The discussion of mercury toxicity deserves a few words. The position adopted by all scientific investigators in this country has been, there isn't enough mercury available after the silver restoration has SET to be a problem to a living organism. The mercury becomes bound up and fused inside the silver amalgam so that it is measurable only in parts per million. This exposure threshold has been established as a safe guideline that is not injurious to humans. Unfortunately, there has been a lot of hoopla around this issue and the question remains unanswered for some members of the lay and medical community.
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Because mercury was used in nerve gases in world war II and is basically toxic to all life forms, there is a question if this element can be present in the body in any concentration at all. Furthermore, it is conjectured that ionic mercury is released when fillings rub against each other and as such may be reabsorbed into the body. This has been measured in hair testing as a barometer of mercury presence in the body and has fueled an entire new age dental practice of mercury-type amalgam filling elimination. Many individuals with maladies ranging from chronic fatigue syndrome to multiple sclerosis have besieged their dentists with requests to "remove the mercury" and place alternative restorations. It has even been theorized that metal fillings upset the electric meridians of the body and introduce galvanic forces which are not harmonious or natural to basic health, and as such, may be involved in upsetting delicate subtle forces which may encourage disease.
Consequently, the result has been a wide range of professional attitudes. In the 70's and 80's, there were some practices that used scare tactics to "encourage" their patients to replace all silver fillings. In some cases, these practitioners pushed the envelope of what was ethical and some licenses were revoked by State Boards of Dental Examiners. In other cases, composite was placed in any and all teeth without regard for it's strength or adequacy of placement. Many of these cases resulted in more complicated dentistry over the years and probably were detrimental to the dental health of those patients.
There have been reports of miraculous reversals of health problems as a result of silver removal from teeth. This information has not been scientifically documented and an opinion cannot be rendered. In our experience, those patients who have had difficult medical histories and have asked for silver replacement, continue to deal with those complicated medical histories. We have not seen any miracles.
At the same time, there are many individuals who are dealing with a myriad of issues and justifiably should look at everything in their environment. We see increasing numbers of patients with environmental allergic issues and a host of immunologically compromised individuals who deserve the benefit of the doubt from their dental professionals.
We don't know what information will be forthcoming in the years ahead, but we hope further research will reveal further insights. For the most part, in normal, healthy individuals, silver seems to be harmless, economical and quite durable. Even though we may not choose to use silver amalgam as much anymore because of issues with expansion, leakage and bondability, it still has an important place in dentistry, if only for the time being.
For more on this topic, see the following report
U.S. DEPARTMENT OF HEALTH STATEMENT ON THE TOXICITY OF DENTAL AMALGAM
- GINGIVITIS AND HEART DISEASE
- RISKS OF PRE-TERM BIRTHS
- SILVER FILLINGS AND AMALGAM TOXICITY
- DENTAL INSURANCE: YOUR BILLION DOLLAR PARTNER?
- DENTAL PREVENTION: THE BEST DENTISTRY IS NO DENTISTRY