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Is it a good idea to have your amalgam fillings removed?

A popular online “gringo” bulletin board advertises “holistic dentistry” in Cuenca, and more than one advertisement promotes removal of all silver (colored) amalgam fillings  [mistakenly called ‘mercury fillings’.]

Some ads proclaim that amalgam fillings cause “energy interference” and risk for diseases such as Parkinson’s, cardiovascular disease, and even autism.

What are the myths and facts about amalgam fillings?

First, the facts: Sources: The Guardian, Science Norway, National Capital Poison Control Center, The American Dental Association, Toxicology International, and The World Health Organization.

Why do teeth need fillings anyway?
Tooth decay begins when bacteria in saliva and plaque, a sticky substance found on gums and teeth, interact with sugars and starches in the diet. The result is acid, which can erode dental enamel. Untreated tooth decay leads to holes in the teeth (cavities), infections (abscesses), pain, and tooth loss. The World Health Organization (WHO) reports that tooth decay has historically been considered the most important component of the global oral disease burden, and is still a major public health problem in most high-income countries for children and the vast majority of adults.

Historical evidence proves that dentistry started around the areas of China, Egypt, India, Etruscans of Central Italy, Assyrians, and Japan.

Dental history
“Silver” fillings have been used since the nineteenth century. The American Dental Association estimates more than 100 million amalgam fillings are placed in American mouths yearly and are used around the world.

Amalgam is an alloy of mercury mixed with other metals including silver, tin, and copper. Mercury is what makes the mixture soft enough for it to mold to the hole from your cavity before it stiffens and becomes a part of your tooth. When properly cared for, an amalgam filling can last 15 years or more. Because of the metal alloy used, amalgam fillings offer stronger resistance to damage, making them a superior choice for larger areas of decay.

What happens when you have dental decay?
Dental cavities are treated by drilling out the decayed material and replacing it with a filling, either an amalgam filling or one of the newer types of tooth-colored composite fillings. According to the American Dental Association, you and your dentist will consider what materials to use taking into account the size and location of your cavity. Cosmetic considerations, how long the filling could last, insurance coverage and out of pocket costs are some other factors you might want to consider.

There is a big difference in the hazards of environmental mercury contamination and amalgam fillings. As reported in Toxicology International, mercury is found in the earth’s crust and is ubiquitous in the environment, so even without amalgam restorations, everyone is exposed to the small but measurable amounts of mercury, and can be measured in blood and urine.

Dental amalgam restorations may raise these levels slightly, but the scientific committee of the European Commission reported in 2008 that there was no evidence that dental amalgam caused health problems and warned that much more was known about its safety than newer types of filling.

However, it did say that amalgam was best avoided by pregnant women and children under six.

The main exposure to mercury from dental amalgam occurs during placement or removal of restoration in the tooth. Once the reaction is complete less amount of mercury is released, and that is far below the current health standard. Though amalgam is capable of producing delayed hypersensitivity reactions in some individuals, if the recommended mercury hygiene procedures are followed the risks of adverse health effects could be minimized.

The 2017 Minamata Convention on Mercury, a treaty agreed by the UN Environmental Programme, committed itself to reduce mercury use worldwide, including in dentistry. Norway banned dental amalgam in 2008, Sweden banned the use of dental amalgam for almost all purposes in 2009, and Denmark, Estonia, Finland, and Italy use it for less than five percent of tooth restorations. Japan and Switzerland have also restricted or almost banned dental amalgam. It is available to all dentists in the United States and in Ecuador and in other countries throughout the world.

Although new amalgam fillings are not used in Norway, as reported in Science Norway, we should not be overly concerned about the amalgam fillings we currently have in our mouths. It is noted that the ban on amalgam fillings was less about concern for the safety of those fillings and more about the use and import of toxic mercury. They write that it’s possible to measure mercury levels in both blood and urine, but it’s almost certainly due to the food you’re eating, especially fish and seafood.

What about alternative/composite fillings?
Composite fillings, also known as tooth-colored fillings, are made from a combination of acrylic and ceramic that can be matched to blend with your natural tooth enamel and require less enamel removal and tooth preparation, allowing you to maintain as much of your natural tooth structure as possible. A tooth close to the front of your mouth that is easily seen when smiling or laughing will look more natural with a composite filling. However, silver amalgam fillings are more noticeable, especially when laughing or open-mouth smiling. Over time, amalgam fillings can darken the appearance of the entire tooth, making it appear grayish and dull, negatively impacting the overall look of a smile. For teeth in the back of the mouth that have greater decay, an amalgam filling is the better choice, due to its durability and longevity.

