Dr. Christina Binert & Associates
700 Coxwell Avenue, Toronto,
Ontario M4C 3B9
Phone: 416 - 461 - 2273

Coxwell Dental Care is a Dentist in East York, Ontario.

Dental Amalgams & CDA Statement June 1995

What is Dental Amalgam?
Most people recognize dental amalgam as silver fillings. Dental amalgam is a mixture of mercury, and an alloy of silver, tin and copper. Mercury makes up about 40-50 percent of the compound. Mercury is used to bind the metals together and to provide a strong, hard durable filling. After years of research, mercury has been found to be the only element that will bind these metals together in such a way that can be easily manipulated into a tooth cavity.
Is mercury in dental amalgam safe?
Yes. Mercury in dental amalgam is not poisonous. Its release is extremely small. In fact, the amount released in a dental amalgam is much less than what patients are exposed to in food, air, and water. When mercury is combined with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless. Ongoing scientific studies conducted over the past 100 years continue to prove that amalgam is not harmful. Claims of disease caused by mercury in amalgam are anecdotal, as are claims of miraculous cures achieved by removing amalgam. These claims have not been proven scientifically.
Why do dentists use dental amalgam?
Dental amalgam has withstood the test of time, which is why it is the material of choice. Amalgam is a very durable material and has been used safely for more than 150 years. It is estimated that well over 1 billion amalgam restorations (fillings) are placed annually. Dentists appreciate using dental amalgam because it is easier to work with than other alternatives. Dentists also believe that patients prefer dental amalgam to other alternatives because of its safety, cost-effectiveness, and ability to be placed in the tooth cavity quickly.
Why don't dentists use alternatives to amalgam?
Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins are more costly. Gold restorations take longer to make, and porcelain and composite resins are esthetically appealing, but aren't as durable as amalgam in posterior (back) teeth.
Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins are more costly. Gold restorations take longer to make, and porcelain and composite resins are esthetically appealing, but aren't as durable as amalgam in posterior (back) teeth.
Patients are better served if we know what they're allergic to. The trouble is, a lot of people don't know what they are allergic to. The incidence of allergy to mercury is far less than one percent of the population. People suspected of having an allergy should receive tests by qualified physicians, and, when necessary, seek appropriate alternatives. Should patients have amalgam removed? No. To do so, without need, would result in unnecessary expense, and potential injury to teeth.
Are staff occupationally exposed?
Dental staff are more occupationally exposed to bacteria than patients. Necessary precautions should be taken, such as having open air ventilation, and being careful not to spill mercury. Dental personnel have been shown to excrete three to four times more mercury in their urine than the average patient. Studies have shown that dentists have not suffered from more mercury-related disorders than the general population. In the few instances when dentists have shown evidence of mercury disorders, these cases have been associated with poor mercury management in the dental office, especially mercury spills that have not been cleaned up properly. More dentists are also using pre-mixed capsules, which reduce the chance of mercury spills. And newer, more advanced dental amalgams are containing smaller amounts of mercury than before. An interesting factor can be brought into this: Because dental staff are exposed to mercury more often, one would expect dental personnel to have higher rates of neurological diseases, such as multiple sclerosis. They do not.
What are other sources of mercury?
Mercury can be found in air, food, and water. We are exposed to higher levels of mercury from these sources than from a mouthful of amalgam.
Canadian Dental Association Statement on Dental Amalgam
Because of the importance of questions which are being raised on dental amalgam and since the federal government is responsible for the safety of medical devices and materials, CDA has encouraged the federal government to support definitive research in the dental amalgam area. As studies are completed, CDA will continue to monitor the position approved by the Board of Governors in 1986.
CDA position on silver dental amalgam
Current research on the use of dental amalgam suggests that amalgam continues to demonstrate clear advantages in many applications over other restorative materials. Significant evidence of patient risk associated with its use has not been demonstrated. Most therapeutic materials involve potential side effects or risks as well as benefits and dentists are trained to be on their guard for these reactions at all times. Although amalgam in fillings releases minute amounts of mercury vapour, current scientific studies have not verified that dental amalgam causes significant health problems. It is recognized that there are individuals who are specifically sensitive or allergic to the components of amalgam and amalgam may not be suitable for all patients and in all circumstances. CDA's position respects regulatory requirements and authority, and reflects scientific consensus from the range of relevant scientific literature as distinct from individual and sometimes conflicting studies. Patient interest and informed consent are the backbone of the ethics of the dental profession. A common sense approach to the utilization of dental amalgam should be taken whereby patients discuss their specific circumstances with their dentist and choose the best restorative material appropriate to a particular application for a particular patient. Dentists want patients to be aware of conclusions from the range of scientific studies on dental amalgam so that the appropriate choice can be made.
Who is responsible for the safety of medical devices and materials?
In Canada, medical devices and materials require approval of the Health Protection Branch of Health Canada. For several years, the Canadian Dental Association has encouraged the federal government to fund increased research on dental amalgam. The dental profession recognizes an obligation to use approved devices and materials in the best interests of patients.
Is dental amalgam approved for use in Canada and is it safe? Have recent studies proven that dental amalgam releases mercury vapour and that it should not be used?
Yes, dental amalgam is approved for use in Canada by Health Protection Branch. Scientific studies have not verified that dental amalgam causes any specific problems. It has been known for some time that amalgam in fillings releases minute amounts of mercury vapour, especially with chewing, and that mercury can reach body organs and cross the placenta. Scientific literature on the topic, as a whole, supports the position that amounts released are generally less than mercury picked up from natural sources.
Is the mercury which is released from fillings absorbed into the body.
Yes, but in extremely small amounts, i.e. in MILLIONTHS of a gram (this is a very small amount, 0.000001 gram). Mercury found in the body can also be related to the number of biting surfaces of amalgam. The amounts in the body are in BILLIONTHS of a gram per gram of body tissue, (a billionth of a gram is an extremely small amount 0.000000001 gram). Some researchers claim to detect higher mercury in the blood of people with amalgams than in those without amalgams but other researchers could not detect mercury in the blood of patients even with new amalgam restorations.

BACK TO: