Dental amalgam has been used for more than 150 years to fill cavities. Amalgam is an alloy made up of liquid mercury and a powdered mixture of silver, tin and copper. Most of the filling composition is elemental mercury (about 50 percent). This type of mercury releases mercury vapor and has been the cause for concern with amalgam fillings.
Uses
Amalgam is very durable, so amalgam fillings are usually used on the back teeth, or molars, where people chew the most. Amalgam is also used in areas of the mouth that are hard to keep dry during the restoration.
Disadvantages
Because amalgam fillings are silver-colored, they are not very natural-looking. Dentists also may need to remove more of a healthy tooth for an amalgam filling than other types of fillings. Temporary hot and cold sensitivity is also a possible disadvantage with amalgam fillings.
Advantages
Amalgam fillings are the least expensive filling type. Amalgam is also sturdy and long-lasting. This means less money spent up front for a filling and less money spent in the long run for replacement fillings.
Risks
Elemental mercury emits mercury vapor, and high levels of mercury vapor exposure can lead to problems with the kidneys and brain. Due to the low amounts of mercury vapor associated with amalgam fillings, the FDA deems amalgam fillings safe for adults and children 6 years old and above. There isn't enough clinical evidence to support neither the safety nor the risks of amalgam fillings for pregnant women (including their fetuses) and children under age 6. Individuals with allergies to mercury or any of the other metals in amalgam fillings may have adverse outcomes.
Bottom Line
On July 28, 2009 the Federal Drug Administration announced its decision not to place any restrictions on the use of dental amalgam fillings. The American Dental Association agrees with the FDA's decision. While the FDA and ADA deem amalgam fillings safe to use, individuals should always consult with their dentist for what type of filling to use.
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