Are you curious about the side effects associated with removing amalgam fillings? Amalgam is a common material used to fill cavities caused by tooth decay. If you’ve had dental work done, there’s a good chance your dentist used amalgam. It’s been used for over 150 years on hundreds of millions of dental patients around the world.1
While it’s incredibly common, some people are now opting to have it removed from their mouths.
Concerns over the mercury content in amalgam have caused a spirited debate.
Wherever your thoughts lie, you’ll want to do your own research and speak with your healthcare provider before taking action.
What Elements Are in Amalgam?
Dental amalgam is sometimes called “silver amalgam” because of its color. It does have actual silver in it, along with a combination of other metals. The list of elements in amalgam includes:
Small amounts of other heavy metals like zinc, indium, or palladium may also be used.2
How Are Amalgam Fillings Applied?
Elemental mercury is liquid at room temperature. This element forms the foundation of dental amalgams. In the past, dentists mixed the metals by hand. These days, dentists reduce the risk of occupational mercury exposure by working with a sealed capsule that has two compartments. One side contains liquid mercury and the other contains a powdered alloy of the other metals.
The dentist places this in a machine that blends the metals, creating a thick paste for use in dental restorations. Dentists then push this paste into the prepared tooth cavity.
During this process, some excess mercury rises to the surface. This is removed by the dentist during the dental procedure. The amalgam quickly turns solid and continues to harden over the course of a few hours.3
Why Use Amalgam?
To this day, dental amalgam remains one of the most popular filling materials. It’s strong, durable, and long-lasting. It’s also considered more cost-effective than other dentistry materials. It’s soft enough to adapt to the size and shape of tooth decay. Once positioned, it hardens within a couple of hours.4
Why Is Mercury Used in Amalgam Fillings?
Let’s address the elephant in the room: mercury. We learn as early as grade school that mercury is a toxic material. So why are dentists pouring it in our mouths? The answer is complicated.
Elemental mercury is what gives amalgam filling materials the qualities that make it useful for dental work. The mercury makes amalgam pliable enough to work with. Mercury is what makes the amalgam harden. And mercury is what makes the filling durable enough to withstand the forces of biting and chewing.5
Are Amalgam Fillings Harmful?
The safety of dental amalgam is a controversial topic. The American Dental Association (ADA), U.S. Food and Drug Administration (FDA), and the World Health Organization (WHO) have all conducted research and concluded that amalgam fillings are generally safe.6-8 The ADA calls amalgam material “a durable, safe and effective cavity-filling option.”9
As with most toxins, the level of safety depends on the level of exposure. Very low levels of mercury exposure may not cause adverse health effects. But many studies have shown that high levels of mercury exposure can cause mercury poisoning. The symptoms are:
- Issues with memory
The controversy over amalgam fillings centers on how much mercury is released and how much the body is able to absorb.
Levels of Mercury Released by Amalgam Fillings
For decades, the elemental mercury in amalgam fillings was thought to be inert. Scientists knew that some mercury exposure occurred when a tooth was filled. But they thought the exposure stopped there.11
In recent years, more sophisticated tests have changed this view. New research shows amalgams continuously release mercury vapor as they wear down. When someone with amalgam fillings chews, drinks, or grinds their teeth, a small amount of mercury vapor is released. This vapor is released into the mouth, inhaled, and absorbed by the body.12
But just how much mercury is released, and is it safe?
Research on this issue is complex. One study in Portugal found that children who received amalgam fillings had “slightly higher” levels of mercury in their urine. However, the numbers researchers found fell within the “background level” (0-4 micrograms per liter) that is safe and typical for an average person.13
Another study found that people with amalgam fillings had 2-12 times more mercury in their tissues than those without the fillings.14
Levels of Mercury Absorbed
Mercury is found in the air, water, and soil. People are exposed to this toxic metal nearly every day. Some scientists once believed that the increase in exposure caused by amalgams was slight, so it wouldn’t cause any significant long-term health effects. It was just a drop in the bucket, so to speak.15
However, organic mercury – the kind you get from eating fish – is different than elemental mercury – the kind found in amalgam fillings.16
The Main Differences Between Organic Mercury and Elemental Mercury
Absorption rate. Organic mercury is not easily absorbed by the body. Elemental mercury – the type found in dental materials – is rapidly absorbed and distributed to different organs throughout the body.
Fat solubility. Elemental mercury is lipid-soluble and can cross the blood-brain barrier. Other types of mercury cannot.17
Bottom Line on Safety And Health Risks
Looking at this scientific evidence, the ADA, FDA, and WHO continue to support the use of amalgam fillings. They assert that mercury toxicity levels are safe. To reach their conclusion, The FDA reviewed over 200 scientific articles and 70 relevant abstracts.
