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What’s in an amalgam filling? Is it safe?

Vanessa Giraud

what's in an amalgam filling - a dental inspectionWe’re often asked what’s in an amalgam filling and whether it’s safe. The short answer is that yes, amalgam fillings, sometimes called silver fillings, are considered safe. At the conference Hannah Parsonage and Jo Roberts attended recently in Shrewsbury, the future use of amalgam fillings was one of the topics covered. 

Here’s some information about amalgam fillings:

What’s in an amalgam filling?

The component that people worry about in amalgam fillings is mercury. A traditional amalgam filling is made from about 50% liquid mercury, which bonds with the other powdered elements of silver, tin and copper.  

So is that why there’s concern?

Exactly! But its not so much the mercury in your mouth that’s the problem, it’s got more to do with the one that got away! The Minamata Treaty of 2013, and the EU’s Mercury Regulations, aim to reduce the release of mercury into our environment. During dental processes, small amounts of mercury can end up going literally down the drain. These days amalgam separators catch the metal before it gets into the water system. Dental practices retrieve the amalgam for recycling.

Why do dentists use amalgam?

The main reason for choosing amalgam fillings is because they’re stronger and more durable. They’re good for back teeth where there’s more pressure.  White composite fillings are definitely a more aesthetic choice, but sometimes an amalgam filling is the best option. For example, saliva can prevent a composite white filling from bonding with the tooth. Good isolation of the site is not always possible. If it’s not, then amalgam is the likely solution.

What’s an amalgam capsule?

To ensure that the amalgam mixture is safe, with the correct measure of mercury, the filling material now comes in capsule form. Patients can be sure that they are getting the correct ratio of materials in their filling.

What about children?

There is increasing regulation being introduced.  From 1st July 2018, the BDA states “there will be no use of amalgam in the treatment of:

except when strictly deemed necessary by the practitioner on the ground of specific medical needs of the patient”.

White fillings are a cosmetic choice.

NHS treatment covers white fillings in the front teeth, but not in the back teeth. Many patients, however, opt for white fillings all round, as they look more attractive. As modern materials have improved, so has the durability of white fillings. Some patients choose to replace an old amalgam filling with a white filling too, when it’s possible.

If you ask yourself what’s in an amalgam filling, and you have concerns, discuss options with your dentist.

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