If you have silver-colored fillings from years past, you may have wondered at some point whether they contain mercury — and whether that's something to be concerned about. It's a fair question, and one that deserves a straight answer rather than either dismissal or alarm.
Dental amalgam is an alloy composed of mercury combined with other metals including silver, tin, and copper. Mercury accounts for roughly half of an amalgam filling's composition. It's used because it makes the material pliable during placement and then hardens quickly to form a durable, long-lasting restoration. Amalgam has been used in dentistry for over 150 years and has filled cavities in hundreds of millions of patients.
The mercury in dental amalgam is elemental mercury, chemically bound within the alloy. Once it's combined with the other metals, it behaves very differently than the methylmercury found in fish or the liquid mercury in old thermometers. The primary concern with amalgam isn't the material itself in its stable, hardened state — it's the potential for small amounts of mercury vapor to be released during chewing, brushing, or when fillings are being placed or removed.
Major health organizations including the American Dental Association, the U.S. Food and Drug Administration, and the World Health Organization have reviewed the available evidence and concluded that amalgam fillings are safe for most adults and children over six. The levels of mercury vapor released during normal use are generally well below any threshold associated with known health effects in the general population.
That said, the FDA recommends that certain groups avoid amalgam fillings when possible. These include pregnant women and those planning to become pregnant, nursing mothers, children under six, people with kidney conditions, and individuals with documented mercury sensitivity. If you fall into any of these categories, it's worth discussing your filling options explicitly.
We take a whole-health approach to dentistry, and that includes being thoughtful about the materials we use. We do not place new amalgam restorations. When patients need fillings, we use tooth-colored composite resins — materials that are mercury-free, bond directly to the tooth structure, require less removal of healthy enamel, and produce a result that's indistinguishable from the surrounding tooth.
This is a question we're often asked, and the honest answer is: it depends. Functional amalgam fillings that are in good condition aren't necessarily causing harm by staying in place. In some cases, removing them can transiently increase mercury exposure during the removal process. When fillings are old, cracked, failing, or causing symptoms, replacement with a biocompatible composite is a reasonable decision. If you're concerned about your existing amalgam restorations, come in and we'll evaluate them together and give you an honest, personalized recommendation — not a blanket protocol. Call us at (360) 543-8488.
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