You might be considering mercury filling removal because of cosmetic reasons, health concerns, or a combination of the two. Or perhaps an old silver filling hurts and there is a medical need to replace it.
The general consensus is that the benefits of removing amalgam fillings don’t outweigh the benefits of keeping them in place, provided they are still mechanically sound.
The Oral Health Foundation “advises patients not to have their amalgam fillings replaced unless they are certain they are allergic to dental amalgam, as the process of removal can weaken the teeth.”
The British Dental Association takes a similar stance: “There is no justification for removing clinically satisfactory dental amalgam restorations as a precaution, except in those patients properly diagnosed as having allergic reactions to amalgam constituents.”
The pros and cons of amalgam filling removal are summed up below:
Benefits of removing amalgam fillings
- Better cosmetics (if replaced with tooth-coloured composite)
- No continued exposure to low levels of mercury from chewing
- Deals with any allergic reaction to amalgam ingredients
Side effects of removing amalgam fillings
- Temporarily releases mercury vapour which you may inhale
- Weakens tooth structure
- Increases the chances of needing root canal work later on
- Drilling closer to the nerve may cause sensitivity
Because of all the possible risks, dentists will often advise against replacing silver fillings with composite unless:
- You have experienced an allergic reaction to dental amalgam
- An old amalgam filling has cracked, shrunk, come loose, or failed in some other way
- A tooth with a metal filling has developed secondary dental caries (tooth decay under the filling)
That’s not to say you’ll have trouble finding a dentist willing to remove your amalgam fillings for other reasons if that’s the treatment you choose. Increasing numbers of dentists now specialise in safe amalgam filling removal because of the growing demand for this procedure.
If you wait until your old black fillings have come to the end of their life and need to be replaced anyway, there is no reason not to replace your silver fillings with white fillings – as long as you’re prepared to pay for private treatment (more on costs below).