Amalgam, an alloy of mercury (Hg), is an excellent and versatile dental restorative material. It has been used in dentistry since 150 years due to its low cost, ease of application, strength, durability, and bacteriostatic effects. Popularity of amalgam as restorative material is decreasing these days due to concerns about detrimental health effects, environmental pollution, and aesthetics. The metallic colour of amalgam does not blend with the natural tooth colour so patients and professionals preferred tooth-coloured restorative material for cavity filling in carious teeth for better aesthetics. Researchers agree that amalgam restorations leach mercury into the mouth, but consistent findings are not available to report whether it has any significant health risk

Dental Amalgam: What Organizations Say

Alzheimer’s Association

“According to the best available scientific evidence, there is no relationship between silver dental fillings and Alzheimer’s Public health agencies, including the FDA, the U.S. Public Health Service and the World Health Organization, endorse the continued use of amalgam as safe, strong, inexpensive material for dental restorations.”

American Academy of Pediatrics

“Although dental amalgams are a source of mercury exposure and are associated with slightly higher urinary mercury excretion, there is no scientific evidence of any measurable clinical toxic effects other than rare hypersensitivity reactions. An expert panel for the National Institutes of Health has concluded that existing evidence indicates dental amalgams do not pose a health risk and should not be replaced merely to decrease mercury exposure.”

Autism Society of America

“There is no known single cause for autism, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism versus neuro-typical children. Researchers are investigating a number of theories, including the link between heredity, genetics and medical problems. In many families, there appears to be a pattern of autism or related disabilities, further supporting a genetic basis to the disorder. While no one gene has been identified as causing autism, researchers are searching for irregular segments of genetic code that children with autism may have inherited. It also appears that some children are born with a susceptibility to autism, but researchers have not yet identified a single “trigger” that causes autism to develop.”

U.S. Environmental Protection Agency

“Since the 1990s, several federal agencies have reviewed the scientific literature looking for links between dental amalgam and health problems. According to the Centers for Disease Control and Prevention (CDC), there is little scientific evidence that the health of the vast majority of people with dental amalgam is com- promised, nor that removing amalgam fillings has any beneficial effect on health.”

Mayo Clinic

“Amalgam fillings are safe. A great deal of research has examined these fillings and found them to be an effective, long-lasting treatment for dental decay. Amalgam, or silver, fillings are made with mercury, silver, tin and copper. In some cases, other metals may be included in amalgam fillings, too. Amalgam has been used for many years to replace decayed areas within teeth. It’s an excellent material for this purpose. Amalgam

is a strong, stable substance that holds up well when placed in a moist environment. It’s also a good choice because it can tolerate the dramatic changes in temperature within your mouth.”

Source: “Amalgam is a safe and durable choice for fillings” in Medical Edge from Mayo Clinic, January 28, 2013

National Multiple Sclerosis Society

“There is no scientific evidence to connect the development or worsening of MS with dental fillings containing mercury, and therefore no reason to have those fillings removed. Although poisoning with heavy metals-such as mercury, lead, or manganese can damage the nervous system and produce symptoms such as tremor and weakness, the damage is inflicted in a different way than occurs in

MS and the process is also different.”

“There have been claims over the years that mercury leaking from amalgam dental fillings damages the immune system and causes a broad range of diseases, including MS. While the cause of MS remains unknown, there is no scientific evidence that heavy metal poisoning is responsible for either the onset or worsening of MS. There is no reason to have your dental fillings removed or replaced. This is a very expensive procedure with no proven benefit for people with MS.”

U.S. Food and Drug Administration

“FDA has reviewed the best available scientific evidence to determine whether the low levels of mercury vapor associated with dental amalgam fillings are a cause for concern. Based on this evidence, FDA considers dental amalgam fillings safe for adults and children ages 6 and above. The amount of mercury measured in

the bodies of people with dental amalgam fillings is well below levels associated with adverse health effects FDA concludes that the existing data support a finding that infants are not at risk for adverse health effects from the breast milk of women exposed to mercury vapor from dental amalgam. The estimated daily dose of mercury vapor in children under age 6 with dental amalgams is also expected to be at or below levels that the EPA and CDC consider safe.”

New England Journal of Medicine

“Current concern arises from claims that long-term exposure to low concentrations of mercury vapor from amalgams either causes or exacerbates degenerative diseases such as amyotrophic lateral sclerosis,

Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease. Speculation has been most intense with respect to Alzheimer’s disease after a report that the brains of patients with Alzheimer’s disease had elevated mercury concentrations. However, several epidemiological investigations failed to provide evidence of a role of amalgam in these degenerative diseases … Patients who have questions about the potential relation between mercury and degenerative diseases can be assured that the available evidence shows no connection.”

Source: New England Journal of Medicine 349;18, October 30, 2003, pp.1731-1737.

International Journal of Dentistry

“According to the available articles and data reviewed in this paper, the following conclusions can be drawn: 1) Mercury released from dental amalgam restorations does not contribute to systemic disease or systemic toxicological effects, 2) Allergic reactions to mercury from dental amalgam restorations

have been demonstrated, but these are extremely rare, and 3) Available scientific data do not justify the discontinuation of dental amalgam use from clinical practice or the replacement with other single-tooth restorative dental materials.”

National Council Against Health Fraud

“The National Council Against Health Fraud believes that amalgam fillings are safe ” “There is no logical reason to worry about the safety of amalgam fillings.”

The National Institute of Dental and Craniofacial Research (NIDCR part of the National

Institutes of Health)

“Both studies one conducted in Europe, the other in the United States independently reached the conclusion: Children whose cavities were filled with dental amalgam had no adverse health effects. The findings included no detectable loss of intelligence, memory, coordination, concentration, nerve conduction, or kidney function during the 5-7 years the children were followed.”

Source: “Studies Evaluate Health Effects of Dental Amalgam Fillings in Children”, 2006

American Cancer Society

“The American Cancer Society has no formal position on the use of mercury in dental fillings. We did have a document called Biological Dentistry on our site that discussed the studies and science around mercury fillings, which stated there was no good evidence that dental amalgams cause health problems in most people. It cited studies that found no link between mercury-containing fillings and the development of cancer and other diseases.”

Source: Complete Guide to Complementary and Alternative Cancer Therapies, 2nd edition, 2009, pp.164-166.

Lupus Foundation of America

“At the present time, we do not have any scientific data that indicates that dental fillings may act as a trigger of lupus. In fact, it is highly unlikely that dental fillings aggravate or cause SLE.”

Source: Lupus Foundation of America website

WebMD

“The cause of autism, Alzheimer’s disease, and multiple sclerosis remains unknown. Additionally, there is no solid, scientific evidence to back up the claim that if a person has amalgam fillings removed, he or she will be cured of these or any other diseases Although amalgams do contain mercury, when they are mixed with other metals, such as silver, copper, tin, and zinc, they form a stable alloy that dentists have used for more than 100 years to fill and preserve hundreds of millions of decayed teeth.”

Source: WebMD website