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Description
A very small but vociferous movement within the dental profession wants to do away with a staple of their craft found in the mouths of millions: silver fillings. These fillings, or amalgams, have also contained mercury for the entire 150 years they have been used to plug cavities.
The typical silver filling is a combination of metals, including silver, mercury, tin, copper, and zinc. Mercury, however, constitutes about 50 percent of a filling. Some now point to this mercury as the underlying cause for conditions ranging from neurological disorders to premenstrual syndrome.
The mainstream dental community dismisses the claims as unsubstantiated, but the small core of anti-amalgamists maintain their ground. One protagonist argues that mercury from amalgams comes off and accumulates in tissues and that brushing teeth or chewing gum can exert enough pressure to transform solid amalgam mercury into a vapor that can be swallowed. Once mercury is in the blood, it can travel to other organs.
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The Dental Consensus
An impressive list of organizations strongly supports the continued use of silver amalgam as the safest and most durable of materials with which to fill tooth cavities. According to those organizations, the amalgam is stronger, more durable and less expensive than any alternative filling yet devised. In its elemental form, mercury is highly poisonous but bound to tin, copper or silver in dental amalgam it is biologically inert.
In the past 20 years, sensitive instruments have been developed that can detect trace amounts of mercury vapor just above amalgam fillings after the metal gas been slightly heated during vigorous chewing. Some of the vapor is undoubtedly inhaled and absorbed into the body's tissues. However, any amounts of mercury absorbed from fillings are extremely low and far less than those absorbed from air, soil, and food. Some fish such as swordfish contain large amounts of mercury and a tuna sandwich may pose a far greater danger than a mouthful of amalgam fillings.
The assertions of instant miracle cures of multiple sclerosis and migraine headaches on removal of amalgam fillings have been dismissed as unscientific and misleading. Removal of mercury fillings presents hazards in that the removal process transiently releases a lot of mercury that lingers for weeks. After a filling is removed, the level of mercury vapor would increase and make people feel worse.
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Public Health Service Findings
The U.S. Public Health Service issued in the Spring of 1993 a Report entitled "Dental Amalgam: A Scientific Review and Recommended Public Health Service Strategy for Research, Education and Regulation" that addressed the question whether the mercury component of amalgam can produce adverse health effects.
This Report, the product of two years of effort by government agencies and consultants, recognized that small amounts of mercury vapor are released from amalgam and can be absorbed into the body. The Report also acknowledges the possibility that rare, local allergic reactions to dental amalgam may occur in an exceedingly small segment of the population. But it concludes that "There is scant evidence that the health of the majority of people with amalgam is compromised, nor that removing amalgam fillings has a beneficial effect on health." Nonetheless, the Report notes that there insufficient scientific evidence to completely rule out the possibility that amalgam could pose long-term health risks, as well as insufficient knowledge of the potential risks of alternative materials.
A recent study (1998) in Sweden summarized some reports on mercury release from amalgam fillings and resulting concentrations in biological fluids, development of antibiotic resistance, and kidney function. In a series of studies of subjects with amalgam fillings, mercury (Hg) levels were followed in saliva, feces, blood, plasma, and urine before and until 60 days after removal of all of the fillings. According to the conclusions of independent evaluations from different state health agencies, the release of mercury from dental amalgam does not present any non-acceptable risk to the general population.
Currently, although still controversial, there is no clear evidence to suggest that mercury amalgam fillings are unsafe.
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Questions to Ask Your Doctor
Are there any tests to detect mercury in the blood stream?
Is there a list of possible diseases or conditions caused by mercury?
Do you recommend the removal of the mercury filling?
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