by Linda J. Golden, DDS
For many years, the cheapest option for dental fillings has been dental amalgam. Dental amalgam is a
combination of mostly powdered silver, tin and copper and liquid mercury.
Before use as a filling material, the amalgam components are mixed by the dentist or assistant in measured proportions, and the resultant paste is placed in the cavity. Dental amalgam, however, does not bond to tooth tissue and therefore requires quite an extensive cavity preparation in order to produce a retentive dental restoration. It also has a silver color, which eventually becomes dark and unsightly, due to oxidation of the metallic components.
Utilizing dental amalgam poses great risk to dental staff and patients. Mixing of dental amalgam results in exposure of all present in the dental facility to mercury vapor. A patient with an amalgam filling also inhales mercury fumes, which evaporate from the filling due to wear. Again, unreacted liquid mercury present in the filling may leak into the surrounding gingiva and other tissues. Removal of a failed amalgam filling also releases even more mercury vapor, which is inhaled by all present at the dental facility, including patients that opt for other nonmetallic filling materials.
Liquid mercury is toxic even in low amounts, and its exposure results in such symptoms as irritability, headaches and general malaise. It may even result in more severe complications, such as brain and kidney disease, with high or constant contact, such as is the case for dental staff.
There are some arguments about the levels of mercury vapor released from dental amalgam, with some suggesting that these levels are too low to cause any harm. However, most experts agree that there is always some amount of mercury vapor escape during placing and especially when removing dental amalgam.
Therefore, the use of mercury must be avoided in the dental setting at all costs, and tooth-colored materials, which bind to tooth tissue and are more aesthetic, should be encouraged. However, for a practice to be truly mercury-free, there should be safe removal of old amalgam fillings by extracting resultant mercury fumes from the dental facility, thus, preventing any further unnecessary exposure to staff or patients.
Mercury-free dentistry is a safe and inevitable way forward and should be embraced everywhere.
Source: Linda J. Golden, DDS, of Golden Dental Wellness Center (444 Community Dr., Ste. 204, Manhasset). For more information or to schedule an appointment, call 516-627-8400.