Has anyone researched the different types of tooth fillings to evaluate their relative safety?

Answered on August 19, 2014
Created February 21, 2013 at 8:01 PM

Hi all,

  1. It seems there's little disagreement about the undesirability of mercury-based fillings. However, there's some disagreement about whether it's better just to leave it in there, or to take it out safely.

  2. Also, if taking it out and replacing it (or if getting a new filling in the first place), what materials are safe and durable?

We assume heavy metals are the worst because they're known to be harmful. However, has anyone really looked into the safety of these other synthetic materials, how much they leach, etc.? Or do we just assume they're safe because they're not heavy metals?

For instance, I've heard gold fillings are safe (but expensive?). I've also heard ceramic fillings can be safe (do we know this for sure), but the material that binds them to the tooth may not be so great (nor so effective at binding).

In short, there's not much conclusive information I've found out there. Any dentists here or at least people who've done substantial research, and can you also share your sources of information (not just opinions)?

For me personally, I'm considering getting one tooth filled and also having an old mercury filling removed and replaced with something else. The dentist would use a rubber dam, suction, etc. to make the process as safe as possible. Still haven't decided what I want to do and what material I'd want him/her to use.

Thanks so much!



on February 21, 2013
at 08:50 PM

Not so sure there's agreement that amalgam fillings are so bad.

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1 Answers



on March 17, 2013
at 04:05 PM


I think the answer to your questions are, like a lot of things in life, complicated and very dependent on the particulars of the situation.

I have researched the topic a few times.

Short answer for me...adults with no mercury allergy (that's me) I would & have used amalgam for non-visible fillings. For cosmetically important fillings, I would use ceramic.

For young children & adults with the allergy.... I'm not totally sure. The best dental treatment for children is prevention.

Long answer:

There are risks & advantages to every material and there are always tradeoffs to be made.

The bulk of your exposure is during installation & removal. Amalgam is a material with YEARS of use. Amalgam is durable, long lasting and cost effective. The removal of old but sound amalgam creates an opportunity to increase your exposure AND potentially cause more damage to your tooth.

Ceramic fillings, especially on chewing surfaces, are much less durable and long lived and thus could require more frequent replacement or attention that could jeopardize tooth integrity.

I have five amalgam fillings (the result of poor teenage oral maintenance & congenital enamel defects) that are over 40 years old and are still sound. If I'm lucky these will continue to serve and I may never need to replace them. If I do have to replace them, it will be only once. I recently had a tiny amalgam filling placed after a discussion with my dentist.

btw.. he uses amalgams on his own children in non-cosmetic locations. He has removed 5 to 10 amalgam per day during his nearly 30 years of practice and he has placed 1000's with no personal ill effects. Nor is there evidence that dentists as a group suffer from mercury exposure.

In your situation, you have history with a single amalgam filling and you are contemplating another one. If it's not a cosmetic location and you want to avoid amalgam...use gold. If cost is an issue, use amalgam.

Personally, without verified personal symptoms, I wouldn't (don't) worry about them.

http://pubs.acs.org/stoken/presspac/presspac/full/10.1021/tx900309c http://www.ada.org/1741.aspx http://dentistry.about.com/b/2009/07/29/final-regulation-on-dental-amalgam-issued-by-the-fda.htm



After composing this reply, I discovered this topic has been discussed here before. Try the search function to see more on the controversy.

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