Cosmetic: White Filings

Here at The Dalkey Clinic we care about your health. Nowadays a lot of media exposure is given to the mercury in dental amalgam fillings. And recently the European dommison has recommended that mercury containing alloys should be phased out of dental use. Here we try to outline what you need to know to make an informed decision.

Is there really mercury in dental amalgams?
On average 50% of an amalgam filling is mercury, the other constituents normally being silver, copper, tin, zinc.

But mercury is toxic to humans isn’t it?
Humans generally uptake mercury in two ways: (1) as methylmercury (CH3Hg+) from, for example, contaminated fish consumption, or (2) by breathing vapourous mercury (Hg0) emitted from various sources such as metallic mercury, dental amalgams, and ambient air. Our bodies are much more adapted for reducing the potential toxicity effects from vapourous mercury, so health effects from this source are relatively rare. Methylmercury, on the other hand, affects the central nervous system, and in severe cases irreversibly damages areas of the brain (from U.S. Department of the Interior, U.S. Geological Survey, Fact Sheet FS-216-95)

So it’s ok then is it?
There will always be a measurably higher level of mercury in a mouth with amalgams than in a mouth without these types of restorations. However, claims of diseases caused by mercury in amalgam are anecdotal, as are claims of miraculous cures achieved by removing amalgam. These claims have not been proven.

Should I get them removed and replaced with something else?
Typically, the release of mercury vapour from amalgam fillings is very low, however when removing amalgams there is a greater release of this vapourous mercury. Thus an individual will be exposed to more mercury when these restorations are being placed and removed. As such, precautions must be taken during this procedure to minimize your exposure to a higher level of mercury vapour. Strictly, they should only be removed when it is necessary to do so due to decay or fracture.

What precautions do you recommend?
When removing amalgam restorations it is advisable, where possible, to use a dental dam which will reduce to an absolute minimum both the ingestion of contaminated water and the inhalation of the mercury vapour.

What material can I use instead?

You can have directly placed tooth coloured restorations, or you can have laboratory made, custom fitted gold or tooth coloured ceramic restorations. Your dentist will advised you which are most suitable depending on the amount of tooth structure that is missing and needs to be restored.