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You may have heard in the news recently that as of last month, dentists in the UK and the rest of the EU are to stop using amalgam fillings. Many reports in the media have raised the public’s concern about supposedly dangerous levels of mercury that may be present in what has been until now the most common type of filling and that most often used for NHS treatment. No doubt many have been left worried about whether their existing fillings present a health risk and whether they should have them removed. So what exactly has changed with regard to amalgam fillings and should you worry? Let’s take a closer look.
Amalgam fillings date back as far as the Chinese Tang Dynasty, where records exist from as early as 659. It was only much later that the technique was introduced to Europe. For the last 150 years it has been the most popular filling material both here in the UK and also in many other countries. Amalgam is a combination of metals that has been chosen for its strength, durability and ease of application. It is sometimes called “silver amalgam”. However, it actually consists of a combination of metals including silver, mercury, tin and copper. When preparing a filling, dentists apply the amalgam whilst it is in a malleable, workable state, allowing it to be applied to cavities before hardening to full strength.
In recent months, many mainstream media channels have picked up on claims from various parties that amalgam fillings can release high levels of dangerous mercury vapour. This is a substance which is known to be very harmful to humans. In its natural form, mercury is one of the most toxic elements on Earth. There is little evidence to suggest that its presence in amalgam fillings presents a danger to health. However, following extensive research by European dental experts, it was decided to withdraw the use of amalgam for vulnerable groups such as pregnant or nursing women and young children.
It is important to note that the concern is not based on any known incidences of reactions. But rather the supposed (but unsubstantiated) risk of mercury vapour being released during brushing. There have been no conclusive findings either for or against this happening, and it is this lack of definitive knowledge that has led to the European Commission introducing new laws that came into effect in July 2018. The British Dental Association, the UK’s professional association for dentists, has been campaigning for such changes for the last decade and welcomes the progress.
The media has widely reported on the ban from July this year but some of the coverage has been misleading. It is important to understand that this is not, to date, a total ban. The new EU laws state that from 1 July 2018, dental amalgam should not be used in the treatment of deciduous teeth, in children under 15 years-old, and in pregnant or breastfeeding women, except when deemed strictly necessary by a dentist based on the specific medical needs of the patient. The government emphasises that the law has been passed on the basis of environmental concerns about mercury pollution, and does not reflect any evidence-based concerns about adverse effects of amalgam on human health. There is currently no blanket ban in place. Although, it is expected that progressive measures will be introduced to eventually completely eliminate amalgam from use in new treatments by 2022.
Whilst there will now be a gradual reduction in the number of new amalgam fillings being offered, amalgam filling removal is a completely separate topic of conversation. At the present moment, with no evidence to indicate any actual risk to health posed by existing fillings, the advice is to leave them in place. Research suggests that disturbing an existing filling may actually increase its potential to release mercury vapour and therefore it is preferable to leave them in place.
In addition, it is unlikely to be in your best interests as a patient to have a filling replaced unless it is necessary for dental reasons. A further, practical consideration is the environmental risk associated should an increasing number of patients decide to opt for removal of amalgam fillings. Research is currently being undertaken to identify solutions to the disposal of amalgam. For the time being, the advice is not to worry about existing fillings which should be considered perfectly safe.
If you have concerns about fillings and are a member of Wickersley Dental Practice, don’t hesitate to call the team on Rotherham 01709 543033 and we’ll be happy to advise.