Dental health plays a vital role in our overall well-being, and for decades, dental amalgam fillings have been a common choice for treating cavities. Mainly because they are durable and cost-effective. The concern surrounding amalgam fillings primarily revolves around the presence of mercury, which is a toxic heavy metal. There is widespread public concern regarding the possible health consequences of mercury vapour exposure from dental amalgam fillings. In this blog, we’ll delve into the ongoing debate and examine the potential health risks of mercury in dental amalgam fillings.

What are Amalgam Fillings?

Amalgam fillings containing mercury have been used since the early 1800s in the Western world. The word amalgam means a “mixture or blend” and usually refers to mercury along with some other metal or metals (Byrum, 2022). The majority of typical dental amalgam formulations contain about 50% elemental mercury (Brownawell, et al. 2005). The mercury is usually in liquid form and mixed with powdered metals such as copper and silver. A mixture of metals is referred to as an alloy or amalgam. Together the liquid mercury and powdered metals form a soft, malleable putty-type material. The putty is inserted and moulded into the prepared cavity before hardening quickly to form a strong, solid filling (Byrum, 2022).

What is Mercury?

Mercury is a naturally occurring element that exists in different forms. One of these forms is elemental mercury, which is the type found in dental amalgam fillings. Mercury is known to be a toxic heavy metal that can have adverse effects on human health when exposure levels are high. However, the debate surrounding dental amalgam fillings centres on whether the low levels of mercury released from dental fillings pose a significant health risk.

Understanding Mercury Exposure Risks from Dental Amalgam Fillings

The major source of mercury exposure from dental amalgam is during the implantation or removal of a restoration in the tooth (Rathore et al., 2012). However, amalgam fillings release small amounts of mercury vapour over time due to factors like chewing, teeth grinding, and exposure to hot beverages. This vapour can be inhaled and absorbed by the body. While the levels of mercury released from amalgam fillings are generally considered low and fall within regulatory guidelines, concerns arise about the cumulative effect of long-term exposure, especially in vulnerable populations.

Mercury Exposure

Mercury exists naturally in low amounts in rock, soil, and water all throughout the earth. However, human activities have elevated overall mercury amounts in the atmosphere by around 450 per cent above natural levels, putting individuals at risk if it enters their systems in the wrong way (Hanlon, 2020).

At room temperature, mercury is a liquid that rapidly vaporises into the surrounding air. It is frequently produced as a by-product of industrial activities. The burning of fossil fuels such as coal and gold mining is the cause of most mercury emissions caused by humans (Hanlon, 2020). Vaporised mercury may enter the atmosphere via rain, soil, and water, posing a threat to animals, plants and humans (Johnson, 2018).

Risk Groups of Mercury Exposure

Mercury may pass the placental barrier and interfere with foetal development. It can also be detrimental to brain development. Pregnant women, foetuses, and young infants are thought to be more sensitive to the effects of mercury exposure. As a result, several medical professionals advise against utilising amalgam fillings in these groups.

Symptoms of Mercury Poisoning

Experimental findings have shown mercury released from dental amalgam fillings is absorbed by the human body. Several studies have found a link between the number of dental amalgam fillings and mercury concentrations in urine in non-occupationally exposed people (Brownawell, et al. 2005). Mercury poisoning can affect the nervous system and lead to a variety of neurological symptoms such as nervousness, anxiety, numbness, muscular weakness, physical tremors, memory problems, nausea, and other symptoms (Johnson, 2018). Worryingly, even with these findings, when compared to alternative restoration choices, dental amalgam is still regarded as a less costly and more readily manipulated material which is why it is still in use (Byrum, 2022).

Regulatory Bodies

According to regulatory authorities such as the National Health Service (NHS), the United States Food and Drug Administration (FDA) and the World Health Organisation (WHO), dental amalgam is considered safe for most individuals. They emphasise that although amalgam fillings can emit tiny quantities of mercury vapour, especially when they are placed or removed, there is not enough evidence that mercury exposure from amalgam fillings is hazardous to health. Because of this, the general consensus is that the benefits of using amalgam fillings for oral health, outweigh the potential risks associated with low-level mercury exposure.

Short-term Mercury Exposure

Short-term exposure to elevated levels of mercury vapour during insertion or removal can potentially pose health risks, especially for individuals who are more sensitive to mercury or have underlying health conditions. Inhalation of high levels of mercury vapour can result in acute symptoms such as headache, dizziness, respiratory irritation, and nausea. However, for most people, the exposure levels during routine amalgam restoration or removal are not considered to be high enough to cause severe acute effects.

Long-Term Mercury Exposure

Mercury exposure can be increased the longer the fillings have been in place. Some people prefer to replace their amalgam fillings in order to limit their long-term mercury exposure. Nevertheless, remember that replacing these fillings also comes with its own risks during removal. Most experts and health regulatory bodies advise against removing mercury fillings unnecessarily due to the potential exposure to mercury vapour during the removal procedure. If you decide to replace your mercury fillings, make sure it’s with a qualified dental professional who will take precautions to minimise mercury exposure during removal.

Removal of Amalgam Fillings

The potential health risks associated with removing mercury fillings versus keeping them in place can be a complex topic. It’s important to approach this issue with caution and consult with a qualified dental professional before making any decisions.

The removal process can generate mercury vapour due to the mechanical disruption of the filling material causing a possibility of increased short-term exposure. Dental professionals are trained to use techniques that minimize mercury vapour release during removal, such as using rubber dams, high-volume suction, and water spray to control heat generation. However, it’s important to note that even with these precautions, some exposure to mercury vapour may still occur during the removal process.

Removing mercury fillings unnecessarily which are still in good condition could expose individuals to a higher level of mercury vapour than if they were left alone. This could potentially create health risks that outweigh any benefits of removing them.

To ease any fears you may have about mercury remember that mercury is contained in the earth’s crust and is widespread in the environment. This means everyone is exposed to small quantities of mercury in their blood and urine even if they do not have any amalgam fillings (Rathore et al., 2012).

Alternatives to Amalgam Fillings

Alternative dental filling materials, such as composite resins, ceramics, and glass ionomers, are available and are deemed more aesthetically pleasing and do not contain mercury. These materials are considered less controversial in terms of potential health risks. Individuals who are concerned about amalgam fillings should consider these materials instead. Always discuss your options with a dental professional.

Reducing Mercury Risks: Smart Seafood Choices

Remember that amalgam fillings are not the only cause of exposure to mercury. It is a good idea to limit the amount of seafood you eat, especially if you already have amalgam fillings in place. Avoid mercury-containing seafood, especially large fish such as tuna, swordfish and shark. The mercury in fish is an extremely toxic form known as methylmercury, which develops when mercury dissolves in water. Fish and other sea creatures can absorb methylmercury from the water, which moves up the food chain in a process called bioaccumulation.

Bioaccumulation

Mercury has the ability to build up in the body over time. An example is small organisms, such as prawns, which consume methylmercury and are then eaten by larger organisms, such as fish. These fish now have more methylmercury than the original prawns. This process continues all the way up the food chain with mercury increasing in toxicity the higher up the food chain you go (Johnson, 2018). Therefore, the largest organisms in a food chain contain the highest mercury levels in their system. Think about how large we humans are!

Combat Mercury Effects with a Heavy Metal Detox Smoothie

Incorporate a Heavy Metal Detox Smoothie into your diet in order to combat the side effects of any mercury poisoning to your body. The information about this smoothie and its benefits comes from Anthony William, also referred to as the Medical Medium who has a variety of books on foods that heal the body.

Ingredients:

2 bananas
2 cups wild blueberries
1 cup cilantro
1 cup orange juice
1 tsp barley grass juice powder
1 tsp spirulina
1 small handful of Atlantic dulse
Optional: water or coconut water or fresh orange juice to blend

Directions:

In a high-speed blender, blend all ingredients until smooth. If a thinner consistency is desired, add up to 1 cup of water. For more information on the benefits of each of the ingredients used in this smoothie, and how they help reduce mercury poisoning, you can visit https://www.medicalmedium.com/blog/heavy-metal-detox-smoothie.

