Amalgam filling vs Composite filling

Researchers at the University of Georgia have rekindled the dental amalgam debate by releasing the results of a study involving more than 15,000 individuals.

The very robust study, reported in September, showed that persons with eight or more silver amalgam fillings had 1.5 times the level of mercury compared to people with no silver fillings. The study controlled for confounding factors such as gender, ethnicity, race, smoking, seafood consumption, age, and education.

The report also notes that people with eight or more amalgam fillings had higher levels of the most toxic form of mercury, methyl mercury. Recent research suggests that methyl mercury may be dangerous even at low levels.

This study is almost certain to rekindle the debate around the dangers of silver amalgam fillings. As a dental professional, part of your job is to translate research findings into workable courses of action for your patients. With that in mind, here are some thoughts.

First, calm the panic. There's a significant percentage of the population that will panic at the suggestion that anything might be hazardous to their health. When dietary fat was being demonized, a number of people decided that if too much fat was bad, they'd eat as little fat as possible. That didn't end well for them because dietary fat plays many important roles in maintaining our nervous systems, among other things.

It's important to point out that the researchers found the raised mercury levels in people with eight or more amalgam fillings. You almost certainly have some of those people in your practice. For them, you might consider suggesting replacement of at least some of the amalgam fillings with composite restorations to lower their risk of mercury exposure.

But for those with one or even several amalgam fillings, there's no evidence, even from this large-scale study, that's there's a serious health risk. Still, there's no real reason that amalgam fillings can't be replaced with composite, so if your low-risk patients insist, you can accommodate them.

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