Dear Doctor Column, September 16, 2002
Question:
What's the latest on the safety of silver fillings in your teeth? I heard a few years ago that the mercury used in silver fillings was linked to Alzheimer's disease and arthritis. I want to know something before my child needs to have fillings.
Answer:
A new survey by the American Dental Association (ADA) indicates 1 in 4 people have heard that silver-colored fillings (known as dental amalgam) are "bad for you" or could cause health problems, despite assurances from major U.S. health agencies that this is not the case. The growing debate over the safety of amalgam pits science against emotion, and consumers are caught in the crossfire, according to the ADA.
Used for more than 150 years, dental amalgam is an affordable, durable material used to restore the teeth of more than 100 million Americans. It contains a mixture of metals, such as silver, copper, and tin, in addition to mercury, which chemically binds these components into a hard, stable, and safe substance.
Interestingly, the ADA reports, people are exposed to more total mercury from food, water, and air than from the minuscule amounts of mercury vapor generated from amalgam fillings, and the current formulations of amalgam require less mercury to be incorporated in the mix than the original ones. Just like aspirin, amalgam has withstood the test of time and is still a valued option for patients.
Despite amalgam's long and impressive track record, a small group, communicating primarily through the Internet, claims they know more than the Food and Drug Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, the U.S. Public Health Service, and the World Health Organization, when they say that amalgam is somehow responsible for diseases such as autism, Alzheimer's, and multiple sclerosis because it is an alloy with mercury.
Yet these and other health organizations responsible for protecting the nation's health have extensively evaluated amalgam time and time again and declared it safe and effective. Additionally, the Alzheimer's Association, the American Academy of Pediatrics, the Autism Society of America, and the National Multiple Sclerosis Society endorse the continued use of amalgam as a safe, strong, inexpensive material for dental restorations.
Large-scale studies by the NIH are currently under way to provide definitive scientific answers to many of the questions raised about dental amalgam. The studies are designed to measure cognitive development and neuro-behavior in children who have amalgam fillings compared with those who do not. Results of the NIH studies are expected to be released sometime in 2006.
Deciding which type of filling you need to fill a cavity is a decision best made by you and your dentist, taking into account your individual situation, the ADA says. Some fillings are more durable in the back teeth where lots of chewing is done; other fillings are more attractive to people because they resemble natural tooth color; some fillings require more time to place (sometimes requiring two dental visits instead of one); and some fillings may not be covered by your insurance.
To learn more about the different types of dental fillings available, the ADA offers a patient brochure, "Restoring Your Smile: Dental Filling Choices," on the ADA's Web site.
Key resources for oral health-care information and additional information about amalgam include the following: