Dental Amalgam is a commonly used dental filling that has been used for over 150 years. Dental amalgam is made from a combination of metals that include mercury, silver, tin, and copper. Sometimes described as “silver-colored” fillings, dental amalgam has been used by dentists for more than 100 years because it lasts a long time and is less expensive than other cavity-filling materials such as tooth-colored composite fillings.
Amalgam has many advantages over other restorative material, such as low cost, strength, durability, and bacteriostatic effects.
Amalgam is used in dentistry for a number of reasons. It is relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity than other direct restorative materials, such as composite. On average, most amalgam restorations serve for 10 to 12 years, whereas resin-based composites serve for about half that time. However, with recent improvements in composite material science and a better understanding of the technique-sensitivity of placement, it should be noted that this difference is decreasing.
There are circumstances in which composite (white fillings) serves better than amalgam; when amalgam is not indicated, or when a more conservative preparation would be beneficial, composite is the recommended restorative material. These situations would include small occlusal restorations, in which amalgam would require the removal of a more sound tooth structure, as well as in “enamel sites beyond the height of contour.”
Because of their durability, these silver-colored fillings are often the best choice for large cavities or those that occur in the back teeth where a lot of force is needed to chew. Amalgam hardens quickly so it is useful in areas that are difficult to keep dry during placement, such as below the gum line. Because it takes less time to place than tooth-colored fillings, amalgam is also an effective material for children and special needs people who may have a difficult time staying still during treatment.
One disadvantage of amalgam is that these types of fillings are not natural looking, especially when the filling is near the front of the mouth, where it may show when you laugh or speak. Also, to prepare the tooth, the dentist may need to remove more tooth structure to place an amalgam filling than for other types of fillings.
Although dental amalgam is a safe, commonly used dental material, you may wonder about its mercury content. It’s important to know that when combined with the other metals, it forms a safe, stable material. Be assured that credible scientific studies affirm the safety of dental amalgam. Study after study shows amalgam is safe and effective for filling cavities. The American Dental Association, U.S. Centers for Disease Control and Prevention, U. S. Food and Drug Administration and World Health Organization all agree that based on extensive scientific evidence, dental amalgam is a safe and effective cavity-filling material. The Alzheimer’s Association, American Academy of Pediatrics, Autism Society of America and National Multiple Sclerosis Society—all science-based organizations like the ADA—also say that amalgam poses no health risk.
The Mayo Clinic recently stated that dental amalgam is a safe and durable choice for dental fillings. They also note that “there are several kinds of mercury. The mercury (methylmercury) found in water that can build up in fish and lead to health problems if you ingest too much is not the same type of mercury used in amalgam.”
The ADA supports continued research on all dental filling materials and would promptly inform the public if the scientific community and government regulatory bodies determined that any cavity filling material was unsafe for patients. Dr. Pham’s foremost priority is your health and safety. That’s why it is important to talk with Dr. Pham about your cavity treatment options and what’s right for you.
The American Dental Association Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.
Ultimately, the best dental filling is no dental filling. Prevention is the best medicine. You can dramatically decrease your risk of cavities and other dental diseases simply by: