Amalgam Fillings

Are amalgam fillings safe?

Metal (amalgam) fillings contain mercury and some patients fear the mercury could have a negative impact on their health. However there is no evidence that dental amalgam presents a direct health risk to individuals who have amalgam fillings.

Amalgam fillings are being phased out in the EU and other regions, but this is due to their environmental impact and certainly not due to any personal safety or health concerns. 

What are the environmental and health concerns with amalgam fillings?

When old dental amalgam fillings and amalgam waste are disposed of, microorganisms in the environment can release the mercury that was stably bound within dental amalgam. Once released by microorganisms, the mercury from dental amalgam contributes to mercury pollution. Dental amalgam accounts for 5% of the 2,223 tonnes of mercury pollution released into the environment by humans each year.

Mercury pollution finds its way into our waterways and the sea, and can accumulate to toxic levels in fish and other marine life. Animals that eat affected fish can further accumulate mercury pollution.

By contaminating the environment, dental amalgam can therefore contribute indirectly to a health risk to humans that eat animals or fish.

Why are amalgam fillings still being used in the UK?

The UK has not yet set a date to fully phase out the use of amalgam fillings and so the NHS is currently continuing routine use of amalgam fillings. This is mainly due to the relatively higher cost of alternative filling types. Cosmetic white fillings have higher material cost and take much longer to for dentists to place. Completely eliminating the use of amalgam fillings would require the government to invest more public funds into NHS dentistry.

Are white or metal fillings better?

As dental filling materials, cosmetic white (resin based composite) fillings and metal (amalgam) fillings have different advantages and disadvantages. Improvements to the technology of cosmetic fillings now allow for them to used almost interchangeably with metal fillings. There are some situations however, where an amalgam filling may be superior, and some situations where a resin-based-composite (or other alternative filling material) may be better. Your dentist will best placed to explain any filling material recommendations and options for your specific situation.

Environmentally, while cosmetic white fillings do not cause any mercury pollution, they do contribute to microplastic pollution.

Can my amalgam fillings be replaced on the NHS?

Since there is no known health benefit to replacing sound amalgam fillings, NHS funding is not available for this purpose. If you wish to replace your amalgam fillings you will therefore need to fully fund this treatment yourself. NHS dentists can only offer this service as a private treatment option.

All fillings need replacing eventually. As each individual filling needs replacing, your dentist may offer the option to replace your filling with a private cosmetic filling or a new NHS amalgam filling.