Are Amalgam (Silver/Mercury) Fillings Safe?

There is perhaps no other material or topic in the dental field that has been researched and criticized as much as amalgam used as a dental filling. Initially, amalgam was mixed and applied crudely and unsafely. The current amalgam formula is much improved and after extensive scientific research has been recognized by both the ADA and FDA as safe for use as a dental material.

The percentage of mercury in amalgam fillings is around 50%, then about 20% silver, 16% tin, 15% copper plus other trace metals. The exact composition a dentist uses may vary slightly, but there is always between 45% and 55% mercury in an amalgam filling.  Tiny amounts of mercury can be released from the amalgam fillings in the mouth over time but at these insignificant amounts there is no evidence that amalgam is responsible for any health conditions.

Even though amalgam has been deemed safe for use as a dental filling there are other concerns to consider.  One such concern is the environmental impact of the use of amalgam as it relates to the proper handling and disposal of the material. According to the National Resources Defense Council, dental amalgam is often a large source of mercury in municipal wastewater, and it also contributes to mercury pollution in the soil and air. Most of this comes directly from dental clinics, but mercury can also end up in the environment through the burial or cremation of deceased people who had amalgam fillings.

We at Chandler Dental have decided based on the evidence and information available to us to not use amalgam as a dental material.  This is not because we feel that it is unsafe as a dental filling but we feel that it does have negative environmental ramifications in general.  However, the biggest reason we choose not to use amalgam is because there are better materials available.

What Are Tooth Colored Fillings Made Of?

Tooth colored fillings are made of Resin Composite. Composites were first introduced in the 1960’s and have undergone many changes and improvements over the years. Now, after years of extensive research and development, Composite fillings have been shown to be just as strong as Amalgam fillings but with several added benefits.

• The first obvious benefit is that composite is tooth colored and can be created in several different shades to match to teeth. The use of composite has changed the world of dentistry and especially the world of cosmetic dentistry.
• Composite tooth preparations are more conservative. This means that dentists do not have to remove unnecessary tooth structure in order to help the material stay in place and be strong. Amalgam tooth preparation had certain requirements for use and therefore dentists sometimes had to prepare a hole in the tooth that was bigger than the cavity just to meet the physical properties of the amalgam.
• Another huge benefit of composite is that it is chemically bonded to teeth instead of needing to be packed into a hole in a tooth to stay in place. This means that instead of causing cracks in teeth after years of chewing like amalgam can, the composite actually binds the walls of a tooth together increasing the overall strength of a tooth.
• Composite is environmentally safe and there is no evidence to suggest that it is harmful to use as a dental material.

What Are Tooth Colored Crowns Made Of?

In the past crowns were made of gold or a combination of metals. Then PFM crowns were introduced as a more esthetic alternative to metal crowns. PFM stands for Porcelain Fused to Metal. The problem with PFM crowns was that the bond between metal and porcelain was a weak area in the crown and the porcelain commonly sheared off the metal substructure. Gold/Metal crowns, and PFM crowns still have their uses in certain situations.

 Thankfully, full porcelain crowns were introduced and continue to be developed and improved and are the preferred crown of choice. There are many types of porcelain crowns but the strongest has been shown to be a solid Zirconia crown. These crowns are especially important to use on teeth in the back of the mouth where the most strength is needed. However, as a solid piece of Zirconia this material is not as esthetic as other types of porcelain. Conversely, there are other porcelain crown types that are very esthetic but are not as strong.

Fortunately, there are also porcelain types and combinations that allow us to create esthetic crowns that are also very strong. We have found lithium disilicate porcelain to be a great combination of beauty and strength. This type of porcelain can be used on back teeth and on the front teeth for veneer cases. At Chandler Dental we always use the best materials available in dentistry so that we can provide crowns that are beautiful and last a long time.  For your convenience we also offer same day CEREC porcelain crowns which are created using an in office digital scanner and porcelain mill.  If you have amalgam fillings that need to be replaced or you need a crown, give us a call so we can determine if you need one of our high-quality fillings or crowns.