Few things have been around longer than the debates over mercury (amalgam) fillings or fluoride use in dentistry. There have been long and hard debates on whether to even address this question, for several other reasons. The truth is so overwhelmingly clear that only a small segment of the population is really even concerned about it. It’s one of those issues like the JFK assassination; the more facts you present, the more the other side is convinced you’re trying to hide something because you’ve taken a stand. But people who ask about the mercury issue are genuinely concerned and simply want the advice of experts.
Mercury-containing fillings are no more harmful than any of the alternatives that dentists use, and are a much healthier alternative than the decay invading the tooth. Are they 100% safe? Probably not, few things in life are, but the other alternatives (gold, resin and glass) are not without their drawbacks. Particles of these materials wear away with time and become hopelessly lodged in your “insides” for all eternity. Gold is probably the ideal material because it is inert (doesn’t react with the body) and wears at rates almost identical to that of natural teeth. It is cost prohibitive though, for the average filling so the other two alternatives must be addressed. Resin, or composites, is the white or tooth-colored fillings many of us have. They wear away slightly faster, are more technique sensitive, and cost two to three times as much as amalgam. Porcelain is very aesthetic, but costs about the same as gold, wears away opposing tooth structure faster, and is much more brittle, and therefore more likely to fracture.
Amalgam fillings have been used for many years, and amalgam remains a relatively easy, inexpensive, safe, and time-tested way to prolong the life of a tooth. It’s important to understand that the amount of mercury in dental fillings is relatively small, and it undergoes a chemical change in the setting phase, which binds it up and makes it relatively inert. Undoubtedly, there are trace amounts that do escape or are released by wearing away of the surfaces over time, but these concentrations are extremely small, and that ultimately is the key.
The trend in dentistry is moving away from amalgam restorations toward other alternatives. Why? Not because of the fear of mercury poisoning but because they’re ugly, and really big ones tend to expand over time and break teeth. Also, the culture we live in today demands aesthetics and like everything else in the world, demand drives the market. Hence, these restorations are being done more often. As this demand continues, research escalates to find materials that are more wear resistant, cheaper, easier to use, more aesthetic, and meet the demand of the consumer.