Chelation therapy

Chelation therapy entails weekly infusions, given directly into a vein, with a chelating agent such as ethylenediaminetetraacetic acid (EDTA). Each treatment might last anything from 30 minutes to many hours. The chelating agent identifies and adheres to metals within the blood circulation. This activity produces a chemical that exits the body via the urine (Lopez-Jimenez, 2023). The problem with chelating medications is that they also bind to minerals and may remove elements that your body needs, such as calcium, copper and zinc. This can result in a lack of certain essential chemicals. Some people end up having low calcium levels in their blood along with renal impairment (Ratini, 2021). For this reason, chelation therapy should only be used in severe cases of mercury poisoning.

Ongoing Research

The debate surrounding the health risks of mercury in dental amalgam fillings remains ongoing. Some studies suggest a potential link between mercury exposure and neurological or systemic health issues, while others find no significant association. The scientific community continues to evaluate the available evidence to reach a more conclusive understanding of the potential risks involved.

Conclusion

The long-term health impacts of dental amalgam fillings are still being researched. Some studies imply a possible relationship between mercury exposure and neurological or systemic health problems, while others find no such link. This is confusing for those looking for definitive answers. My advice is that if you are unsure about dental amalgam fillings then look for alternatives. Do your research and decide what’s best for you.

In my case, I have decided to keep my amalgam fillings in place until they are ready to be replaced by natural wear and tear, rather than expose myself to mercury vapour during the process of removal. Additionally, I incorporate the Heavy Metal Detox Smoothie, mentioned above, into my diet to combat the side effects of any mercury poisoning to my body. I also limit tuna in my diet, which I used to eat regularly, due to the mercury content it contains.

Both keeping mercury fillings in place and removing them have implications for mercury exposure. The decision about whether to remove them should be based on careful consideration of the potential risks and benefits, as well as consultation with a qualified dental professional.

References

Brownawell, A.M., Berent, S., Brent, R.L., Bruckner, J.V., Doull, J., Gershwin, E.M., Hood, R.D., Matanoski, G.M., Rubin, R., Weiss, B. & Karol, M.H. (2005) The Potential Adverse Health Effects of Dental Amalgam. Toxicological Reviews. Rev 24, 1–10. [Online] Available from: https://doi.org/10.2165/00139709-200524010-00001 [Accessed: 16 August 2023].

Byrum,. K. (2022) History of Dentistry: History of Dental Amalgam. Contour. [Online] Available from: https://digitaleditions.walsworth.com/publication/?i=744575&article_id=4254552&view=articleBrowser [Accessed: 17 August 2023].

Hanlon,. P. (2020) So Where Does All That Mercury in Fish Come From? Food Print. [Online] Available from: https://foodprint.org/blog/so-where-does-all-that-mercury-in-fish-come-from/ [Accessed: 18 August 2023].

Johnson, J. (2018) Mercury poisoning: Symptoms and treatment. Medical News Today. [Online] Available from: https://www.medicalnewstoday.com/articles/320563 [Accessed: 18 August 2023].

Lopez-Jimenez, F. (2023) Chelation therapy for heart disease: Does it work? Mayo Clinc. [Online] Available from: https://www.mayoclinic.org/diseases-conditions/heart-disease/expert-answers/chelation-therapy/faq-20157449 [Accessed 22 August 2023].

NHS. (2021) What are NHS fillings and crowns made of? [Online] Available from: https://www.nhs.uk/common-health-questions/dental-health/what-are-nhs-fillings-and-crowns-made-of/ [Accessed: 20 August 2023].

Rathore, M., Singh, A., & Pant, V. A. (2012). The Dental Amalgam Toxicity Fear: A Myth or Actuality. Toxicology International. 19(2), 81-88. Available from: https://doi.org/10.4103/0971-6580.97191 [Accessed: 20 August 2023].

Ratini, M., (2021) What is Chelation Therapy? WebMD [Online] Available from: https://www.webmd.com/balance/what-is-chelation-therapy#:~:text=Chelating%20drugs%20can%20bind%20to,the%20blood%20and%20kidney%20damage. [Accessed: 22 August 2023].

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