Silver amalgam fillings advantages and disadvantages and is it really safe

The silver amalgam filling is one of the oldest and most popular types used by dentists to treat cavities. It is known for its strength and durability, which makes it last for many years without breaking. However, over time, there has been significant debate surrounding its components, particularly because it contains a certain amount of mercury. This has led many people to be concerned and seek alternatives, such as white composite fillings.In this article from Dally Medical, we will explore what silver amalgam fillings are, their advantages and disadvantages, and whether they are truly safe and necessary. This will help you make an informed decision about what's best for your teeth while feeling confident.

⚖️ Are Amalgam Fillings Banned?

No, amalgam fillings are not banned in most countries. However, with advancements in cosmetic dentistry, many people now prefer modern fillings like composite or porcelain due to their aesthetic appeal and closer resemblance to natural teeth.

What is the Healthiest Type of Filling?

The best type of filling varies from person to person depending on:

The extent of decay
The location of the tooth
Your preference for aesthetics or durability

If you're concerned about mercury or prefer a more natural look, white fillings or porcelain are better options. However, if you want a strong, long-lasting filling for your back teeth, silver amalgam is still an excellent and safe choice.

Are Amalgam Fillings Safe or Harmful?

Amalgam fillings, also known as silver fillings, are one of the oldest types used to treat tooth decay, particularly in the molars and premolars that endure heavy chewing forces. Their main advantage is strength, affordability, and faster placement compared to other types of fillings.

But the big question is: Are they truly safe?

Amalgam contains mercury as part of its composition, which has raised concerns for some people. High levels of mercury can affect the nervous system and cause issues like insomnia or mood disorders. However, recent studies show that the amount of mercury in amalgam fillings is very low, and there is no strong evidence to suggest it causes health harm when used properly.

In simple terms, amalgam is generally safe in most cases, especially when placed by a qualified dentist within the allowable mercury limits.

Why Are Amalgam Fillings Still Used?

They are chosen for:

Very high strength, capable of withstanding pressure and chewing forces.
Long lifespan compared to cosmetic fillings.
Lower cost.
Easier placement, even in difficult-to-reach areas inside the mouth.

Therefore, amalgam remains an excellent choice for back teeth that require more durability than aesthetic concerns.

⏳ How Long Do Amalgam Fillings Last?

One of the main benefits of amalgam fillings is their longevity. They typically last between 10 to 15 years, and possibly longer with good oral hygiene and regular dental check-ups.

How Are Amalgam Fillings Placed?

The procedure for placing an amalgam filling is simple but precise:

The dentist removes the decay and thoroughly cleans the cavity.
The amalgam material is prepared by mixing powdered metals with liquid mercury.
The mixture is placed inside the tooth and shaped to match the natural contours.
After it hardens, the filling is polished for a smooth finish and comfort.

The Result?

Are Amalgam Fillings Really Safe?

Even though many people are concerned about the safety of amalgam fillings due to mercury content, scientific studies confirm they are perfectly safe when used correctly. According to reports from the FDA (Food and Drug Administration), amalgam fillings are safe for children over the age of 6 and adults, with no conclusive evidence linking them to serious health issues.

Furthermore, the amount of mercury a person is exposed to from amalgam fillings is much less than the mercury we encounter daily from food, water, and air, making them a safe option for most people.

Why Is Mercury Used in Amalgam Fillings?

Mercury plays a crucial role in the composition of amalgam because it:

Binds the metals together (like silver, copper, and tin).
Provides flexibility, allowing the filling to fit the shape of the tooth.
Helps the filling harden quickly, making it strong enough to endure pressure and chewing for many years.

Simply put, mercury is what gives the amalgam filling its strength and its characteristic silver appearance.

⚠️ Is Mercury in Amalgam Harmful?

Mercury in amalgam fillings can cause concern for some people, especially those with mercury allergies. However, studies show that the mercury levels are extremely low and do not pose a danger to healthy individuals. For those with confirmed mercury allergies, the dentist may opt for alternative fillings like white or porcelain fillings.

Is the Mercury in Dental Fillings the Same as the Mercury in Fish?

No, there's a big difference.

The mercury in amalgam is elemental mercury, which releases small amounts of vapor that can enter the body through inhalation.

On the other hand, the mercury in fish is methylmercury (an organic form), which enters the body through the digestive system.

The body handles both types differently, and tolerance levels vary. However, some recent studies suggest that both forms may convert into each other inside the body, which is why scientists recommend continuous monitoring for any potential long-term effects.

What is Bioaccumulation?

Bioaccumulation refers to the gradual buildup of a chemical substance inside the tissues or organs of the body over time, leading to higher concentrations. Mercury is one of the substances that can bioaccumulate, whether from amalgam fillings or from eating fish that contains methylmercury.

While the body can eliminate most of the mercury it absorbs, a small amount may remain in the kidneys or brain. However, recent studies confirm that the amount of mercury released by amalgam fillings is very low, and there is no evidence to suggest that it causes any organ damage or serious health problems.

Should I Remove My Amalgam Fillings if I’m Concerned About Mercury?

If your fillings are in good condition and there’s no decay underneath them, it’s best not to remove them. According to the FDA, removing amalgam fillings without a medical reason could:

Damage the healthy structure of the tooth.
Expose you to an increased level of mercury vapor during the removal process.

Therefore, it is not recommended to remove amalgam fillings unless there is a medical necessity, such as:

Decay under the filling.
Mercury allergy.
Issues with the kidneys or nervous system that require replacement.

For sensitive groups like pregnant women, breastfeeding mothers, and children, it's advised not to remove preventive fillings unless directed by a qualified dentist.

Does Amalgam Cause Cancer?

