There are many good reasons to avoid fillings and to prevent gum disease at all cost. Over the past twenty years, a number of dentists have been so concerned about silver filling materials that they have removed them for the sake of their patient’s health. Silver fillings are a mixture (an amalgamation) of metals that include almost 50 percent mercury. Mercury is a liquid metal used to bind the other dry metals together, just like an egg or oil is used in a cake mix. Like steam, however, mercury can vaporize and is toxic to humans when it is inhaled, ingested, or absorbed through the skin.
Today dentists no longer handle mercury or mix silver fillings directly. The ingredients are in capsules that are mixed automatically without contact with the skin. In many countries, organizations are trying to limit the use of mercury in health care and other industries.
The argument in favor of silver fillings is that they have a long history in dentistry. The American Dental Association (ADA) claims that “the best and latest available scientific evidence indicates it [amalgam] is safe.” Records indicate that about 70,000 kilograms of mercury are used in more than 100 million dental fillings each year. Most dentists say they prefer amalgam over white fillings materials for molar teeth. I have been personally utilizing amalgam for more than a quarter of a century and cannot convince myself of any significant disadvantage in its use.
Despite this endorsement, many people distrust silver fillings. In Sweden, Denmark, Germany, and Austria it is illegal to use silver fillings; a dentists can go to jail for using them. It is now illegal in California to put silver fillings in the mouth of a pregnant woman because mercury can transport across the placenta and also enter mother’s milk. In every dental office, old fillings or extra filling material must be placed in a special container and disposed of as toxic hazardous waste. If fillings break down in the mouth, it is easy for patients to eat or swallow pieces of them by mistake. Crumbling and failed fillings appear in acidic mouths, and some people have silver fillings replaced frequently throughout their lifetime, exposing themselves to mercury poisoning at each repair.
If you have a healthy mouth, silver fillings can remain stable. Personally, I consider it safer to leave them in place rather than rushing to change them to another material. I would encourage everyone to protect and strengthen their enamel, because at this time there do not seem to be any perfect alternatives. Even white filling materials have safety questions, and few studies have been concluded to evaluate them. In addition, plaque bacteria appear to stick more readily to white fillings than to silver or gold ones. Gold or porcelain may be the best choice for molar teeth, but be aware that if gold and silver fillings are both present in an acidic mouth, they can mimic the chemistry of a battery and even create an electrical current. In any event, if such materials are being used as filling materials here in Guyana that would certainly be a rare and unusual procedure.
Dental materials are changing all the time, so if you need a filling and have any reservation, discuss the topic with a trusted dentist and learn the advantages and disadvantages of the dental materials he or she suggests. Cost and availability are the two most crucial factors in such a decision.
By Dr. Bertrand R. Stuart dds.