In recent years, the question of whether to remove silver fillings has created a great deal of controversy among dental professionals. For some dentists, the belief is that the mercury found in silver fillings contribute to patients’ health problems including; Alzheimer’s disease, memory loss and leukemia. Since there is no compelling research evidence proving that silver fillings are responsible for medical illnesses, some dentists hold the view that silver fillings are still harmless.

In this column, we will discuss the latest best practices approach to the idea of placing or removing amalgam fillings.

Silver fillings or dental amalgam have been used for over 100 years.

In fact, as a child when I visited the dentist, I received silver fillings. At that time, silver fillings were the standard of care. They were the most durable, affordable and a safe choice. Today, silver fillings are not used as much; primarily because of public health concerns and their dark grey coloring. Over the past several years, there has been increasing debate and interest on the safety of silver fillings.

What are silver fillings and why are they used?

Silver fillings are called amalgam. It refers to a blend of metals including: silver, tin and copper. These metals are mixed with a liquid version of mercury then molded into a putty and placed into the cavity. Although very limited, silver fillings are still placed in some dental offices, hospitals and public clinics. Other dental restorative materials, like composite resins or porcelain are now regarded as the standard of care because they are widely accepted as safer and more attractive. They contain no mercury and are similar to the color of your natural teeth.

Why the controversy?

Mercury is a naturally occurring metallic element that is found in the volcanoes and fossil fuels. It is liquid at room temperature and becomes a gas when heated. According to the World Health Organization, this can be hazardous because mercury can be toxic on the nervous, digestive and immune system.

Since the toxic effects of mercury have long been recognized, you may wonder whether it’s safe to use in the human mouth. While the American Dental Association has stated that silver filling are safe despite the use of mercury, many dentists and patients are concerned about the negative effects of any mercury being placed into their bodies. As a result, many patients choose to replace their silver fillings because of the health and cosmetic concerns.

The American Dental Association Scientific Council continues to state that silver fillings are safe and effective. Studies revealed that even in a mouth full of amalgam fillings, the amount of mercury released is far below the level associated with the ill effects as established by the World Health Organization. Reportedly, we get 10 times more mercury from our diet; especially from fish but also from some vegetables, breads and beverages.

Best practice in dealing with silver fillings-

Silver fillings were the standard of care for many years. Today, there is overwhelming evidence that white composite fillings, tooth colored porcelain fillings or even gold are regarded as “best in class” when determining what is best for patients.

This is because white fillings have improved in its ease of placement, costs, durability and cosmetic application. Most dentists recommend white fillings for their patients.

If you have a silver filling should you immediately remove them?

I would suggest you pause for a moment and determine with the help of your dentist if your silver filling is still intact. An adequately functioning silver filling gives off less mercury than you get when you eat fish.

Secondly, studies show that the placement of amalgam and its removal are the two greatest risk factors to exposure to mercury vapor. Additionally, tiny particles are given off and could be swallowed.

The relationship between the patient and the dentist is critical to successful outcomes.

Patients should know the facts so they can make wise decisions. Your dentist should be your advocate in seeking to advance your best health and wellness.

Dr. Kendal V. O. Major is Founder and CEO of Center for Specialized Dentistry which is a comprehensive family dental practice operating in Nassau and Freeport. He is the first Bahamian Specialist in gum diseases and dental implants since 1989. He also is a certified Fast braces provider. His practice is located at 89 Collins Avenue, Nassau at (242)325-5165 or [email protected].


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