ABBOTT FAMILY DENTISTRY, LLC

Amalgam Fillings


Yes, I do offer the amalgam filling material otherwise known as the silver filling, (this may change soon as the cost of waste disposal and the cost of the filling material itself has taken away the one advantage of the filling, it used to be less expensive).  Yes, there is mercury in it. Yes, there is some exposure to mercury, most of that exposure is when the filling is placed and when it is removed.  Studies showing the harm of this mercury are inconclusive and contradictory.  On July 28, 2009, the FDA has changed the classification of the silver/mercury amalgam from a type 1 to a type 2 medical device and recommends not using it on pregnant women and children younger than 6 years old.

​With a tooth like this one, you really don't know if the cavity (caries) came first or if the crack came first.  What we do know is that cracks like the one above can be the means in which the bacteria that cause the cavity enter the tooth and the nutrients that feed the bacteria get in the tooth.

The main reason to offer the silver filling is to offer a lower cost filling material to my patients.  Metal costs have increase, waste disposal costs are about to increase the cost of placing the filling, and the time to place it is no longer less that that of a composite (tooth colored filling).  My current stock of amalgam has expired.  If the cost of replacing it is comparable to that of composite, I will stop offering it in my pracitce.  More to come.


Generally, I would rather use a tooth colored composite filling.  They look more natural, they don't conduct temperature to the tooth was well, and most of all they don't wedge the tooth.  The picture above shows a premolar tooth.  This premolar tooth as a silver/mercury amalgam filling.  Metal fillings, (even some gold ones), are stiff and wedge the tooth.  When you bite your tooth flexes.  If you have a metal filling, the filling does not flex and can act like a wedge in the tooth.  This wedging affect can make the tooth more prone to cracking.  Observe the cracks on the side of the tooth above.  Now look below at the cavity that was under that crack.  Tooth colored composite fillings do flex so they don't wedge the tooth like the metal fillings can.  In fact, if I have a patient who wants an amalgam on a premolar tooth, I take the time to make sure they understand the affects an amalgam can have on the tooth.  I do this because the shape of premolar teeth often makes them more prone to cracks from the wedging affect of a metal filling.


With a tooth like this one, you really don't know if the cavity (caries) came first or if the crack came first.  What we do know is that cracks like the one above can be the means in which the bacteria that cause the cavity enter the tooth and the nutrients that feed the bacteria get in the tooth.


You may have noticed that some of my links go to web pages like this that I made and others go to an information site in which I pay a fee to use and is done by the ADA (American Dental Association).  I found it interesting that there were not information links for fillings at all.  The topic of mercury in fillings is a hot political topic.  I don't know if this is why the ADA is avoiding the mention of fillings on this information site.  I can tell you that the FDA has cleared the use of the silver/mercury amalgam for use and it has been used for well over 100 years.  People are not falling over dead!  Studies that show great harm from the mercury in amalgam fillings have not been able to be reliably reproduced.  With that in mind, we now know that trace exposure to harmful metals can affect the human body in ways we did not previously envision.  I do not know why the FDA changed the silver/mercury metal filling from a type 1 to a type 2 medical device, but I suspect it is out of concern that further research is needed before we continue to use it on people with developing organs and nervous systems.  This is just a guess on my part, and I think if you are a grown adult the silver/mercury amalgam filling is safe, but not as good a choice as the tooth colored composite filling.  Being well informed is important, and the choice is yours!  Keep in mind that if new regulations require special devices to remove mercury from our waste lines the cost of providing the silver/mercury amalgam filling will go up.  That combined with the fact that the cost of the material used in the silver/mercury amalgam filling has gone up due to higher metal prices means that soon it may no longer be less expensive to do an amalgam.  I plan on continuing to provide the amalgam filling as long as the FDA says it is safe, and as long as the cost of providing the service is less than that of providing a tooth colored composite filling.