Thanks to advances in modern dental materials and techniques, dentists have more ways to create pleasing, natural-looking smiles. Dental researchers are continuing their often decades-long work developing materials, such as ceramics and polymer compounds that look more like natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials to repair missing, worn, damaged or decayed teeth.
These new materials have not eliminated the usefulness of more traditional dental materials, such as gold, base metal alloys and dental amalgam. That’s because the strength and durability of traditional dental materials continue to make them useful for situations, such as fillings in the back teeth where chewing forces are greatest.
Used by dentists for more than a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.
Dental amalgam has been proven safe and effective for years, yet unfounded controversy still surrounds it, a Medical College of Georgia researcher says.
Dentists have used amalgam, an alloy of mercury with at least one other metal, in fillings for over 200 years. Amalgam fillings don't contain enough mercury to cause potential health problems associated with larger doses, says Dr. Rod Mackert, professor of dental materials in the MCG School of Dentistry Department of Oral Rehabilitation.
"The dose makes the poison," he says, quoting 16th century Swiss physician Paracelsus. A person would need between 265 and 310 amalgam fillings before even slight symptoms of mercury toxicity could be felt. A person with seven fillings, which is average, absorbs only about one microgram of mercury daily. About six micrograms are absorbed daily from food, water and air, according to the Environmental Protection Agency.
To create a dental filling, liquid mercury dissolves and reacts with a powder of silver, tin and copper, forming a compound that contains no free mercury. "Anti-amalgam activists say mercury is soaked into metal powder, like water into a sponge, and can come back out of the fillings, but that's not at all true," Dr. Mackert says. In fact, the evaporation rate of mercury from amalgam is a million times lower than from pure mercury.
The amalgam controversy began in the 1970s. Awareness that dental fillings contained mercury was heightened and people were concerned by a couple of mercury-related health scares. In Japan, the release of methyl mercury into industrial wastewater caused a mercury buildup in shellfish and fish, leading to severe mercury poisoning and Minamata disease. Also, a grain covered in mercury fungicide was baked into bread and consumed in Iraq, killing hundreds. "Mercury poisoning was on people's minds and in the press," he says.