Dental amalgams have long been controversial. A mixture of mercury, silver, tin, copper and other metals, amalgam fillings were first introduced to America in 1833 by two French entrepreneurs, the Crawcour brothers. According to Norwegian researcher and science writer, Geir Bjørklund, amalgam fillings were used as early as the T'ang Dynasty in China (618-907 A.D.), and in Germany by Strockerus in 1528.
By the mid 1800s a substantial number of dentists denounced the use of fillings containing mercury. Yet to its supporters, amalgam fillings seemed to be the pinnacle of dental practicality: affordable and durable. In 1844 approximately fifty percent of all dental restorations placed in upstate New York consisted of amalgam.
However, these fillings received anything but a warm welcome from the sole American dental association at the time. The American Society of Dental Surgeons (ASDS), formed in 1840, labeled the use of mercury fillings as “malpractice” and asked its members to sign a pledge promising to cease their use of amalgam.
Quick linguistic tidbit: Germans often referred to mercury as “quick silver” during the 19th century. “Quack” is the German pronunciation for “quick.” And dentists who used amalgam fillings? They were disparagingly referred to as “quacks” – thus sparking the use of the slang term we know today.
But back to our star of the article: mercury.
Despite its 160+ year controversial past, its reputation remains at least partially unscathed, with nearly half of all dentists today placing mercury fillings. But what about the remainder? Are amalgam fillings waning in popularity due to perceived or actual danger?
Here is what we know for sure:
Mercury is a neurotoxin. Exposure risks include neurological issues, autoimmune disease, chronic illnesses and mental disorders. Even a single drop on human skin can be fatal. With amalgam fillings, mercury vapor is released when fillings are placed or removed, or even when a patient chews or grinds their teeth – but the only question that really matters is this: does the amount of mercury vapor released from fillings cause harm?
The FDA says no. On July 28, 2009, the administration issued its final regulation on mercury used in dental amalgam fillings, acknowledging that although high doses of mercury could cause negative effects to the kidneys and brain, the amount used in fillings is not high enough to cause harm to patients. The agency did, however, restrict its controls on mercury fillings, changing the encapsulated amalgams from Class I devices (lower risk) to Class II.
The ADA agrees that amalgam is a safe restorative material. This being said, there are wide ranges in the amount of mercury vapor released based on situational and lifestyle variables such as number and age of fillings, diet, the amount of acid consumed (from soft drinks, etc.) and bruxism.
Despite the FDA and ADA stances, a quick web search brings up a plethora of organizations opposing mercury fillings in addition to dentists’ offices offering safe amalgam filling removal. Which begs the question: will mercury fillings ever shed their controversial reputation?
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