“Is an Amalgam Filling Safe?”

“Can I get rid of my black fillings?”

Macro of a tooth with amalgam filling
Molar tooth with amalgam filling

This question will only come from people born before Generation Y (after which has only received white composite fillings). Dental amalgam is a silvery dental restorative material most widely used for filling cavities up until the end of Generation X, which is made by mixing mercury (about 50%) with a metallic alloy powder (silver, tin, copper). Over time, in harsh oral environments, these fillings get tarnished, and can be oxidized to a black or dirty silvery color. Amalgam has been used for over 100 years as a standard filling material, for its durability and easy handling properties. However, its usage has declined due to its detrimental health effect, undesirable aesthetic appearance and its tendency to weaken tooth structure.   Composite fillings (quartz filler in a medium resin) are now the restorative material of choice for dentists and patients alike. If you have an amalgam filling, however, should you be concerned?

Composite fillings are white in color and blend in naturally with your existing teeth. Composite fillings also stay within the tooth (with chemical adhesion), so the dentist only needs to remove the tooth decay then fill, a very conservative treatment for the tooth structure. Amalgam fillings rely on mechanical retention within the tooth, so the dentist must remove decay as well as shave the tooth to a certain form to receive the amalgam, involving more tooth reduction and more weakening of the tooth over long term usage. Also, composite material does not contain mercury, one of the possibly negative characteristics of amalgam. Sweden, Norway and Finland have all outlawed dental amalgam due to these concerns.

If you do have amalgam fillings, should you have them removed? If the tooth shows signs of stress, like crack lines – or if your fillings look tarnished showing an unstable chemical reaction, you might choose to have your amalgam replaced with composite. If the size of the filling or the condition of the tooth warrants it, or if you believe the tooth would be better protected with other porcelain restorations like inlays or crowns, you need to speak with your dentist and arrange for an evaluation. Ultimately, dental amalgam has been a controversial topic surrounding health for decades, but it is important to know, if you are healthy and the fillings are in good condition, it is probably unnecessary to have your amalgam fillings hurriedly replaced. When it is time to update your fillings after your dental professional has made a recommendation, however, treatment options like composite fillings, gold or porcelain inlays, or porcelain crowns for example would be presented to you depending on the clinical evaluation. Have a discussion with your dental professional and make an educated decision to get yourself a better looking (and healthier) mouth.

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