A certified implantologist and prosthodontics specialist with 20+ years in dentistry, I conduct clinical research, teach at University of Kiel, and contribute to implant system development. Recipient of the Camlog Research Award, I frequently publish and deliver global lectures.
Amalgam has long been used as a material in dental fillings for the teeth. The advantage of amalgam fillings in dentistry is that it has a long shelf life and is relatively cheap. It is made of up to 50 percent of mercury and various other heavy metals such as copper, tin or silver filling material. Amalgam is now being avoided not only for aesthetic reasons, but also for health reasons. Because amalgam is subject to chemical changes in the oral cavity, the mercury it contains is distributed throughout the body. Many patients who are still being supplied with amalgam fillings are considering having them removed.
Dental amalgam filling removal: yes or no?
The effects of amalgam fillings on the body are not fully understood. Some patients develop symptoms, while others can tolerate amalgam fillings without any problems. The problem with this is that various symptoms of intolerance only appear gradually. We have, therefore, never used amalgam fillings at our dental clinic in London. The question of whether an amalgam filling should be removed depends on various factors. Among other things, the condition of the tooth filling is important to consider before the amalgam removal procedure. If the amalgam fillings are brittle or leaky, they should be removed. The same applies to tooth decay on a tooth that has already been treated. A substitute made of ceramic or plastic is also useful for fillings that are more than 10 to 15 years old. Another important point that should not be overlooked is the patient’s wellbeing. Anyone who simply does not feel comfortable with possible mercury exposure and the effects it has on the body, should have the filling removed.
Symptoms of amalgam intolerance
The symptoms of an allergy or intolerance can develop slowly and over many years. Toxic mercury can sometimes accumulate in the organs, causing possible health problems. The liver and kidneys are particularly affected due to amalgam use. Quite often, mercury makes it difficult to absorb important trace elements such as zinc or selenium and can even have a negative effect on the heart. The metal can also cross the blood-brain barrier and reduce stimulus transmission. Since mercury also accumulates in the placenta, amalgam fillings have been banned for pregnant women and generally for children up to 15 years of age, since 2015.
Typical symptoms of intolerance are:
- autoimmune diseases
- chronic fatigue, exhaustion
- Memory problems and difficulty concentrating
- mental disorders
- chronic inflammation
- allergic reactions such as rashes and itching
Interesting Fact: Mercury pollution has decreased continuously over the past decades. The change from amalgam to ceramic and plastic fillings have been a contributing factor in this.
How does amalgam restoration work?
First of all, it must be clarified whether or not the amalgam removal process is necessary, since mercury can also be released when removing amalgam fillings. The advantage, however, is obvious: once safely removed, the filling cannot cause any further potential damage to the body. At our clinic in London, our dentists have extensive experience in the removal of amalgam fillings and use all safety measures to prevent even the smallest amounts of mercury vapor from being released. Before the actual treatment, the area around the tooth is covered with a dental rubber dam. This is a special elastic strap that prevents the patient from swallowing parts of the amalgam filling. Glasses are also used to protect the eyes during the treatment. The filling is then removed from the tooth with a special milling cutter, while cooling with water. A suction device is then used to remove any small particles. As soon as the amalgam has been removed, we either insert a plastic filling directly or prepare the tooth for a ceramic filling, which is then inserted in a second appointment. If there are caries under the old amalgam filling, it will of course also be removed.