Amalgam Fillings

In the best interest of our patients and staff, our office no longer provides amalgam (silver) fillings. Our reasons are as follows:

Amalgam contains mercury. The release of trace amounts of mercury vapor into the body from amalgam fillings is a serious concern for many. Although the FDA and the American Dental Association still approve it, a number of European countries have outlawed its use. Since there is an "alternative, "bonded acrylic resin", we have decided to use it exclusively.

Amalgam is a metal based filling material that expands as it sets. This stresses the tooth causing sensitivity and predisposes the tooth to microfractures.

Metal conducts hot and cold causing sensitivity.

Mixing the amalgam is another concern for us. Mercury vapor is released during the trituration process exposing our staff and patients daily.

Because acrylic resin is bonded to the tooth structure, mechanical retention is not critical; therefore, we can be more conservative when removing tooth structure. In other words, we only drill away what needs to be removed leaving more healthy tooth untouched.

Lastly, the tooth colored filling material blends naturally with the tooth, creating a restoration that is durable and cosmetically pleasing. While amalgam is initially silver in color, after a year or two it turns nearly black due to surface corrosion.

We hope this clarifies our decision. We certainly encourage you to call us with any questions you may have about our treatment procedures.

Hard facts about amalgam

Some health controversies never go away, and mercury in "silver" amalgam used for filling cavities is one of them. Dental amalgam is a mixture of copper, silver, tin, and zinc; mercury is added for strength and durability. Some people claim that amalgam is toxic and causes everything from cognitive problems to multiple sclerosis, and that existing fillings should be removed and replaced by other compounds. In recent years there have been petitions to the FDA and local ordinances (including a proposed measure here in the city of Berkeley this year) to ban amalgam fillings or make it difficult for dentists to use them. Here are the facts:

Mercury occurs naturally in the environment and also comes from industrial pollution. Just about all people have traces of it in their bodies, even if they have no amalgam fillings. At high levels, mercury can cause gastrointestinal, kidney, and neurological damage; lower levels can harm fetuses, infants, and young children. About 70 percent of the mercury in humans, on average, comes from fish, according to a study in Environmental Science & Technology in March.

There no convincing evidence of harm from the minuscule amounts of mercury that may be released from amalgam when you chew or when a filled tooth is damaged or drilled. In fact, numerous studies have found no increased risk. Notably a large, well-designed Harvard clinical trial in 2008 found no cognitive problems in children with amalgam fillings compared to those with other types of fillings.

Scores of experts and government organizations have concluded that these fillings are safe-the CDC, FDA, EPA, NIH, world Health Organization, U.S. Public Health Service, Health Canada, American Dental Association, and virtually every other major dental organization.

Once again I have to say "pay no attention to that man behind the curtain" regarding a segment on the Dr. Oz Show. It featured a demonstration purporting to show that brushing teeth containing amalgam releases "toxic" levels of mercury vapor in the mouth. This did not mimic real world conditions and was totally misleading. For a full critique of this show, go to

Removing undamaged amalgam fillings is unnecessary, expensive, and potentially damaging to teeth. Beware of dentists or other health care providers who propose testing you for mercury, unless you know you've had high exposure (for instance, if you work with heavy metals at your job) and/or you have the classic symptoms of mercury poisoning. And run for the hills if anyone tries to sell you "detoxification" supplements and programs that are supposed to counter the effects of mercury in dental amalgam*or for any purpose.

Amalgam use is declining, partly because other substances are now also being used for fillings. Most of these are white composite materials, which are less visible than silver amalgam

One piece of semi-sweet news; Americans have been getting fewer cavities in recent decades, thanks to fluoride in toothpaste and drinking water and good dental hygiene. Unfortunately, millions of Americans can't afford dental care, have few dentists in their area, and/or live in areas where water isn't fluoridated. lf not for that, fillings in teeth-and the controversy about them-would probably soon pass into history.

John Swartebetg, M.D.
Chair, Editorial Board December 20l3  

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