Are silver fillings dangerous?

Q. I have a bunch of silver fillings in my mouth that were put in when I was younger.  I have heard that they are made of mercury and I’m worried that they are damaging to my health.  I’ve considered having them taken out.  Are silver fillings dangerous and should I have them removed?

A. Amalgam (AKA “silver fillings”) has been used as the go-to material in dentistry for most of the last 150 years.  Recently, the debate over amalgam has centered on questions about the health impact of the mercury portion of the material.

Amalgam does contain mercury but it also contains a mixture of other metals such as silver, copper and tin which binds these components into a hard, stable and safe substance. Some have pointed to the volatile elements of sodium and chlorine that combine together to form stable table salt as an example of this type of phenomenon.

The FDI World Dental Federation and the World Health Organization concluded in a 1997 consensus statementi: “No controlled studies have been published demonstrating systemic adverse effects from amalgam restorations.”

Though newer research has demonstrated that small amounts of mercury are released from amalgam restorations during chewing, the impact of minute amounts of mercury exposure during placement, function, and removal of amalgams on patient health has, thus far, proven to be insignificant.

For some patients, however, the thought of having a heavy metal in their mouth is unsettling and prompts them to ask for their amalgam restorations to be replaced with newer composite restorations.  What many of these patients don’t realize, though, is that although mercury exposure can be limited during amalgam placement and removal in the dental chair, mercury exposure is at its highest when removing the amalgam.  Mercury is most dangerous when it is airborne and has the potential to be inhaled… which is precisely the scenario that removal can create. The path to the least amount of mercury exposure is usually leaving the amalgam restorations in place.

For this reason, unless the restoration is failing, amalgams are usually best left alone.  Ultimately, of course, the patient is free to make his/her own decision about which type of restorative material is used. Fortunately, we have an ever-increasing arsenal of dental restorative materials to serve as alternatives to amalgam for those who choose to avoid metal restorations.

Read the ADA’s stance on amalgam.