Composite fillings are made of thousands of different substances — most commonly composed of Bis-GMA and other dimethacrylate monomers (TEGMA, UDMA, HDDMA), a filler material such as silica and in most current applications, a photoinitiator. Dimethylglyoxime is also commonly added to achieve certain physical properties such as flow-ability.

Not as durable as metal alloy, composite results generally last about seven to 10 years. Overall, these fillings are considered to be safe and effective. Your tooth may feel more sensitive to cold or pressure for a week or two after you receive a composite resin dental filling. Composite resin dental fillings may be more prone to cracking, breaking, and wearing out than metal fillings, and over time leaks may develop in composite resin fillings. In rare cases, people have developed allergic reactions to composite resin fillings, usually resulting in a localized rash or swelling in the area. Composite resin fillings are also usually more expensive than metal fillings because they take longer to apply.

Should you replace amalgam fillings?
No mainstream dental organizations recommend you replace your amalgam fillings as long as they are in good condition and there is no decay beneath them. Drilling out amalgam will make you lose more healthy tooth and the process will expose you to considerably more mercury vapor than if you left it well alone.

I wrote to Dr. Alan Woods, an American dentist in practice here in Cuenca to ask him this question, after researching this topic. Dr. Wood wrote that unlike many years ago (when his own father was practicing dentistry in the United States) dentists placing amalgam fillings and their staff are operating in a safer environment but that he does not use amalgam, opting instead for either alternative materials or crowns and inlays.

Woods says that gold by far is the best material for dental fillings because it is inert, it doesn’t oxidize, and wears almost exactly like teeth — he sees gold crowns and inlays that have been in place for 50 years and says, “They look as good as the day they were placed.” However, he notes that today’s patients want their teeth to look like teeth, not gold or silver.

Dr. Woods says that composites are good for kids, but because they absorb saliva over time, statistically they have a short life, only about seven years. He says, “Constant replacement over the years is costly — each time [composite fillings] are replaced, less tooth remains, and absorption by saliva and the leakage around the edges has led to a great need for root canals and subsequent crowns.”

Woods notes that porcelain crowns and inlays are another aesthetically pleasing option, but again, there are high associated costs, including materials and time, and the dentist, like all who work with these materials, has to be highly skilled to place these alternative materials correctly.

Woods writes, “We do not have an ideal filling material, though the quest and the promise of success have been around for my entire professional life. There is little evidence that old amalgams release any toxins in normal wear and tear. When removed, there is a release of mercury that needs to be dealt with in the removal process.”

Woods continues, “I am afraid that many dentists view the wholesale replacement of old amalgams as an opportunity for the practice and not so much as a value for the patient.  I do not place amalgams, but I do not remove them unless necessary.”

If you’re concerned about mercury in your amalgam fillings, the best thing you can do is keep your teeth healthy and ensure your fillings are still intact.

If your fillings are damaged, they’ll need to be examined by your dentist and will likely need to be replaced. If they aren’t damaged, it’s best to leave amalgam fillings alone at the risk of exposing yourself to more mercury.

Your professional dentist will screen for decay underneath your existing fillings and determine if they need to be replaced. If your fillings do need to be replaced, ask your dentist about their experience removing amalgam fillings. You need an experienced dentist who can safely remove the fillings and provide you with a healthy replacement to continue protecting your tooth.

Be sure your dentist follows the protocol recommended by the International Academy of Oral Medicine and Toxicology (IAOMT) to minimize the amount of exposure to mercury for the patient, dentist, and assistants.

If you want to learn more about the removal of amalgam fillings, HealthFirstDental in Calgary, Alberta, Canada notes, ” If improperly performed, the haphazard removal of mercury fillings can cause more harm than good. During the removal of amalgam fillings, the patient can be exposed to amounts of mercury, which are a thousand times greater than the EPA allowable concentration. Several precautionary steps must be taken to reduce additional mercury absorption.”
Click here for more information.

Finally, I attended an informative and free webinar just yesterday by the Collaborative on Health and the Environment (CHE). The CHE “cultivates a learning community based on the latest, evidence-based science to share knowledge and resources, and improve individual and collective health.”

