QUESTION: Hello Dr Kaufman- I have some amalgam fillings i was thinking about removing. i wanted to find out if there is any exposure to mercury if i were to have these removed? I feel i have developed some health issues as a result of mercury and i dont want to expose myself and make it worse. I tested high for mercury levels in my system and before i do chelation i want to make sure the source is gone, so the obvious thing would be to remove my old fillings. any info would be appreciated. thanks!
ANSWER: Dear Russ:
I completely understand your concerns. However, before you "jump" to replace the amalgam fillings in your mouth, you need to look at a few factors.
If you read my answers before, you will notice that yours is a common question. Amalgam restorations have been around for many years. They are still the most cost effective, predictable and best "bang for your buck" restoration around. They require minimal acceptable dental skill and care from a practitioner and essentially, any dentist, with minimal training, can provide a long lasting, cost effective, however ugly, restoration.
There is no evidence in peer reviewed journals (real scientific papers, not the National Enquirer) of mercury contamination resulting from having amalgam fillings, and health issues associated with them. There is always a "story" of someone who was miraculously cured by having all amalgam fillings removed. This is NOT scientific evidence based research.
However, if you do want to have the amalgam fillings removed, they will have to be replaced with other long lasting restorations. Unfortunately, composite (white plastic fillings) restorations, especially on back teeth, do not last nearly as long as amalgams and are far more technique sensitive for the dentist to produce. I have seen enough people in my career who went in to replace perfectly acceptable amalgam restorations with "not so great" composites and ended up with root canal treatments and expensive crowns.
There are options, but they should be carefully considered.
Since I know nothing about you, and cannot personally examine you, the best advice that I can give you is to go to www.gotoapro.org and look up a Prosthodontist (who is the expert in restorative dentistry) in your area and go in for a proper consultation. Have the prosthodontist evaluate the integrity of your current restorations and see if removing them will cause more harm than good.
Best of luck,
Dr. Zev Kaufman
---------- FOLLOW-UP ----------
QUESTION: Hey Dr. Kaufman,
Appreciate the detailed email as well as you getting back to me. I am no longer convinced that amalgam restorations are safe based on what I have been reading and it even looks like the FDA is pushing to but a ban on any restorations containing mercury at some point in the next few years. There are just too many studies with data supporting the adverse effects of mercury in the body. Granted in a healthy person, they may not notice any effects but someone who has chronic illness, a weak immune system and is pregnant should not have mercury in their body (as well as children). I recall developing symptoms after a conventional dentist blasted out an old filling to put a crown on years ago. No precautions were taken and he didnt seem to care that I was breathing in the vapors and probably swallowing some old amalgam. Shortly after I started getting headaches and then went on to develop oral lichen planus. Interestingly enough my mother developed chronic mouth sores after having some similar dental work. Is there a specific composite you would recommend? I have had one for 2 years with no problems. I found a local dentist who uses the appropriate methods for amalgam removal so I am going in for a consult in January. Thanks again for your feedback and I am certainly open to any more suggestions.
Sorry for not responding earlier. I was on vacation and forgot to sign out.
There is no particular composite to recommend, since it is NOT the material, but the skill and knowledge of the dentist which determines how good the restoration will be. In addition, much is also attributed to the home care of the patient.
I am glad that you have found a dentist which addresses your concerns. I wish you the very best of luck for the New Year.
Dr. Zev Kaufman