Silver Fillings vs. Composite Fillings

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Silver Fillings vs. Composite Fillings

Mercury, Toxicity, Bonding, the Law, and You

Controversy

Since its introduction onto this continent in the early 1800's, the use of a mixture of half silver and half mercury as dental "Amalgam" to fill teeth has created controversy. To this day the arguments continue. Much scientific research has been done, but the divisions seem to be so strong that those in favor of its use rationalize away the condemning research. Those against its use claim that politics and personal interest motivate amalgam's proponents.

The Facts (as I see them...)

Mercury is a known poison. It is, in fact, one of - if not the - most toxic of all the elements known!!! It is fact that mercury is fully one-half of the mass of the filling you see when you look at any "silver" filling. It is fact that mercury vaporizes in the mouth and that the vapor is inhaled and also directly absorbed into the body. It is fact that mercury travels to all body tissues and concentrates in tissues where it can do damage in several known ways. I have a collection of reprints of research articles along with the literature from the Public Health Service and other material on the subject if you are interested in a lot of reading on the subject.

The question is not whether the above facts are true, but whether enough of it occurs to be significant. Organized dentistry in the USA has taken the position that amalgam use is perfectly safe. Those against its use have found compelling relationships to many serious illnesses ranging from depression to cancer, and from kidney disease to Alzheimer's. How can it be thought to cause so wide a range of problems? The suggested answer is that mercury from fillings doesn't cause a specific disease. It causes poisoning. And depending on which tissues it concentrates in, the symptoms will differ from one person to another. Two of the most common sites of concentration and damage, however, seem to be the brain and the kidneys.

Sweden and Germany have passed laws to stop or greatly curb the use of mercury-silver fillings. Their nationalized dental plans even help to pay for removal and replacement with alternate non-mercury materials.

Canada may soon do the same. The excellent dental school in Zurich has stopped teaching "silver fillings" technique.

The Dilemma

We are faced with compelling data that the mercury in fillings may be a real hazard to our health, but both sides seem so sure about their positions. What should we do? Is there a way to reason through this?

I think there is! First, we are being constantly bombarded with all sorts of chemical and biophysical noxious influences in our food, air, water...everywhere. Our immune systems are being stressed more and more. I believe we are seeing more chemically sensitive people and more illness from "environmental" causes. I think it makes sense to avoid known toxins, especially if there is a reasonable alternative...and there is (read on...).

Regarding mercury (in fillings), a friend of mine, a Virginia dentist, stated:

"Somehow I just don't feel comfortable using a substance designated by the EPA to be a waste disposal hazard. I can't [legally] throw it in the trash, bury it in the ground, or put it in a landfill, but they say it's OK to put it in people's mouths. That just doesn't make sense."

The Choice

In the past if you wanted to avoid mercury-silver fillings your only alternative would have been gold. Gold works well - very well, in fact - but it is expensive, technically difficult, and while I think it looks much better than "silver" which corrodes and turns rough and black, it still doesn't look even close to natural. Additionally, it is not a practical choice for children because of the cost and the lengthy procedure and high degree of cooperation needed to do a good job. Now, however, we have other choices.

Porcelains, glass, and composites are new materials (or old ones used in new ways) that can not just fix a tooth, but truly restore it. That is, restore not only its function, but also its natural appearance and youthful beauty. These restorations are very natural in appearance and feel and wear very much the way natural teeth do. Obviously no material is as nice as naturally beautiful and healthy teeth, but with these materials we can come amazingly close!

Bonding

In addition to the natural appearance of these new techniques, the way they are attached to the teeth is a whole new revolutionary shift in dentistry. Silver fillings are just stuffed in a hole in the tooth. It is the shape of that hole that prevents the filling from falling out...it is not really stuck to the tooth. That is why so often when the tooth has been hollowed out for a silver filling, creating a shell of enamel around the silver, part of that shell of enamel cracks and falls off. Then you need caps and often root canals, etc. On the other hand, the new esthetic materials are strongly bonded to the tooth. That refers to a chemical and micro-mechanical technique that intimately binds or bonds the material to the surrounding tooth structure. The enamel cannot just fall off any more once it has been bonded. The resulting restoration restores not just function and beauty, but returns most of the original strength to the tooth. It has been shown that a large silver filling reduces the strength of a tooth to about 30% of original values! Bonded esthetic fillings return the tooth to 80% or more!

The Solution

It seems to me a no-brainer to conclude that if there is even any possibility that the mercury-containing silver could be a danger to your health, and given the fact that "silver" fillings are ugly and weaken teeth and that there are now techniques available that don't seem to have any negative health potential, strengthen teeth, and look beautifully natural, that it makes no sense to have any more silver fillings placed in your mouth! Right?

What about silver fillings already in your teeth? Here's where it gets a little harder... Certainly if you would like your teeth to look much more natural and youthful, the answer is simple. Replace the old silver. What about if your teeth have been breaking and needing root canals and caps? Again, other teeth with large silver fillings can be restored to be stronger while regaining their appearance of youth and health.

