At the end of a root canal procedure, your dentist usually advises you to opt for a silver dental filling for your tooth. This is because it is considered to be the most durable and affordable option.
But there is more to the seemingly harmless and affordable silver dental filling. Medically known as Dental Surface Restoration, the filling is composed of dental amalgam — a mixture of mercury, silver, tin, and other metals. Although dental amalgam has been used for over 150 years, research from the University of Georgia’s Department of Environmental Health Science in the College of Public Health has highlighted that it contains 50% mercury, which can cause brain, heart, kidney, lung, and immune system damage. The study further revealed that people with more than eight dental fillings are at an increased risk because the mercury in their blood is about 150% more than usual.
The International Academy of Oral Medicine and Toxicology (IAOMT) has revealed, there is scientific evidence about mercury vapor getting released from silver dental filling during brushing, cleaning, clenching of teeth and chewing, etc. Mercury vapor is also released during dental procedures involving amalgam fillings putting dental professionals and especially fetuses at risk.
European countries like Norway, Sweden and Denmark have banned the use of silver fillings due to their toxic effects.
The U.S. Food and Drug Administration considers dental amalgam fillings safe due to a lack of sufficient evidence for adults who don’t have pre-existing neurological conditions and kidney disorders. Their site advises pregnant women, nursing mothers, and parents with children under six to talk to their dentist.
However, the American Dental Association continues to highlight dental amalgam as a safe, affordable, and durable material. Even so, this viewpoint has been criticized by other organizations, including IAOMT.
Silver dental fillings: Safe or unsafe?
Speaking about mercury’s safety, Dr Ashok. V, a Bengaluru-based dentist and owner of Wisdom Dental Clinic says there are no comprehensive and robust studies to support the harmful effects of mercury in dental fillings. This could be the reason why the FDA has allowed clinicians to use silver fillings widely in the US, he states. “There are patients here in India too in their 70s who have had mercury fillings for years and they are healthy,” he added.
In an email interaction with Happiest health as to why over 100 million silver fillings are used in America each year, Dr Joe Thomas, a dentist from Chicago-USA says, “The majority of dentists in the US use silver fillings because they are cheaper, faster, and most importantly well-covered by insurance.” On being probed if he considered these fillings safe, the doctor says that he prefers using composites (resin fillings) for his patients provided they are willing to shell out more.
Most of the studies on the toxic effect of silver fillings on human kidneys point out minimal or no differences in renal function before and after the removal of amalgam fillings. Even the National Institute of Health(NIH) in a study published in 2012 refuted IAOMT’s toxicity claim of mercury vapours during dental procedures, reiterating ADA’s stand on the safety of silver fillings.
However, Professor Altaf Patel, director of the Department of Medicine, at Jaslok Hospital, Mumbai, in his interaction with Happiest Health said that mercury exposure is understated. According to him, mercury in the blood causes high blood pressure and heart disease and can exacerbate the problem in people with existing kidney conditions. The professor interestingly adds that he has observed people getting relief from migraine after their silver dental fillings were removed.
There are studies, which correlated toxic mercury exposure with an increased risk of cardiovascular diseases. The research explains that mercury causes the inactivation of paraoxonase, an enzyme that plays an important role in preventing the deterioration and rancidity of fats. This increases the risk of atherosclerosis, acute myocardial infarction, cardiovascular disease, coronary heart disease, and carotid artery stenosis. Another study reveals that mercury exposure could have a long-lasting effect on cardiac activity and heart rate variability in children.
Speaking on how the mercury in the dental filling affects the brain, Dr Sudhir Kumar a Hyderabad-based neurologist says, “There is no conclusive proof that it affects the brain significantly but there are case report studies that reveal that people with silver dental fillings have more pronounced symptoms of anger, fatigue, insomnia, depression, anxiety, memory impairment, trembling of hands, imbalance, and hearing and vision problems.
Alternatives for silver filling
According to Dr Ashok, composites, ceramic, and gold fillings are alternatives to silver dental amalgam. But there is a downside to each of them, he says.
“Though composites are popular, more research is required to understand the biocompatibility of resins,” he says. Furthermore, composite filling is a very technique-specific job. The filling requires a 100% dry environment to be used effectively, as saliva can cause the filling to crack and cause sensitivity, adds Dr Ashok.
The ceramic fillings need to be prepared in a lab for accuracy and effectiveness, says the dentist and adds that these fillings are not as cost-effective as the composites. Gold fillings, though expensive, are safest for adults and glass ionomer cement is the best option for kids with milk teeth according to him.
The doctor doesn’t hesitate to name the silver filling as the best bet when it comes to strength and durability.
Should you remove existing silver fillings?
Dr Taikhum, a Bengaluru-based Prosthodontist and Implantologist says that people don’t need to worry about their existing silver dental fillings as the levels of mercury are below the toxic levels, though he advises them to opt for alternative fillings in the future.
Dr Ashok however mentions there are chances that the prolonged presence of mercury in the mouth could have an impact on health. “The longer you have silver fillings in your mouth, the more mercury you likely have in your body,” he says.
Takeaways
- Studies indicate that the silver dental filling can harm the brain, heart ,lungs, kidneys and immune system.
- The U.S. Food and Drug Administration considers dental amalgam fillings safe due to a lack of sufficient evidence.
- Composites, ceramic, and gold fillings are alternatives to dental amalgam.
