Are you thinking of removing your old metal amalgam filling?
There is a small but vocal group of individuals in this country and around the world claiming that amalgam fillings are unhealthy and unsafe, despite mountains of evidence to the contrary. These people usually recommend that the amalgam fillings be replaced with composite white fillings. I always get a chuckle out of that recommendation, as the number of chemicals in a composite filling is pretty large and many are known to be toxic to some degree. BPA is used directly in the manufacturing of some resins, it is also a byproduct of chemical degradation of resin-based dental materials, and residual amounts can be found in nearly all composites from incomplete chemical reactions. (reference and JADA July 2014) Composites also have been proven to result in higher levels of BPA in the urine (for how long is unknown) no matter how they are applied (a protective rubber dam has 0 influence on amount of BPA leaked into your system). BPA in the urine does mean the body is eliminating it, but how much of it? JADA Dec 2012
bis-GMA based resin fillings
There has also been a proven association (which is not the same as cause and effect) between bis-GMA based resin and a slew of emotional problems in 6-10 year olds, that increase in proportion to the number of fillings. I’ve never seen any study like that about amalgam. My thought on this is that we know children of higher SEC are more likely to have composites and are more likely to be diagnosed with emotional problems due to access of care; that explains the differences between amalgam and composite. The fact that more composites are associated with more emotional problems is almost certainly due to the fact that the emotional problems are resulting in more decay and thus more fillings. A child with more emotional problems will be less likely to listen to their parents about brushing and flossing and is more likely to ingest more candy and soda. Maserejian 2012 Maserejian 2012
What can you use besides bis-GMA and amalgam?
The bottom line is that nothing we can put into you mouth is totally safe or as good as what God or nature gave you. Doing nothing is not a good option either, as the bacteria and the inflammatory response your body creates to the bacteria are much worse than any minute amount of chemicals that could be released into your body. Remember, any dose you receive from even a mouth full of fillings is insignificant compared to the environmental doses we are all exposed to in the air (mercury),water (BPA), and home environment (BPA). If you are an individual thinking of replacing your metal fillings either for esthetics or concerns over safety, I have no problem doing that for you.
What if you want your amalgam removed?
If you are replacing an amalgam filling due to health concerns…….
- I do not believe that the amalgam fillings are at all dangerous but will replace them for you if it is a concern for you.
- I will remove the amalgam with a rubber dam in place, so that none of the material will even touch your mucosa.
- The only thing I will replace them with is gold or porcelain that is cemented in with a primarily glass ionomer cement. These are the most inert materials we have to offer, but are more expensive than a filling material.
Here is some more information on composite vs amalgam.