So far, there is no scientific evidence proving that amalgam fillings cause cancer. Extensive research conducted over many years has not found any direct link between amalgam fillings and the development of tumors. The FDA (Food and Drug Administration) has also confirmed that amalgam is safe for adults and children over 6 years old. However, in rare cases, some individuals may develop a mercury sensitivity, and in such cases, the dentist may opt for a safer alternative like white or porcelain fillings.

⚠️ What Are the Risks of Amalgam (Silver) Fillings?

Mercury is a naturally occurring element found in air, water, and food, meaning we are all exposed to it in small amounts daily. In amalgam fillings, mercury is part of the metallic mixture used for dental restorations, which is why some people worry about its health impact. Over time, amalgam fillings can release tiny amounts of mercury vapor, which the body may absorb.

However, studies have shown that the amount of mercury released from these fillings is very minimal and insufficient to cause any health problems in most people. In rare cases, if there is excessive exposure or the person has a mercury allergy, mild symptoms such as:

Frequent headaches
General fatigue or sleep disturbances
Mild mood changes

can appear. But these cases are extremely rare, and most people live with amalgam fillings for years without any issues.

Key Benefits of Amalgam Fillings (Silver):

Very High Strength:
Amalgam is one of the strongest types of fillings, able to withstand chewing pressure in back teeth. It lasts for many years without cracking or weakening, even with tough foods like nuts and meats.
Very Long Lifespan:
These fillings typically last between 10 and 15 years, and can last even longer with good oral hygiene.
Affordable:
Amalgam is much less expensive than cosmetic fillings like composite or ceramic. It's a great choice for those with multiple cavities or those seeking a budget-friendly solution.
Fast and Easy to Place:
The dentist can prepare and place amalgam fillings quickly in a single session. They don't require as dry an environment as white fillings, making them easier to use even in challenging areas of the mouth.
Strong Bond with Tooth:
Amalgam bonds mechanically inside the cavity without requiring complex adhesive materials, which makes it less prone to falling out or breaking over time.
Bacterial Resistance:
The silver and copper in amalgam fillings help reduce bacterial growth around the filling, lowering the chances of further decay.

Components of Amalgam Fillings:

Amalgam is composed of a mix of metals that work together to provide strength and durability. These include:

Mercury: About 50% of the mixture, which helps bind the metals and turn them into a solid, durable material.
Silver: Provides strength and resistance.
Tin: Makes the amalgam more flexible and easier to shape.
Copper: Increases strength and reduces wear over time.
Zinc: Helps prevent oxidation and maintains the quality of the amalgam for a long time.

⚗️ What is Silver Amalgam Filling?

Silver amalgam is a mixture of various metals used to fill decayed teeth. Its primary component is mercury (around 50%), which reacts with silver, copper, and tin to create a solid, durable substance. This makes it ideal for filling back teeth that undergo heavy pressure during chewing.

Benefits of Silver Amalgam Fillings:

Very Strong and Durable: It can withstand chewing pressure and last many years of use.
Long Life: Amalgam fillings can last more than 10–15 years.
Cost-Effective: Less expensive than cosmetic fillings.
Quick Preparation: Usually done in one session.
Firm Bond: Mechanical bonding inside the tooth.
Bacterial Resistance: Helps prevent further decay due to silver and copper.

What Are the Risks of Amalgam Fillings?

Mercury in amalgam fillings can release tiny amounts of vapor over time, which the body may absorb. However, the amounts are usually well below the safety threshold set by global health organizations like the World Health Organization (WHO). Excessive exposure or numerous old, degraded fillings could slightly increase mercury levels in the body, which might lead to rare cases of mercury poisoning.

Symptoms of Mercury Poisoning:

Neurological and Psychological Symptoms:
- Frequent headaches
- Memory or concentration issues
- Unexplained depression or anxiety
- Mild tremors in the hands or lips
- Numbness or tingling in the limbs
- Sleep disturbances
General Physical Symptoms:
- Persistent fatigue
- Muscle and joint pain
- Dizziness or frequent vertigo
- Weakened immune system, leading to recurrent infections
Oral Symptoms:
- Metallic taste in the mouth
- Gum inflammation
- Changes in the filling color or falling out
Digestive Symptoms:
- Loss of appetite
- Nausea
- Digestive disturbances

⚠️ In Severe Cases:

Kidney damage
Blood pressure or vision problems

Types of Amalgam Fillings:

By Composition:
- Traditional Amalgam: Silver + Tin + High Mercury Content.
- High Copper Amalgam: Stronger and less prone to corrosion, this is the most commonly used type today.
By Particle Shape:
- Lathe-Cut: Rough particles that require more pressure to fit.
- Spherical: Smooth and easier to shape.
- Admixed: A mix of both.
By Preparation Method:
- Manual: Previously done by hand.
- Pre-Capsulated: Ready-to-mix capsules, mixed in the clinic, offering greater accuracy and safety.

✅ Are Amalgam Fillings Safe and Necessary?

Generally, yes, they are safe for most people. Modern studies confirm that the mercury released from amalgam fillings is very low and not harmful. However, pregnant women, children, and those with kidney issues may avoid them as a precaution.

As for necessity, it depends on your case. If you have deep decay in back teeth and want a long-lasting filling at an affordable price, amalgam is a great option. But if aesthetics matter more to you, then white fillings (composite) might be a better choice.

Symptoms of Mercury Poisoning (Amalgam) and Why It’s Important to Be Aware:

Mercury poisoning from amalgam fillings is extremely rare, but in certain cases, symptoms may appear due to bioaccumulation of mercury in the body. While studies haven't shown major health effects in most people, it's essential to be aware of potential symptoms, especially if exposure increases or persists over time.