Amalgam filling
Valeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.
More about the experts All content is checked by medical journalists.An amalgam filling is used to repair tooth defects inexpensively and easily. Amalgam is an alloy of mercury, silver, copper and tin. It is the longest used and best researched restorative material in dentistry. Read everything you need to know about the amalgam filling, its advantages and disadvantages and why some experts say that you should replace an amalgam filling and discard amalgam.
What is an amalgam filling?
The amalgam filling (amalgam tooth filling) is very often used for tooth defects. Amalgam is an alloy of mercury and other metals (copper, tin and silver). It is the oldest dental material. However, it is controversial because of the poisonous mercury:
We know that the heavy metal attacks the nerves, among other things, which is said to lead to nervousness, sleep disorders, depression and other diseases. So far, however, it has not been proven that this danger also emanates from an amalgam filling: Tiny amounts of mercury can be released from an amalgam filling over the years and be deposited in the body. So far, however, there is no clear evidence that amalgam can damage health in this way - for example in the form of nerve damage, fatigue, chronic headaches or an increased risk of cancer.
When do you make an amalgam filling?
An amalgam filling is particularly suitable for extensive and difficult-to-access caries defects in the area of the molars (posterior teeth). Because it is very durable and can withstand the high chewing pressure to which the posterior teeth are exposed. Due to the shiny, silvery color, an amalgam filling is not used in the area of the incisors.
As a precaution, pregnant women, breastfeeding women and children under 15 years of age are not allowed to use amalgam fillings, unless the treating dentist considers it absolutely necessary.
How is the amalgam filling used?
First the dentist removes the diseased, carious tooth substance (usually with a drill). The resulting hole (cavity) must then be closed with a filling. The soft, easily malleable amalgam that hardens quickly is well suited for this:
The cavity is first dried and disinfected. With the help of an underfilling (e.g. made of glass ionomer cement), the deep-lying tooth pulp (pulp) is additionally protected. Then the dentist stuffs the freshly mixed, malleable amalgam into the hole. In doing so, he applies sufficient pressure so that the amalgam in the tooth is strongly compressed and its resistance is maintained. Any protrusions are carved out after hardening.
Afterwards, a varnish is applied that protects the amalgam filling for the first 24 hours. After that, the amalgam has reached its full strength. Now its surface only needs to be polished smooth.
What are the advantages of the amalgam filling?
Amalgam is a very resistant material that can withstand chewing loads well. It is easy to work with and is extremely inexpensive. In addition, the amalgam filling expands due to the pressure when it is inserted, so that small gaps between the tooth and the filling are closed.
Is an amalgam filling harmful?
Many patients would like to have their old amalgam filling removed because they fear health risks from the mercury it contains. This is because an amalgam filling releases the poisonous heavy metal, especially during and shortly after the filling is inserted and when it is removed, and to a lesser extent during wearing, for example through abrasion when chewing.
How much mercury an amalgam filling actually releases and how much of it is absorbed by the body and stored in the tissue has not yet been clearly clarified. There have been many studies on this, but their results vary. Experts suspect that the actual mercury intake from an amalgam filling differs from person to person and is influenced by several factors (number, age and condition of the amalgam fillings, chewing habits, etc.).
As mentioned, it can become particularly dangerous when patients want amalgam restoration - i.e. the replacement of old amalgam fillings with fillings made of a different material: When the amalgam is removed, large amounts of mercury can be released, which may be deposited in the body. Therefore, amalgam drainage is sometimes recommended.
Amalgam removal
The amalgam is drilled out of the tooth in the largest possible pieces under local anesthesia. A rubber dam - a kind of rubber band around the tooth in question - should protect against swallowing and a suction device against inhalation of the harmful mercury. In addition, the patient wears special glasses (eye protection) during the amalgam removal. The resulting hole is given a different filling material (e.g. a plastic filling).
Amalgam drainage
The removal of amalgam from the body is a highly controversial issue. Mercury residues in the body should be excreted via the detoxification organs liver, intestines and kidneys. In amalgam drainage, this process is carried out using various methods such as phytotherapy (medicinal plant science) or heavy metal drainage according to Dr. Klinghardt supports. The benefit of amalgam drainage has not been proven and is not paid for by health insurance companies.
Amalgam tattoo and amalgam allergy
A so-called amalgam tattoo has been described in a few patients. This means a blackening of the oral mucosa due to the spread of amalgam. In rare cases, people also have an allergic reaction to an amalgam filling. This must then be removed.
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