken, worn down or when decay occurs beneath the filling. 

If you are concerned about mercury and would like to resort to amalgam removal, do seek assistance from a dentist who is familiar with the removal process. 

This article will help you understand more about the basics of dental amalgam and whether you are exposed to any health risks. 


Seek a consultation with a dental office that is familiar with dental amalgam removal. 


What is dental amalgam?

Dental amalgam is sometimes referred to as “silver amalgam.” This term does not accurately reflect what dental amalgam is as it actually contains a combination of metals. Besides silver, amalgam is also made up of silver, tin and copper. Small amounts of palladium, indium and zinc may also be included. 


Why is mercury used in amalgam?

Mercury is used in amalgam because it can help make the filling material more pliable. When mixed with alloy powder, it can create a compound soft enough to be pressed into the tooth. More importantly, it can cause it to harden really quickly. This material property helps it become strong enough to withstand biting and chewing forces. 


Should I be concerned about mercury found in dental amalgam?

If you are concerned that mercury found in dental amalgam can poison you, the quick answer to that is no. Mercury is a metal that is found in our environment. It exists as a liquid but turns to gas when heated. Mercury can also be found in other materials. It is highly unlikely that the low traces of mercury present in your dental amalgam will lead to mercury poisoning. 

However, this does not mean that you should proceed to accept treatment that is done with amalgam fillings. Whilst you might not be at any risk of mercury poisoning, in recent years, sophisticated tests have shown that minimal amounts of mercury (in the form of mercury vapor) are released when your filling wears out.  


What are the effects of mercury on the human body?

You are exposed to mercury everyday. 

Did you know that you are exposed to mercury through drinking water, the soil that fertilizes your fruits and vegetables, the food you eat and the air you breathe? 

However, the impact of mercury on your human body is dependent on the levels of mercury present. In other words, very low traces of mercury content do not cause ill effects. At higher levels, it can manifest several tangible health problems including irritability, headaches, memory loss, anxiety, and fatigue.

This leads us back to the controversy on the use of mercury in dental fillings. In the past, amalgam fillings were believed to be inert – no mercury is released once the fillings are placed into the dental cavity. This is why dental amalgam was widely used to prevent cavities. 

What recent research studies have shown is that mercury fillings can release mercury which our body ends up absorbing. 


Worried about the impact of mercury on your health? Book an appointment to remove your dental amalgam. 


Are dental amalgam fillings safe? 

The American Dental Association (ADA) and the British Dental Association (BDA) maintain that dental amalgam is safe and can be used safely as restorative material. 


The U.S. Food and Drug Administration (FDA) does not recommend having your amalgam fillings removed or replaced if your current fillings are in good condition with no decay. 


In a 2012 study by the European Commission, it reports that there is no scientific consensus on the direct health impact of dental amalgam, apart from allergies. The key concern for them is the water contamination and potential environmental impact caused by the removal of amalgam fillings. 


The World Health Organisation (WHO), on the other hand, has a phase-down approach on the use of mercury in dentistry. The directive is that nations can sunset mercury-based dentistry according to their domestic needs. 


To avoid the risks of ingesting mercury, Elite Dental Group does not use mercury or mercury amalgams in our restorations. We highly recommend removing or replacing dental amalgam only when there is decay or defects to the amalgam. 


What are treatment options to dental amalgam? 

There are many treatment alternatives to dental amalgam should you require fillings for your cavities

Nowadays, indium can be mixed into the dental amalgam. Indium can help retain mercury so less will be released into the environment. High-copper amalgams also exist. These options contain more copper and less mercury.

It is common for dentists in Singapore to make use of materials like porcelain, gold and resin to restore your teeth. Amalgam is considered stronger than composite resin and will require less time in the dentist office. Composite resin, however, wears faster than amalgam, so it is not always used in every situation.


Should I consider amalgam removal?

In most cases, amalgam fillings are only removed when they are broken or worn or when decay occurs beneath the filling.

A lady patient waiting to seek treatment for dental amalgam removal

If you are concerned about mercury and would like to resort to amalgam removal, book an appointment with me to see whether it is necessary for you to undergo the treatment procedure. 


Dr. Gerald Tan