The U.S. Food and Drug Administration (FDA) threw up the caution flag for people with silver dental fillings -- referred to as “dental amalgam.” The agency warned that those particular fillings have been shown to cause health problems for some high-risk groups such as pregnant women and those with hypersensitivity to mercury.
When the FDA uses the term amalgam, it’s referring to fillings that are a mixture of copper, mercury, silver, and tin. The inclusion of mercury has been a sore point for years for some dental professionals, but both the FDA and the American Dental Association (ADA) were on record as saying the amalgam was safe.
It’s taken almost 10 years for the FDA to raise its hand about the adverse effects of mercury in dental fillings. Finally, in December 2019, its immunology advisory committee revisited the situation and new guidance was created.
What concerns dental patients should know about
The FDA says the “general population” has nothing to worry about when it comes to exposure to mercury. The agency isn’t proposing a ban on the amalgam, either. It also plays it safe by saying that “little to no information is known about the effect this exposure may have on members of the specific groups...who may be at greater risk to potential negative health effects of mercury exposure," but it still wants dental patients to know that there are possible issues.
Vulnerable groups include:
Pregnant women and their developing fetuses;
Women who plan to become pregnant;
Women who are nursing;
Children, especially those that are under the age of six;
People with kidney problems; and
People with pre-existing neurological conditions like multiple sclerosis, Parkinson's or Alzheimer's.
Replace fillings only if necessary
The FDA says that if anyone has an existing amalgam filling and it’s in good condition, they should sit tight -- unless it is considered medically necessary by a health care professional (for example, a documented hypersensitivity to the amalgam material).
“Removing intact amalgam fillings may result in a temporary increase in exposure of mercury vapor released during the removal process in addition to the potential loss of healthy tooth structure,” the agency cautioned.
If a filling needs to be replaced, the FDA strongly suggests that non-mercury fillings such as composite resins and glass ionomer cements be used.