Based on evidence that spans across a number of scientific disciplines, medical practitioners are realizing that mercury can adversely impact human health. Some physicians are even testing their patients for mercury toxicity, which can occur due to occupational exposures and dietary exposures from certain types of fish that contain methylmercury. Also, all dental amalgam fillings (which are often called “silver fillings” because of their metallic color) are comprised of approximately 50 percent mercury, and researchers, dental and health professionals, consumers and others are expressing concern about this potential route of mercury exposure.

Meanwhile, over 100 nations have signed the United Nations Environment Programme (UNEP) 2013 Minamata Convention on Mercury.  The U.S. was the first country to give its support for ratification of this legally-binding treaty which calls for a global phase-down on industrial releases of mercury, including that from dental amalgam. In this regard, some of the initiatives in the treaty are to set national objectives aimed at minimizing the use of dental amalgam and to promote the use of cost-effective and clinically effective mercury-free alternatives for dental restoration.

While it appears that the international use of dental amalgam will inevitably decline in the future, these fillings are still used in the U.S., and millions of patients have the mercury-containing dental material in their mouths. However, many patients are opting for mercury-free alternatives when they need new fillings, and existing amalgam fillings are often removed for a variety of reasons, ranging from device failure to consumer preference for tooth-colored restorations.

Yet, research has shown that mercury release occurs when amalgam fillings are removed. Like other groups, the International Academy of Oral Medicine and Toxicology (IAOMT) is concerned about the potential for elevated mercury releases during amalgam removal procedures. In fact, the IAOMT, an accredited member of UNEP’s Global Mercury Partnership, has developed a safe removal protocol. Thus, it’s important not to just discuss health-related ramifications of mercury exposure but to increase basic awareness off the IAOMT’s protocol for safe mercury amalgam filling removal.

The IAOMT’s suggested safe mercury amalgam removal technique includes cutting out the fillings in chunks, and keeping the temperature cool with plenty of water; utilizing special HVE (high volume evacuation) to minimize mercury vapors; using a non-latex dental dam with a saliva ejector underneath it; covering the patient’s body with a barrier to prevent splattered amalgam particles from landing on the hair, clothing, skin and eyes; and providing the patient with piped-in oxygen to breathe through a nasal mask during the removal. Visit iaomt.org/safe-removal-amalgam-fillings/.  

It’s important to emphasize that, in general, each dentist, including a “mercury-free dentist” and/or a “mercury-safe” dentist, varies in his or her techniques of removing amalgam fillings.  Additionally, a “biological dentist”, whose techniques can likewise vary, usually works in conjunction with physicians, some of whom prescribe nutritional support and other detoxification methods for the patient before, during and after the replacement of mercury fillings.

In summary, patients should discuss their concerns about the amalgam removal procedure (or any dental procedure, for that matter) with their dentist to ensure that they are comfortable, confident, and satisfied with the techniques that will or will not be used.   

Scott Silver, DMD, is a biological dentist and member of the International Academy of Oral Medicine and Toxicology. He practices in South Jersey at Silver Dental. Biological Dentistry is located at 621 White Horse Pike, Haddon Twp. For further information or to schedule an appointment call 856-854-4354 or visit BiologicalDentistsofNJ.com.