The webinar was entitled, ‘Cognitive decline, dementia, and Parkinson’s disease: Environmental contributors and prevention’ and in the Q&A segment I was able to get Dr. Ted Schettler to answer my questions about whether or not it was advisable to have amalgam fillings removed. Dr. Schettler reaffirmed the research that shows that drilling into otherwise healthy teeth to remove amalgam fillings is unnecessary and that for new decay/need for fillings there are other options besides amalgam fillings: speak with your dentist. View the webinar here.

CHE is focused on how environmental risks can impact human health. By informing and connecting affected and interested groups, CHE hopes to build a groundswell of demand for prevention-focused behaviors and policies, as well as economic and legal structures that protect public health.

_______________________________

Food, Nutrition, and Your Health columnist Susan Burke March moved to Cuenca after working for more than 25 years as a Registered and Licensed Dietitian and Certified Diabetes Educator in the United States. She currently serves as the Country Representative from Ecuador for the Academy of Nutrition and Dietetics. 

Susan helps people attain better weight and health, and reduce the risk of heart disease, diabetes, and other conditions that can be improved with smart lifestyle modifications. Contact her at SusantheDietitian@gmail.com.

 

 

29 thoughts on “Is it a good idea to have your amalgam fillings removed?

  1. I must be quite lucky as a friend in dental school back in the early 80’s replaced all of my amalgam fillings with composite and none of them have needed to be replaced in over 35 years!

    1. Yes, I think the literature underestimates durability of both amalgam and composite fillings. I have two amalgam fillings that have probably been in my mouth for an equal time as your replaced composite. They’re quite stable.

  2. Three friends wrote to me personally to comment on this article: I’ll share their comments:
    “I know a woman who had hers removed by a Cuenca dentist who advertises that she has special equipment so that it can be done safely. The woman had a terrible experience and can describe specific ways in which the safety equipment wasn’t used or wasn’t effective. Tragically and ironically she got acute mercury poisoning from the removal itself and suffered greatly.”

    “I have had friends remove mercury fillings to their detriment. My excellent dental advisors say to remove them only if there is a problem. I do not recommend them for new fillings, however.”

    “My former boss had it done when he was diagnosed with ALS but it didn’t halt the progression. He also flew to Brazil to be treated by a shaman but that too was not effective in halting his declinó or death.”

  3. The ignorance displayed on this discussion is overwhelming. The amalgams are OK is an old paradigm. How many of you know that every tooth is on an acupuncture meridian and it’s energy is transmitted to the part of the body represented by the tooth. Did you know that the American Dental Association gets royalties from amalgam usage?

    1. No, we didn’t know, Castiglia, your claim is supported with a reference from… ? Please post the proof about the “royalties” claim, and while you’re at it, clarify what you mean about the “energy” transmitted by teeth and why an amalgam filling would be less advantageous than … oops – I’ll let you explain.

      1. I do not have the reference to the royalty subject as I was made aware of it years ago. If you do a search for teeth and organs you will find many websites that will explain my point about teeth and energy relationships. Teeth the are removed or have root canals or have amalgams will have disturbances in their body electric. Most dentists are unaware of the tooth body organ connection which places you above the average dentist!! Studies done in Calgary years ago showed that mastication releases mercury vapor from teeth even though it was done with sheep that had amalgams placed in their teeth!!

        1. The sheep study!! Well, Castaglia – it’s just like you to pull out this thoroughly debunked 1991 study on six sheep. In my research I noted a reference to the study as one that was reported on by 60 Minutes as an example of bad science. Oh well. * The Canadian researchers prepared their amalgam with a method that has been obsolete for more than 40 years. The resultant amalgam contained excess mercury and was softer and therefore more easily worn by chewing, especially in a cud-chewing animal such as a sheep.
          * The amalgams were placed in opposing teeth, so they would grind against each other. This enhanced the already enhanced rate of release of materials.
          * Because rubber dams were not used when the fillings were installed, scrap amalgam was free to enter the sheep’s mouth and be swallowed.
          * The methods used to detect and calculate the amount of mercury absorbed were not valid.
          * Although the researchers claimed that body mercury levels rose during the experiment, they had not measured the levels that were present initially. The data actually showed that the animals swallowed a lot of free mercury during the placement of the fillings.
          * Their claim of kidney toxicity was based on urinary findings that show just the opposite of what is known to occur in mercury poisoning in humans.”

          1. He’s simply saying that nerves of the teeth have many varied connections and effects throughout the body. Everything inside us is interrelated and interconnected in fascinating ways.

    2. Thanks Anthony. It took western medicine 20 years to believe that washing hands between autopsies and surgery/delivering babies would save patients. Why should this be any different. Some people are paid to spread false information; others are just out of date.

  4. As we follow the medical mysticism expressed in this and other forums, in preparation for our move there, we realize that many of these “controversial” medical issues were debunked in the states years ago. Everyone with a terrible disease like ALS or Alzheimer’s wishes it could be cured by removing fillings or sitting in green light 4 hours a day. But even here, there are entrepreneurial medical professionals who purchase equipment for testing and treatment that does not work, but they have to pay for the equipment somehow (I love the statement, “You have to pay cash because insurance does not pay for it, it’s so new and state of the art”). My current dentist said, when I asked him about this, “Don’t tell me that people actually believe that this is an issue again”. There are others we have seen discussed and advertised there that those of us who have been in the medical profession for years in the states recognize as quackery. I would strongly suggest that anyone who receives information about “revolutionary” medical miracle treatments proceed with caution, and seek factual evidence before paying money for invasive procedures. I always had a steady stream of patients who had unfortunate adverse outcomes from other practitioners.

    1. Quackery runs both ways. Plenty of alt med quackery, and plenty of conv med quackery. Loads of conv med treatments have caused enormous suffering, as has alt med. In many cases conv med polices itself fairly well and eventually eliminates dangerous drugs and treatments. But there is always the profitability question with med treatments, in order to offset the huge cost of new drug/treatment approval. ‘Tis a dicey situation.

  5. This is for those people who are not easily bullied and told what to think. Safe removal of a highly toxic heavy metal that has been put in our teeth should be considered. Whether mercury is safe in our teeth, however is not controversial. Mercury is not safe — never has been.

    Evidence of Harm documentary, 14 minutes: https://www.youtube.com/watch?v=nYDbybGP_5A

    Questioning Dental Amalgam Safety: Myth and Truth: https://iaomt.org/resources/dental-mercury-facts/dental-amalgam-safety-myth-truth/

    Dental Amalgam Harms the Environment with Mercury Pollution: https://iaomt.org/resources/dental-mercury-facts/dental-amalgam-mercury-pollution/

    Dental Amalgam Danger: Mercury Fillings and Human Health: https://iaomt.org/resources/dental-mercury-facts/amalgam-fillings-danger-human-health/

    Mercury Poisoning Symptoms and Dental Amalgam Fillings: https://iaomt.org/resources/dental-mercury-facts/mercury-poisoning-symptoms-dental-amalgam/

    Multiple Sclerosis & Mercury Exposure; Summary & References: https://iaomt.org/resources/dental-mercury-facts/dental-amalgam-mercury-multiple-sclerosis/

    1. “Easily bullied and told what to think”?? Really Jennifer? And you’re doing…what? That’s pretty funny today. OK – let’s see…IAOMT – all of your links are from the same sources?? What is this source? This org asserts that amalgam fillings are poisonous and pose a serious threat to the health of everyone who has one, which is totally baseless. The amount of mercury absorbed from amalgam fillings is only a small fraction of the average daily intake from food and is far below the level that exerts any adverse health effect. Thus there is no logical reason for consumers to be concerned about “amalgam toxicity.”

      If you read my column you would see that I included the fact that there are alternative materials that are available, that if you can afford them you can choose them, but to drill into stable teeth unnecessarily is a far worse option and unnecessary. READ the column.

    2. Every single one of your links are bogus because not a one of them presents a study that was published in a respected peer reviewed journal. All you have done is posted links to what has already been debunked. This is the hallmark of anti-science heretics like yourself. Sadly, I know this won’t prevent you from dragging out the same debunked nonsense the next time this subject comes up.

      1. A “… respected peer reviewed journal” is getting more and more difficult to find.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/

        http://alturl.com/3naos

        “[…] The problems I’ve discussed are not limited to psychiatry, although they reach their most florid form there. Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices.
        It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion,which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.
        (Drug Companies & Doctors: A Story of Corruption, Jan 15, 2009)”
        Marcia Angell, MD

        With such blatant conflicts of interest on multiple levels, how can anyone trust what goes on in the peer-reviewed journal arena?

