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Probably none of us likes the situation when the tooth starts to hurt and it turns out that the cause of the unpleasant ailments is a cavity. It is then necessary to visit a dentist who will fill it with an appropriate filling. And although now, in most cases, he will offer us a white composite filler, a dozen or so years ago the most frequently used were dark and not very aesthetic amalgam fillings. Certainly some of us still have them in our dentition. However, are amalgam fillings safe? Or maybe they should be replaced immediately?
Amalgam fillings have been used in dentistry for over 150 years. Amalgam, i.e. the material from which the filling is created, is nothing more than a combination of the right proportions of mercury, copper, zinc, tin and silver.
Despite cyclically recurring debates about their harmful effects on the human body, amalgam fillings are still used in dentistry in Poland. In our country, it is forbidden to use this type of filling only in pregnant women, nursing mothers and children.
In the world, amalgam fillings have been withdrawn from dentistry for a long time. In Japan, they were banned more than 40 years ago, in Scandinavian countries – in the early 90s. And although it was said that the European Union would categorically ban their use by 2018, this did not happen.
Amalgam seals Although they are no longer used in private dental offices, they are still used in dental clinics financed by the National Health Fund. It is estimated that up to 20 percent. of all used amalgam fillings are made in Poland. Are amalgam fillings really that dangerous? What are the other alternatives for filling cavities?
Amalgam and composite seals
Nowadays, composite fillings are an alternative to not very aesthetic amalgam fillings. Both amalgams and composites have their advantages and disadvantages. Undoubtedly, the former are much more durable – it is estimated that a well-placed amalgam filling is able to survive up to 30 years.
In the case of white and almost invisible composite fillings, this time is much shorter and is only 10 years. After this time, the filling becomes less resistant and begins to fall out by itself, and the process of filling the cavity should be repeated.
Types of amalgam fillings
The biggest objection against amalgam fillings is their alleged one mercury release toxicity. However, it is important to know that not one, but two types of amalgams were used for the fillings.
The first is the old type fillings, also known as gamma 2 amalgams. Indeed, with these fillings, studies have shown that they can release mercury, which may not be neutral to our bodies.
In turn, the second type of amalgam fillings are those free from gamma 2 phase. This type does not release mercury and does not threaten our health. In 2013, the then Minister of Health signed an ordinance according to which all amalgam fillings, supplementing cavities at the expense of the National Health Fund, must be made only with amalgam free from gamma 2 phase.
Amalgam fillings – pros and cons
Silver amalgam fillings they also have properties desirable in dentistry. They are much harder and more resistant to compression than white, light-cured composite fillings. A correctly placed amalgam filling performs its function well even up to 30 years, while a composite filling retains its properties for about 10 years.
The disadvantage of amalgam fillings is their inability to bond with tooth enamel or dentin. For this reason, gaps may appear between the silver fillings and the tooth tissue, into which cariogenic bacteria penetrate. After placing such a seal, it can happen discoloration of the tooth tissueand in extreme cases – also the gums. There are cracks in the thin, weakened walls of the tooth due to the thermal expansion of the amalgam.
Moreover, amalgam fillings are not very aesthetic, as it is not possible to match their color to the shade of the patient’s teeth (which is possible in the case of light-cured fillings).
Unfortunately, numerous studies on the harmfulness of amalgam fillings to human health did not allow for an unambiguous statement of this fact.
However, some are the harmful effects that too much can cause in our bodies mercury exposure. This element is absorbed into the bloodstream and goes to the kidneys where it occurs blood filtration process and the excretion of pollutants and harmful substances in the urine. However, if the concentration of mercury in the blood it is too big, the kidneys and brain are damaged and impaired.
The results of a study conducted by the US Food and Drug Administration on the harmfulness of amalgams, published in 2008, confirmed that these may affect the development of autoimmune diseases as well as Alzheimer’s and Parkinson’s diseases. On the other hand, a study conducted and published in the same year by a scientific team of the European Commission denied that amalgam fillings may have any connection with health problems.
Here, too, opinions are divided. Some dentists believe that any amalgam fillings require immediate replacement due to the fact that it is not known if caries develops underneath it. Its color effectively makes it difficult to judge the situation, and the only way to find out is removal of the tooth filling. Procrastination with the removal of the seal may result in the development of serious dental diseases.
However, other specialists are of the opinion that if nothing is happening to an amalgam-filled tooth, there is no need to remove the seal, as this may only weaken it or cause unnecessary removal of part of it.
However, it should be remembered that if we decide to remove the amalgam filling, we should decide to perform the procedure in an appropriate dentist’s office, which maintains certain safety procedures. When removing the seal, the rest of the patient’s mouth should be properly secured. Equally important is an oxygen mask to prevent inhalation of mercury vapors.
Źródło: Luisa Dillner, «Should I have my amalgam fillings removed?»; theguardian.com