Any danger of taking out amalgam filling?

Hoot_Owl

Hi guys,

I posted a few weeks ago regarding an infected upper first molar that requires a RCT (planning on going private with endo) , also a crown to reinforce the tooth.

Unfortunately, the molar that needs treatment has an old large amalgam filling and will need to be removed first beforehand. As you may be aware there are many very controversial opinions on the safety of the Mercury part of the amalgam in regards to general health. I follow the thoughts of dental professionals, in that due to being alloyed with other metals, it is safe, hence why it is so widely used throughout dentistry.

But, one safety concern I have is the removal of amalgam fillings. I’ve read drilling into amalgam fillings will release mercury vapours, which if breathed in can be rapidly absorbed into the body.

So my question is, without specific protective procedures in place to prevent breathing in these vapours, is there a risk of mercury poisoning when having amalgam removed? This concern has me now leaning towards having the tooth extracted instead, then just getting an implant for the gap.

Would appreciate some opinions.

Thanks in advance.

Toothsmith

If there is any danger of damaging levels of mercury vapour being released when taking out amalgam fillings - then believe me, every single dental professional in the world would be in full Hazmat suits every time they went to work!

If mercury is being released into the air in any quantity that's likely to cause concern, then dentist, nurse and patient would all be at risk. With the dentist and nurse more so as they are removing a decent number each day, whereas for most patients, it's a once every few years sort of frequency.

It is true that quantities of mercury vapour are detectable by very Sensitive instruments when amalgams are removed. The vast majority of this tiny amount will be suppressed by the water spray coming out of the drill, and virtually all of it will be sucked away by the aspirator (that vacuum tube thing stuck in your mouth). This is not the prime function of the water though, that is there to cool the tooth as the drill generates heat at 250k rpm. Neither is it the prime function of the aspirator, which is there to get rid of the water and any chunks of filling. So even if you breath in the vapour, swallow the water, or even swallow chunks of filling, none of them would harm you.

You are right that elemental mercury is absorbed by the body, but it is also readily excreted by the kidneys. Mercury only builds up in the body if it is within organic compounds that are used by the body - so a diet high in fish is much more likely to raise your mercury levels than the removal of a filling. Even then, you'd really have to go some to damage yourself with a fishy diet!!! That is, unless the fish became unnaturally contaminated themselves (as in the case when a chemical plant in Japan contaminated the sea a few decades ago - the local fishing population began to suffer)

It is also true that mercury vapour has caused problems within dental surgeries to dental staff in the past - but these incidents have always been due to large, but unnoticed/unreported spillages contaminating the surgery environment over a long period.

There are a few dentists out there offering 'safe' amalgam removal.

These guys tend to dress up in hazmat suits, have 'clean' air supplies and rubber dam screening of the operating area. And all sorts of other whistles and bells more suited to an Ebola outbreak!

These people are there to 'play to the crowd' though. There are people out there who are convinced amalgam is a deadly poison, and will pay the very high price these people charge to take them out.

There is absolutely no evidence at all that having amalgam fillings put in your mouth, in your mouth, or removed from your mouth causes any harm whatsoever.

Hoot_Owl

Thank you very much Toothsmith for your detailed and reassuring post.

It was because there was so much info out there regarding ‘safe removal’ of amalgam fillings, the use of respirators, ‘detox protocols’ etc etc, I was looking for reassurances and your post provided that.

Thanks again.

unlucky_lass

Having been given a mouthful of amalgam fillings by a dentist more interested in being paid for how many he was doing (in the 1960’s) I had them all taken out, and replaced with white ones. I went to a dentist in Birmingham who specialised in removal using a rubber dam. This blocks the mercury from entering the airways when being drilled.
I can honestly say my health improved, and after years of craving sugar, I didn’t want sugar at all! Which was odd. Headaches declined, didn’t get a metallic taste in my mouth anymore and the muzzy head I used to get in the mornings had gone.
This was about 25years ago my filling have lasted, on majority of dental visits I don’t need anything done. I would definitely recommend getting amalgams taken out but done safely.

Hoot_Owl

unlucky_lass wrote: »

Having been given a mouthful of amalgam fillings by a dentist more interested in being paid for how many he was doing (in the 1960’s) I had them all taken out, and replaced with white ones. I went to a dentist in Birmingham who specialised in removal using a rubber dam. This blocks the mercury from entering the airways when being drilled.
I can honestly say my health improved, and after years of craving sugar, I didn’t want sugar at all! Which was odd. Headaches declined, didn’t get a metallic taste in my mouth anymore and the muzzy head I used to get in the mornings had gone.
This was about 25years ago my filling have lasted, on majority of dental visits I don’t need anything done. I would definitely recommend getting amalgams taken out but done safely.

Hi, sorry for the very late reply, as I have only just come across your post.

Thank you for sharing your experience. It is very interesting you had clear, noticeable health improvements from removal of your amalgam fillings. There are quite few another positive experiences from other people doing the same.

I think whenever it comes to replace each old amalgam fillings, I will have a preference for composite instead.

Toothsmith

That's fair enough. There are not many good reasons for using amalgam these days, but fear of toxicity shouldn't be one of them. There is no proper evidence to say they cause any problem. But material improvements mean that in a lot of cases they are a superior choice to amalgam, provided they are done well.

They are not sanctioned on the NHS in the vast majority of cases though, and there are a few situations where moisture isolation of the cavity may be so difficult (maybe in patients with limited opening, or those with a hyperactive gag reflex) that amalgam still has to be the material of choice.

Be guided by your dentist.