At our holistic dental practice, we understand that dental decisions can significantly impact your overall health. One topic that frequently arises is the use of amalgam fillings, which contain mercury. In this blog, we aim to provide you with a comprehensive understanding of amalgam fillings, their advantages and disadvantages, the circumstances under which they should be replaced, and how to do so safely.
Amalgam Fillings: The Basics
Amalgam fillings, also known as silver fillings, have been a common choice for restoring decayed teeth for over a century. These fillings are composed of a mixture of metals, with approximately 50% mercury, along with silver, tin, and copper. The primary advantage of amalgam is its durability. They are robust and long-lasting, making them an attractive option for dental restorations.
The Mercury Question: Pros and Cons
Pros of amalgam fillings:
- Durability: Amalgam fillings are known for their longevity, often lasting over a decade.
- Cost-Effective: They tend to be more affordable compared to alternative materials.
- Strength: Amalgam can withstand the forces of chewing.
Cons of amalgam fillings:
- Mercury Content: Amalgam fillings contain elemental mercury, which can be a concern.
- Aesthetics: They are conspicuous and less aesthetically pleasing compared to tooth-coloured alternatives.
- Expansion and Contraction: Amalgam can expand and contract with temperature changes, potentially leading to tooth fractures.
When Should Amalgam Fillings Be Replaced?
The decision to replace amalgam fillings often centres around patient health, aesthetic concerns, and the desire to avoid potential mercury exposure.
Indications for Replacement:
- Mercury Allergy: Some individuals may exhibit allergies or sensitivities to mercury, making replacement necessary.
- Aesthetic Concerns: For cosmetic reasons, patients may opt for tooth-coloured, more aesthetically pleasing alternatives.
- Tooth Fractures: Over time, the expansion and contraction of amalgam can weaken teeth, leading to fractures.
- Desire to Minimise Mercury Exposure: Concerns about mercury exposure, even though it is generally considered safe in dental amalgam, may lead patients to seek removal.
The SMART Protocol for Safe Removal
Safety is paramount when it comes to removing amalgam fillings. The IAOMT (International Academy of Oral Medicine and Toxicology) has developed the SMART protocol, which stands for Safe Mercury Amalgam Removal Technique. This protocol aims to protect patients, staff, and the environment during removal procedures.
SMART Protocol Steps:
- Patient Isolation: Utilising a rubber dam and protective eyewear to prevent mercury exposure.
- Air Quality Control: Employing high-volume evacuation and air filtration systems to minimize mercury vapor.
- Respiratory Protection: Both the patient and dental staff wear appropriate respiratory masks.
- Safe Removal Technique: Implementing precise techniques to minimize the release of mercury vapor.
- Mercury Separator: Installing chairside amalgam separators to capture waste material, ensuring it doesn't enter the water supply.
- Protective Clothing: Dental personnel wear impermeable gowns and head coverings.
- Post-Operative Procedures: Rinsing and cleansing the patient's mouth thoroughly, as well as evaluating air quality after removal.
FDA Recommendations and Beyond
The FDA recognizes the safety of dental amalgam fillings for most patients. However, they have provided information regarding potential risks, particularly for sensitive populations. This underscores the importance of informed decision-making when it comes to your oral health.
As holistic dentists, we support your right to choose the best dental materials for your well-being. If you are considering amalgam filling removal, consult with a dentist experienced in the SMART protocol. Your safety, the safety of our staff, and the environment are our top priorities.
Want to learn more about amalgam removal and if it’s right for you? Book a free consultation with Dr. Verma now.