Is there a future for silver fillings?
The European Parliament has agreed that the use of dental amalgam for fillings is going to be phased out by 2030. This phasing out is part of the European Union Mercury pollutant legislation in the 2013 United Nations Minamata Convention, although where we will stand after Brexit is anyone's guess!
What is dental amalgam used for?
Dental amalgam is used when there is dental decay in your tooth, the decay is removed by the dentist and then the hole is often replaced with the dental amalgam (Many other techniques to get the same outcome exist). Amalgam is a mixture of mercury (50%), silver, copper, tin and zinc. Due to the Mercury and silver the amalgam appears silvery in colour.
Why have the Europeans decided to phase out amalgam?
Mercury is harmful to both the environment and humans. It is poisonous to the nervous system and gets into the system mainly by inhaling vapours. These vapours are absorbed into the body via the lungs and can easily move through the bloodstream to the brain. However, when elemental mercury is eaten or swallowed there is very little that is absorbed into the body.
What is the alternative to dental amalgam?
If dental amalgam is to be phased out following ratification by the European Council than one needs to consider what the alternatives are.
These fall into a few different categories:
Bonding involves your dentist using a specially light cured resin to replace the missing tooth structure after the dental decay has been removed, it is used very similarly to dental amalgam.
Advantages: Quick, simple and painless
Disadvantages: Stains more easily, wears more than amalgam
These are often made by a highly skilled dental technician and will usually be made out of a dental ceramic material.
Advantages: restorations last an extremely long time
Disadvantages: more than one injection required as the restoration will take approximately 2 weeks to make
Is dental amalgam safe?
The British Dental Association says that:
The European Parliament agreed on 14 March 2017 to the final version of its Regulation on Mercury. The Regulation is the EU's instrument to ratify the Minamata Treaty of 2013
They go on to say:
.. amalgam remains one of a range of safe and effective filling materials that are available to dentists to provide the most appropriate treatment for the needs of each individual patient.
The EU's Scientific Committee has recommended that, from 1 July 2018 :
"To reduce the use of mercury-added products in line with the intentions of the Minamata Convention (reduction of mercury in the environment) and under the above mentioned precautions, it can be recommended that for the first treatment for primary teeth in children and in pregnant patients, alternative materials to amalgam should be the first choice."
The British Dental Association stress that the EU regulation on Mercury is an environmental regulation, not a health regulation as the EU can't make laws that directly change the way health systems in member states are arranged.
The best way to cut down on the amount of dental amalgam used is to increase the preventative measures that many practices and patients take as standard, this includes dental health advice and information, brushing your teeth twice per day for 2 minutes each time using a fluoride toothpaste and cleaning in between your teeth each day with an interdental floss or brush.
Patients can play their own part in the reduction of amalgam use by looking after their dental health and ensuring they have a good dental health routine, whilst working in conjunction with the dentist to treat any dental health problems which may arise.
If you are concerned about any of the issue is raised in this blog post, please contact our Devon dentist in Barnstaple who will be pleased to help.
After qualifying in 1992 in Birmingham, Donna moved to Cornwall then helped to set up Trinity Dental Centre in 2000, with the aim of providing kind and gentle dental care. Donna's interest is in the cosmetic field and she frequently updates her knowledge in this area. Outside of work she likes to read and to cook. She is married to Rodney and they have two sons. View all posts by Dr Donna Hill ➤ .