If you have silver fillings that are functionally excellent and appearance is not an issue for you, but you are concerned about possible health implications you have heard or read about regarding mercury, you have found yourself in the twilight zone, because we dentists are prohibited by the legal/political powers that be, from replacing silver fillings for medical reasons unless a referring medical doctor has prescribed it! Don't ask me why; write your congressman!!!

But old fillings can be replaced because they are defective or the tooth needs something stronger, or you desire something more esthetically natural and healthy looking...

Seriously, the rationale for the legal position as stated is that since the official position of organized dentistry in the US is firmly that there are no adverse effects from having mercury-containing fillings, then it is considered malpractice for a dentist to recommend their removal for health reasons. It is "practicing medicine without a medical license". Personally, I think it will change before long, but that's how it is now.

Testing for Mercury Levels in Your Body


Various tests, blood, urine, hair analysis have been used to test for mercury and other heavy metals. I think the most reliable test is done with a fecal sample. Not the most esthetic approach, but hey, there are no needles and you don't have to cut off lumps of hair close to the scalp... Every cloud has a silver lining, they say. Anyway, it's a take home thing (you probably don't want your dentist helping you with it anyway, right?) that you can put a sample in and mail it away to the lab. The results come back with literature to help interpret them. For info on where to get the test done if you are not near my office call:

Doctors Data Inc.
PO Box 111
Chicago Illinois 60186-9986
800-323-2784
Fax 630-587-7860
email: inquiries@doctorsdata.com

www.doctorsdata.com

Here are some thoughts regarding other methods of testing

Intra-oral Vapor Testing An interesting test to demonstrate the fact that mercury is present in your mouth from your mercury fillings. It's a motivator and can be a scare tactic but it doesn't show you how much mercury your body tissues are storing.

Blood and Urine Testing Again, interesting, but both high and low urine mercury levels could be a problem. It won't necessarily tell you the level of stored mercury. It only shows you what is presently being excreted. Blood levels can indicate recent exposure, recent excretion, or high levels.

DMPS Challenge Test A urine mercury test before and after a chelation "challenge" with DMPS that liberates mercury stored in body tissues. This is much more accurate and meaningful than plain blood or urine testing.

Hair Testing Indicates levels of mercury and other metals stored by your body over a period of time. hair closest to the scalp [newer, more recent growth] gives the most recent indication. Apparently there are many variables with hair - possibly including the kind of shampoos and conditioners etc. used - so that the alternative "experts" mostly seem to have little faith in hair analysis. I trust them since they are closer to the scientific research that checks these things out.

Skin Patch Testing - Hypersensitivity This is controversial. There are concerns that it could "sensitize" a person and make things worse. It should only be done by a medically trained professional like a dermatologist or medical allergist and should be done with ammoniated mercury [not mercury chloride].

Electrical Galvanic Testing Interesting in that it shows how the amalgam fillings have created a "battery" in your mouth and actually produces an electrical current that can speed the release of mercury and maybe even create havoc with acupuncture meridians. But it does not tell you how much of a problem you have with mercury toxicity or stored mercury levels.



Removal of Silver Fillings [Note: also see topic "Is amalgam removal safe?"]

If silver fillings are removed, I feel it is important to respect the possibility of it being a dangerous substance (as EPA and OSHA say it is...). There are several things I can do to minimize your (and my) exposure to the mercury which is known to be released during removal of old silver fillings. I can also suggest nutrient supplement regimens which have been designed to scavenge mercury from your body during this period of increased exposure and redistribution.

If you are under the care of a physician concerned about metal toxicity problems I can work in concert with him or her in your interest. If you are receiving alternative healthcare, I would be most happy to speak with your practitioner about these issues and work in harmony with him or her. I have had some training myself in cranial osteopathy and homeopathy and interest in many other disciplines.

Bonded Esthetic Dentistry

This is a relatively new field of treatment which I have been doing exclusively since at least 1985. It is rapidly changing for the better and is complicated and difficult to learn [to do well ]. It is said to have a Steep "learning curve". That means it takes a relatively long time in the beginning to gain proficiency with it and for that reason, I believe, many dentists who have tried it, have become frustrated with failures and problems of all sorts, and so gave up, blaming the technique. They never gave it a chance to experience how truly revolutionary and remarkably good this technique really is! Every day I have patients tell me their former dentist told them composite fillings are no good in back teeth (which are the hard ones to learn to do!) and tried to intimidate them into getting "silver"! Which way is malpractice from your point of view?

My experience has been overwhelmingly positive. Practically all of my composite fillings I have been able to observe over twelve years are still in excellent condition. Problems have been few and the level of satisfaction has been exceptionally high. If I needed a filling today, composite would be my number one choice, even over more expensive techniques.