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Are amalgams safe?

The National Institutes of Health estimates that more than 10 million Americans have TMD, or problems affecting the jaw joint and/or muscles.
Many patients frequently ask me if dental amalgams, the silvery colored material used in "fillings" are safe. The answer is an unequivocal yes. Dental amalgam has been used for more than a century. Studies have failed to find any link between amalgam restorations and health problems.

Amalgam continues to be a safe restorative material for dental patients.

In rare cases, some people will have an allergic reaction to amalgam fillings. Fewer than one-hundred cases have been reported and in these rare instances, mercury was identified as the trigger to the allergic response. Symptoms of amalgam allergy are very similar to a typical skin allergy. In many cases, patients allergic to amalgam have a family history of metal allergies.

When amalgam, which contains mercury, is mixed with metals such as silver, copper, and tin, it forms a stable alloy that dentists have used for years to successfully treat dental disease in millions of people.

The American Dental Association is concerned that misguided fears about the safety of amalgam, coupled with the added costs of the more expensive filling options, may cause people to forego necessary dental care. Far fewer people have dental insurance than medical insurance, and not all insurance plans cover filling options, according to the ADA. The Food and Drug Administration recently affirmed amalgam's safety in a March 2002 study. If there is a confirmed allergic reaction to amalgam, an alternative material can be used.

For example, composite resins, which are tooth-colored, plastic materials made of glass and resin can be used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from your natural teeth. Composites are often used on the front teeth where a natural appearance is important. They also can be used on the rear teeth, depending on the location and extent of the tooth decay.

In most cases composite resins are more expensive than amalgam fillings.

Sometimes your dentist may recommend replacing a filling even if you are not experiencing any pain or additional decay. Constant pressure from chewing, grinding or clenching can cause dental fillings or restorations to wear away, chip, or crack. A routine dental exam usually uncovers weaknesses in your restorations.

If the seal between the tooth enamel and the restoration breaks down, food particles and decay-causing bacteria can work their way under the filling, exposing you to the risk of additional decay. Left untreated, decay can lead to infection of the dental pulp and may lead to an abscess. If the restoration is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.

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