How Safe Are Amalgam Fillings and Should You Replace Them?

How Safe Are Amalgam Fillings and Should You Replace Them?

Almost half of US dentists still use dental amalgam fillings ( “silver fillings” ). But did you know that amalgam fillings contain about 50% mercury. Studies found that small amounts of mercury are continually released from amalgam fillings and it is mostly absorbed into the body. (1, 2)

Researchers have found that for most people, amalgam fillings are responsible for most of the mercury stored in their tissues, along with fish consumption. Levels of mercury in hair and urine have been shown to directly correlate with people’s exposure to mercury-containing fillings. (3)


The American Dental Association (ADA) and the FDA claim that amalgam fillings are safe and that the low levels of mercury they release does not present a health problem. However, some experts disagree and claim that the safety of dental amalgams is questionable.

The World Health Organization says that inhaling or ingesting mercury, even in small amounts could cause “serious health problems”. Some of them include depression, tremors, memory loss, cognitive and motor dysfunction, as well as damage to the lungs, kidneys, eyes and digestive and immune systems. (5)

Could your amalgam fillings be slowly damaging your health? Should they be removed or are they safe as they are? This article aims to provide some information to help with the decision about your dental work.

What is Exactly Amalgam?

Every year, about a billion amalgam fillings are fitted. They have been used for over 150 years and are popular due to their durability, affordability and ease of manipulation.

Amalgam fillings are a preferred choice for many dentists and patients, especially when fixing back teeth that need strength for chewing and are not visible when we smile, so their appearance is often less of a priority.

Amalgam is a mixture of mercury, copper, tin and silver. 50% of amalgam filling is mercury, which is used to bind the other elements together. To this day, no alternative to mercury has been discovered, so it continues to be used.

This is where the problem with silver fillings starts. Many people are not even aware that their dental work contains mercury that produces potentially dangerous vapor in their mouth. The vapor levels are particularly high when inserting and removing the fillings, so possible extraction needs to be completed with great care.

The Dental Amalgam (Silver Fillings) Safety Controversy

According to different studies, the level of mercury you get exposed if you were fitted with amalgam fillings ranges from 1 microgram a day to 27 micrograms a day.

The World Health Organization (WHO) also states that the exposure significantly increases – up to 5 times – with certain practices and habits such as grinding your teeth, chewing gum and drinking carbonated drinks.

If we consider the higher numbers from these studies, the WHO’s statement, and continuous exposure, mercury vapor from amalgams should be deemed unhealthy as per standards set by the Occupational Safety and Health Administration (OSHA).


However, the American Dental Association (ADA) doesn’t consider amalgam to be unsafe. The US Food and Drug Administration (FDA) also advises against the removal of amalgam and warns that this could cause more harm to the patient compared to leaving the fillings as they are.

Not only that, the FDA brands the removal of amalgam for fear of mercury vapor unethical, and dentists performing the procedure risks losing their license.

Yet, in 2009, the FDA itself moved the use of amalgams to Class II (moderate risk) from the previous Class I (low risk), which is slightly contradictory to their position on the safety of amalgam.

Health Risks Related to Amalgam Fillings

When exposure to mercury reaches a certain level, this powerful neurotoxin can cause neurological damage, mental health problems, chronic diseases and autoimmune conditions.

A study performed in Sweden revealed that 78% of people who had pre-existing neurological and health issues (for example, chronic fatigue syndrome) reported an improvement in their health after they had their fillings removed. In 2008, Scandinavian countries banned the use of amalgam in dentistry.

Reports from the US contradict the above decision. Studies funded by the FDA found insufficient evidence that would link mercury from amalgams to various health complaints.

They explain that when mercury is linked with other materials, its chemical composition changes and it becomes non-toxic. Furthermore, the FDA and the ADA believe that the amount of mercury that gets released from amalgam fillings is too small to be harmful to humans.

How to Know If You Have Mercury Poisoning From Fillings

Many of the symptoms of mercury poisoning from fillings are related to you brain function because inhaled mercury vapor leads to deposition of elemental mercury in the brain. (4)


Common brain-related symptoms mercury poisoning from fillings include fatigue, anxiety, depression, memory loss, and difficulty concentrating.

However, the mercury vapor from fillings is also easily inhaled and absorbed in your body. Therefore, the symptoms of mercury toxicity can be physical and body-wide, in addition to being mental and emotional.

Symptoms of Mercury Poisoning from Fillings Could Include:

  • Weakness and fatigue
  • Headache
  • Gastrointestinal issues
  • Widespread joint pain
  • Skin rashes
  • Weight loss
  • Reduced color vision and visual acuity
  • Lack of coordination of movements
  • Tremor
  • Memory loss
  • Decreased mental concentration and mood swings
  • Depression or anxiety
  • Excessive anger

Environmental Risks of Amalgam

Mercury presents a great threat to the environment, too. The WHO established that 53% of mercury emissions could be attributed to amalgam and laboratory devices. That is why a correct removal technique that can decrease the release of mercury into the sewer system is so important.

Amalgam separators can mitigate the negative impact, but they are not mandatory in many countries, including the US.

Should You Remove Amalgam Fillings?

This is not an easy and straightforward decision to make and should be carefully discussed with your dental team. As mentioned before, during removal, more mercury vapor gets released, which can worsen your health situation.

Generally speaking, a non-amalgam restoration is usually recommended if the fillings are older than 20 years, cause gum inflammation and prevent you from keeping good dental hygiene.


How much mercury might be leaking into your body also depends on the number of fillings and your diet. For example, if you like to indulge in carbonated drinks, this will increase the mercury levels as the bubbly drink erodes amalgam.

If you do decide to remove your old amalgam fillings, make sure that your dentist uses a dental rubber dam that will isolate the tooth and minimize mercury vapor.

What are the Alternatives?

Instead of amalgams, resin composite fillings can be used. They mimic the appearance of your teeth and are usually used for front teeth. They used to be considered not durable enough for back molars, but the techniques and materials have improved now, so they can also be used for high-pressure grinding and chewing. Still, many dental plans don’t cover them.

Other, more expensive alternatives include laboratory-fabricated porcelain and gold.

Final Thoughts

It is still not clear if mercury in amalgam presents a health risk. More research by independent bodies is required and the results need to be made available to the patients.

Don’t just rush into removing your existing amalgams as most mercury vapor is released during placement and removal.

Scandinavian countries banned or restricted amalgams due to health and environmental reasons. When you are deciding about your future fillings, consider the alternatives that are available and might be safer and healthier.

Read more about oral health in my other articles:


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