Mercury Rising – When Should You Replace Old Amalgam Fillings?

In this month’s Ask Dr. Josh, we take on the issue of amalgam fillings, decay and mercury!

State of Decay

How dangerous are your silver amalgam fillings? Unless you have a specific allergy to any of the filling components (mercury, silver, copper, or tin), the answer is: Not very. This may change with time, however, when the amalgam reaches the end of its lifespan and starts to break down. This normally begins to happen around the 10 year mark, but it is not unusual for amalgam fillings to last 20, even 40 years. But in the end, they will eventually go the way of all good things, and need to be replaced. A simple visual check is all that is required to determine their condition. Open up, and let’s have a look-see. Ah-ha! Just as we thought…

Before Replacement:

During Replacement:

After the composite filling is complete!

Isolate With Isolite

A decaying amalgam actually looks porous, as if it were bubbling or boiling. It is at this point that dangerous levels of mercury vapor may be released, and the filling should be immediately replaced. But is it safe? Not to worry. Here at Benchmark Dental, removal of dangerous, decomposing amalgams is accomplished safely and securely with the Isolite Dental Isolation System.

Removal of Amalgam Fillings

We start with the placement of a comfortable mouthpiece designed to capture wayward bits of material produced by the drilling-out of the old filling, while the negative-pressure vapor recovery system insures that toxic gases are drawn safely away, and not inhaled. This ensures not only the safety of the patient, but the staff as well! Gone are the days when pieces of old amalgam were inadvertently swallowed, and everyone got to breathe the vapor. After removal of the old filling, a decision must be made: What to replace it with? Silver amalgams have a distinct number of advantages:

  • Strength – They can take it still.
  • Longevity – They typically last longer than plastic, or resin composite.
  • Cost – Silver amalgam is half the price of alternative fillings.

And one big disadvantage:

  • Mercury – Silver amalgam fillings contain mercury, a toxic heavy metal.

For most individuals, this is not a problem. The materials that comprise an amalgam filling are very tightly bonded (At least in the beginning. Then comes the running…and the screaming). Every cell in your body already contains trace amounts of mercury. It’s natural. It’s all around us. This, from the FDA (Food and Drug Administration): “FDA has reviewed the best available scientific evidence to determine whether the low levels of mercury vapor associated with dental amalgam fillings are a cause for concern. Based on this evidence, FDA considers dental amalgam fillings safe for adults and children ages 6 and above. The weight of credible scientific evidence reviewed by FDA does not establish an association between dental amalgam use and adverse health effects in the general population. Clinical studies in adults and children ages 6 and above have found no link between dental amalgam fillings and health problems.”

The Composite Revolution

For many sensitive individuals, mercury amalgam fillings are contraindicated. Resin composite fillings are the next most popular choice, and also have the distinct advantage of being aesthetically pleasing. Improvements in filler technology and the formulation of composite materials have resulted in lifespans that nearly rival those of their amalgam brethren. These materials are constantly improving to a point where they will eventually surpass the unbecoming amalgams, and consign them to the spit sink of history.

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