        1. The problem you point out is real, but the greatest function of peer review is to weed out the bad apples. It ain’t perfect, but it is the best system available.

          1. Agreed. The option is to accept the advice of witch doctors or the collective wisdom of anonymous posters on social media sites.

          2. Agreed. The option is to accept the advice of witch doctors or the collective wisdom of anonymous posters on social media sites.

  6. Let’s stick to facts, vaccine, along with those type of fillings, are the leading cause of becoming a zombie. Next time you encounter a zombie eating on you, look at his teeth, lots of them fillings. Oh, if you eat GMO you also will become a zombie. I prevent that by using essential oils

  7. For those who need the facts, the ADA does indeed have patents for amalgam fillings.
    U.S. Patent #4,018,600 issued April, 1977
    U.S. Patent #4,078,921 Issued March 1978

    1. And what is the point of this statement? Who has the patents on composite fillings? The point of my column is those amalgam fillings that are stable and without decay around them are advised to be left alone. It’s much safer than to drill into otherwise stable and intact teeth to remove them because the tooth is then more weakened. And credible sources advise this.

      1. I’d rather be on the safe side, Susan.
        Point was that ADA has a financial interest in amalgam use.

        1. And?? other professional dental organizations throughout the world use amalgam too – READ the article – IF you have the financial means, by all means, opt for a composite option. IF you have stable dental fillings, there is not one credible dental organization that advocates drilling out intact and stable amalgam fillings – there is much more danger to the tooth and the person’s health and their pocketbook. By all means, there are alternatives, and eventually, composites will become more affordable and amalgam will be phased out. In the meantime, having your healthy teeth drilled out is unnecessary. There are no credible studies that link stable amalgam fillings to ill health.

    2. Myth #9: The American Dental Association holds the patent
      on amalgam and receives a royalty on each amalgam placed.
      Fact #9: Neither the ADA nor the ADA Health Foundation has ever
      received remuneration from any amalgam restoration ever placed.
      An internet search [5] revealed that of 67 patents held by the American Dental Association Health Foundation, the non-profit research arm of the American Dental Association, only two were for amalgam formulations (US04078921 & US04018600). The American Dental Association itself has never had a patent on any amalgam formulations. Both of these patents have expired; neither was ever licensed. In other words, neither the ADA nor the ADA Health Foundation has ever received any royalty from any amalgam ever placed. The ADA Health Foundation has not pursued any research activity related to amalgam or its use for more than 15 years. (Eichmiller F, personal communication, February 3, 2000). There is not merely one patent for amalgam; instead there are many different patents for different formulations and applications of amalgams, most of which are owned by the manufacturers, which do receive royalties for their patents.

      If there is an incentive for the ADA to “promote” a particular type of restorative material, then it must be resin composite. The ADA (along with the National Bureau of Standards and National Institute of Dental Research) actually funded the invention of composite restorative materials in the 1950s [6,7]. The American Dental Association Health Foundation holds at least 15 patents related to resin composite. Two of these recently expired, but 12 are still active. Most or all of these are licensed, meaning the nonprofit ADA Health Foundation receives a royalty when its patents are used. The American Dental Association has stated that amalgam is safe and effective despite the fact that its research foundation receives financial remuneration for alternative filling materials and no remuneration for amalgam restorative materials. Furthermore, the ADA continues to support more than US $1 million in research each year through the ADA Health Foundation for the development of nonamalgam technologies. Although the ADA does not “promote” any dental material, it has stated that both amalgam [4] and composite restorations are safe and effective.

      1. Thanks so much for doing the research, Charlie. People grab factoids off the internet and extrapolate into conspiracy theories, and without readers like you doing the legwork, others may come away with false information. I appreciate it. Susan

        1. All I did was go to the link that StillWatching posted and copy and paste it here. Are people really so lazy that they didn’t read it when he posted it, or was it willful refusal to read it because they don’t want to admit the truth?

    3. That is dishonest and disingenuous. Let’s grant, arguendo, that those patents were actually issued and they were what you say they are. Any fool knows that such patents expire in 20 years, which means the patents you cite expired 23 and 22 years ago, respectively.

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