Concerns About Silver Fillings: Risks and Alternatives for Dental Care

Concerns about silver powder removal?

Hello, doctor! I have three teeth filled with silver amalgam, but I have a problem where they tend to fall out or sink (especially the molars) approximately every two years, possibly due to long-term wear from chewing.
I have some concerns:
1.
I found information online stating that removing amalgam can produce vapor, which may be harmful if inhaled.
It seems that professional equipment is necessary for safe removal, but the dental clinic I go to only uses standard methods.
I would like to know if removing amalgam poses significant risks and whether the lack of professional equipment makes a difference.
2.
Given the high frequency of my fillings falling out or wearing down from chewing, would you recommend using other filling materials in the future? I am concerned that repeated fillings will lead to larger cavities, and I also worry about the potential health risks of mercury.
I have heard that ceramic fillings are durable; should I consider that option?
Thank you!

A-Hen, 20~29 year old female. Ask Date: 2022/07/20

Dr. Zeng Guanghui reply Dentistry

1.
There is no scientific evidence indicating that the vapor produced during the removal of silver amalgam has any impact on human health, as long as the medical facility has proper ventilation and the removal process is handled carefully, it will not harm the healthy tooth structure.

2.
The decision to fill teeth with silver amalgam or resin must be made by a dentist based on professional judgment and discussed with the patient, so it is advisable to consult with a dentist before deciding on the type of material to use.
Dr.
Tseng Kwang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/07/20

More Info

When it comes to dental care, particularly regarding silver fillings (also known as dental amalgam), there are several important considerations to keep in mind. Your concerns about the longevity of silver fillings, the potential risks associated with their removal, and the alternatives available are valid and worth exploring in detail.

1. Risks Associated with Silver Fillings
Silver fillings are composed of a mixture of metals, including mercury, silver, tin, and copper. While they have been used for over a century due to their durability and strength, there are concerns regarding mercury exposure. Mercury is a toxic substance, and there is ongoing debate about the safety of dental amalgam. However, numerous studies have shown that the amount of mercury released from silver fillings is minimal and generally considered safe for most individuals. The American Dental Association (ADA) and the World Health Organization (WHO) have both stated that dental amalgam is a safe and effective material for dental restorations.

2. Removal of Silver Fillings
You mentioned concerns about the removal of silver fillings and the potential for mercury vapor exposure. It is true that when silver fillings are removed, there can be a release of mercury vapor. This is why it is recommended that removal be performed in a well-ventilated area, ideally using a dental office equipped with proper suction and filtration systems to minimize exposure to both the patient and the dental staff. If your dental clinic does not have specialized equipment for this procedure, it may be worth seeking out a facility that does, especially if you are concerned about the potential risks.

3. Alternatives to Silver Fillings
Given your experience with silver fillings falling out or becoming compromised, it may be wise to consider alternative materials for future dental restorations. Composite resins (tooth-colored fillings) and ceramics are popular alternatives that offer aesthetic advantages and can be more compatible with the natural tooth structure.
- Composite Resins: These materials are made of a mixture of plastic and fine glass particles, providing a natural appearance and good bonding to the tooth. They are less durable than silver fillings but are often preferred for visible areas due to their aesthetic qualities.

- Ceramics: Dental ceramics, such as porcelain, are highly durable and can withstand significant chewing forces. They are also biocompatible and do not contain mercury, making them an attractive option for those concerned about the potential risks associated with silver fillings.

4. Recommendations
Given your concerns about the longevity of your silver fillings and the potential risks associated with their removal, here are some recommendations:
- Consult a Specialist: If you are considering the removal of your silver fillings, consult with a dentist who specializes in restorative dentistry. They can provide you with information about the safest removal techniques and the best alternatives for your specific situation.

- Consider Material Options: Discuss with your dentist the possibility of using composite resins or ceramics for future restorations. They can help you weigh the pros and cons of each material based on your dental health, aesthetic preferences, and budget.

- Regular Check-ups: Ensure you have regular dental check-ups to monitor the condition of your fillings and overall oral health. Early intervention can prevent more extensive damage and the need for more invasive treatments.

In conclusion, while silver fillings have been a reliable option for many years, it is essential to stay informed about their potential risks and the alternatives available. By consulting with a knowledgeable dental professional, you can make informed decisions that prioritize your health and well-being.

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