Silver Amalgam Restorations

Silver amalgam is scientifically proven to be a safe, durable, affordable and effective material when properly used to treat smaller cavities of the back teeth.

What is Silver Amalgam?

Silver amalgam (a.k.a. dental amalgam, or silver filling) is considered a safe, affordable and durable material that has been used to restore the teeth of millions of people around the world, including more than 100 million Americans.

It is a specially proportioned mixture of the metals silver, copper, tin, mercury, and sometimes zinc.  Small traces of other metals may also be included.  The mercury chemically binds (amalgamates)  these metals into a hard, stable and safe metal alloy.  Dental amalgam has been used for more than 150 years and, during that time, has established an extensively reviewed record of safety and effectiveness.

Like all restorative dental materials, it has advantages and disadvantages when used for different clinical dental conditions; so it is not the best material for every cavity - but then, no dental material is.

Dentists are trained to select the best material for an individual patient's care on the basis of patient needs and desires, nature of the cavity, the tooth, surrounding tissues, and mouth (each as unique  in its own right as a fingerprint). 

Is Silver Amalgam Safe to Use?

Some disturbing mass media reports on silver amalgam have been inaccurate.  Consider the following information before drawing your own conclusions:

In 1998 the American Dental Association's Council on Scientific Affairs issued a report on its review of the recent scientific research on dental amalgam.  This report remains the current standard scientific review on the subject.  The report contains the following conclusions:

"The Council concludes that, based on available scientific information, amalgam continues to be a safe and effective restorative material."

"There currently appears to be no justification for discontinuing the use of dental amalgam."

The World Dental Federation (F.D.I.) and the World Health Organization (W.H.O.) attested to the safety and effectiveness of dental amalgam in 1997in a joint consensus statement issued  which remains in effect.

The United States Public Health Service conducted extensive scientific reviews and issued a report in 1993 stating there is no health reason not to use silver amalgam, except in the extremely rare case of allergy to any one of the components of silver amalgam.  Other agencies of the U.S. government have endorsed silver amalgam as a safe and effective restorative material.  These include the: 

Food and Drug Administration

National Institute of Health Technology Assessment Conference

National Institute of Dental and Craniofacial Research

The U.S. Public Health Service review concluded there is 

"...no persuasive reason to believe that avoiding amalgams or having them removed will have a beneficial effect on health. "

The American Dental Association continues to endorse amalgam as a "...valuable, viable, and safe choice for dental patients and concurs with the findings of the U.S. Public Health Service that amalgam has "...continuing value in maintaining oral health."

A number of these reports agree it is inadvisable to have silver amalgam restorations (fillings) removed unnecessarily because it can cause structural damage to healthy teeth and would pose a significantly risk to general health than leaving well functioning silver amalgam restorations undisturbed.  The Laws of the Commonwealth of Pennsylvania include regulations on the replacement of silver amalgam to protect patients.  These laws place strict limitations on removal of silver amalgam restorations and prohibit dentists from recommending removal simply to cure systemic disease or protect general health.  These laws contain the following statement:

[There is] "..no conclusive evidence that the removal of amalgams will cure or ameliorate disorders other than those associated with confirmed allergic reactions to mercury."

The well regarded, independent consumer research group, Consumer Reports noted in 1991 that:

" Given their solid track record...amalgam fillings are still your best bet  [for smaller routine cavities in the back teeth] "

If you have further concerns, discuss them with your personal dentist.