HISTORY OF THE CONTROVERSY: Around 1830, a revolutionary new dental restorative material called “amalgam” was introduced to the United States. This amalgam was developed in England and France and contained silver, tin, copper, zinc and mercury. The amalgam fillings were not openly embraced by organized dentistry in America, and in 1840, members of the American Society of Dental Surgeons were required to sign pledges not to use mercury fillings. Several New York City dentists were suspended from this organization in 1848 for malpractice for using silver mercury fillings. In 1859, a new organization was formed as a result of the internal strife over the use of mercury in dentistry — the American Dental Association. (Source: Drwolfe.com)
DIFFERENT STANCES ON MERCURY: The World Health Organization, O.S.H.A., N.I.O.S.H., etc. all agree that mercury is an environmental poison and have established specific occupational exposure limits. The Environment Protection Agency has declared amalgam removed from teeth to be a toxic waste. Even the American Dental Association warns that amalgam filling material is hazardous to dental office personnel, but is safe in patients’ mouths. (Source: Drwolfe.com)
FILLING ALTERNATIVES: Composite resin fillings are the most common alternative to dental amalgam. Also known as “tooth-colored” or “white” fillings, composite resin fillings are made of a type of plastic (an acrylic resin) reinforced with powdered glass. The shade of composite resins can be customized to closely match surrounding teeth. Its advantages are that it blends with surrounding teeth and requires minmal removal of healthy tooth structure for placement, but it may be less durable than dental amalgam and may need to be replaced more frequently. It is also more expensive.
Glass Ionomer Cement Fillings are also another alternative. Like composite resins, glass ionomer cements are made of an acrylic resin and often include a component of glass that releases fluoride over time. These fillings are also tooth-colored but are not as close to tooth-colored as composite resins. The composition and properties of glass ionomer cements are best suited for very small restorations. Their primary advantage is their appearance. Their chief disadvantage is that they are limited to use in small restorations.
Gold Foil Fillings, another alternative, are used to restore cavities on biting surfaces. The advantages of gold foil fillings include their strength and durability. The disadvantages include their cost and appearance (they do not match tooth color). (Source: Drwolfe.com)
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