Mercury Amalgam Fillings Banned

In 2008, the American Dental Association, (ADA), announced that the use of mercury-silver, or amalgam, dental fillings has been banned in Sweden, Denmark and Norway. There has been much discussion about the health and environmental risks of mercury fillings in the United States as well as Europe for some time. This new broader ban was instituted because mercury is considered in those countries to be a dangerous environmental toxin as well as a potential health risk.

However, in the USA the use of mercury in dental fillings is still approved by the government and the ADA. It is only in recent years that most American insurance companies have approved payment for alternatives to mercury amalgam fillings. It is considered unethical for a dentist to advise a patient to have mercury fillings removed for health reasons. However, any patient may choose to have their existing amalgams replaced with an alternative material if they so desire.

From a dental point of view, amalgam fillings are inferior to their alternatives for various reasons. Just like a mercury thermometer, as they are exposed to heat, amalgam fillings expand. And with cold, they contract. The problem is that they expand contract at a slightly greater rate than the tooth structure which surrounds them. After years of hot and cold cycling, small cracks develop in the teeth. Eventually, these cracks propagate and the teeth fracture. Then, a larger and more complicated restoration is required to repair the damage. In addition, unlike the alternative materials used to repair teeth which are bonded into place, amalgams do nothing to hold the remaining tooth together. And, from a cosmetic point of view, silver fillings cause the teeth to appear grayish. Such discoloration often increases over time. Although ethically, I am not permitted to recommend removal of amalgams for strictly health issues, I decided over fifteen years ago to stop using mercury-containing fillings. My patients’ experience with the alternative materials has been excellent in terms of longevity of service, comfort, and appearance.

There are two main amalgam alternatives. For fillings which are less than one-third the width of the tooth, composite restorations are wonderful. They are relatively inexpensive, bonded into the tooth for strength, and match the tooth color. Larger restorations are best replaced with porcelain inlays or onlays. These, too, are bonded to the surrounding tooth structure and match in color. They are very strong and can be used to conservatively restore teeth which, in the past, required crowns or caps.

If you have any concerns or questions about such filings, please feel free to call our office at 908.359.6655 for more information. Or, you may send email to

NOTE: Originally posted on January 10th, 2008