According to the FDA, “dental amalgam is a commonly used device with a low risk of adverse events reported to the agency.”18
Despite these statements, some people do have reactions to mercury or one of the other metals in amalgams. These people may choose to have them removed due to this allergy, or for a number of other reasons.
Why Do People Remove Dental Amalgam Fillings?
1. Fillings Are Defective or Show Decay
Amalgam fillings last 10-15 years. Eventually, all fillings need to be replaced.19 Eating, drinking, clenching, and grinding all wear down your fillings. If fillings crack or start to wear away, they can create an entry point for food particles or bacteria. This can cause decay along the filling or underneath it.
If left untreated, a cracked or worn filling can lead to:
- Tooth pain
- A visible crack in a tooth
- The need for a root canal
- A lost tooth20
If you suspect you have a cracked or worn filling, it is smart to see a dentist immediately.
2. They Have A Mercury Sensitivity
Some people experience adverse effects soon after their dentist installs amalgam fillings. These people may be hypersensitive to low levels of elemental mercury exposure.
Some of the symptoms of allergic reactions include:
- Oral lichenoid lesions (OLLs), which are mouth sores caused by allergic reactions22Tremors
- Changes in nerve responses
- Emotional changes
- Decreased cognitive function23
If these symptoms do not resolve themselves, amalgam filling removal is an option. Studies have shown that removing amalgams can help resolve symptoms of oral lichenoid reactions.24
3. They Have Sensitivity or Allergy To Other Metals, Like Silver, Tin, or Copper
Some people opt to remove their silver fillings because of a sensitivity to the other metals in the filling material.25
- Skin rashes26,27
- Concerns About Mercury in the Blood
- Some people choose to have their amalgam fillings removed due to concerns about mercury levels in the blood.28
The population of patients that cause the greatest concern is pregnant women and children under the age of six, where toxic threshold levels may be lower than in adults.29 If you are anxious about amalgam materials and their effect on your health, speak with your doctor. You’ll want to receive guidance specific to your situation.
Removing Amalgam Fillings Side Effects
For those who choose to have their fillings removed, it’s important to understand the side effects of dental amalgam removal.
The process of removing the amalgam may temporarily expose the patient to increased levels of mercury in the blood plasma.31
This increased exposure can lead to short term side effects such as:
- Muscle pain
- Rapid heartbeat32
Once removed, patients have reported seeing an improvement in some health problems. These are self-reported improvements by people who chose to remove their fillings.
They include improvements in:
- Back pain
- Vision disturbances33
- Muscle pain
- Memory and concentration problems
- Mouth lesions34
- “Brain fog” lifted35
Remember, the above improvements are all self-reported, rather than medically studied, so it is important to take that information with a grain of salt.
What Steps Do People Take To Remove Amalgam Fillings?
People who decide to remove their amalgam fillings and potentially reduce their risk of mercury exposure will need to consider several important things.
Pick An Experienced Dentist
If you’re going to get a silver filling removed, you want to work with a skilled, experienced dentist. There’s a chance the filling could release mercury vapor or particles when it’s removed. These toxins can be hazardous. Because of this, you want to make sure your dentist takes proper precautions.
The International Academy of Oral Medicine and Toxicology has developed safety guidelines for the removal of amalgam fillings.
- Using a dental dam so mercury particles don’t mix with saliva.
- Providing oxygen via nasal mask to decrease mercury vapor.
- Removing the filling in large chunks rather than small pieces.
- Using a vacuum to trap and remove toxic particles.
- Protective masks for the patient and staff to reduce occupational exposure.
- Picking better suited restorative materials to replace the amalgam.36
Choose Replacement Material
When an amalgam filling is removed, it must be replaced by a different filling material. These days, several other materials are available. They include:
- Tooth-colored plastic fillings made of composite material (a composite of plastic and glass)
- Porcelain inlays
- Gold inlays
- Glass ionomer37
When deciding on the material for your replacement filling, factors like strength, durability, cosmetic concerns, cost factors, and allergies will all come into play. Speak with your dentist to weigh the pros and cons of each material.
Be Prepared To Detox
If you get your fillings removed, you’re exposing yourself to a higher-than-usual dose of mercury over a short period of time. To counteract this, your doctor may recommend that you detox from mercury.
There’s no easy answer to the question of whether or not you should remove amalgam fillings. It’s a controversial topic with strong opinions – and scientific evidence – supporting both sides of the debate. The right choice for you will depend on your symptoms and reasons for removing your filling.
It is always recommended to speak with your healthcare provider about issues such as this. Speak with a professional. Weigh the risks, side effects, and potential benefits before you take any action.
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