Those who have suffered from tooth decay are highly likely to have had their tooth restored to health by the use of an amalgam ('silver') filling. Dental amalgam has been a popular and effective material used by dentists for more than 150 years, but recently it has attracted growing publicity over possible adverse effects on health.
Amalgam is often referred to as a 'silver' filling and is made by combining mercury with particles of silver and tin, mixed with smaller amounts of copper and zinc to improve its performance.
Although the individual components that make up amalgam (mercury, silver, tin, copper, and zinc) may be toxic in high enough amounts, they combine to form a stable material that has some excellent properties. An analogy with salt is often used; both sodium and chlorine are harmful elements in their natural state, but when combined they form ordinary table salt, which is an essential part of daily life. Those searching the internet for information on amalgam will find a great many claims linking it with all manner of ailments and diseases, including allergies, neuralgia, dementia and cancer. There is no scientific evidence to support such claims.
Mercury is released from fillings in tiny amounts, sometimes during eating or brushing your teeth. However, there is no evidence to indicate that the amounts released are harmful; if there was, the Department of Health would advise dentists immediately. It is, of course, impossible to state that any material is completely safe in any situation and dentists are guided by current scientific evidence.
Amalgam fillings are not the only daily source of exposure to mercury; others include food, the environment and occupational exposure. Some foods such as fish in particular have a high mercury content. Icelanders are exposed to approximately ten times the level compared with residents of the UK because of the amount of fish they consume.
People with known allergies to amalgam will require an alternative filling material, although such cases are extremely rare. As with all other operative procedures dentists will wish to minimise any intervention during pregnancy unless it is absolutely necessary. This will include the removal and placement of amalgam fillings.
Children have different requirements to adults, and small cavities can often be treated with tooth-coloured alternatives, especially if a cavity is in a milk tooth that is due to be shed within a fairly short period of time. However, when a cavity is large and the restoration must be long lasting, amalgam is often the material of choice.
A variety of factors are important when deciding on the type of filling most appropriate for restoring a tooth. These will include the size of the filling, its location, cosmetic concerns and, of course, cost. The dentist will be only too pleased to discuss the options so that an informed decision can be made.
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