Dentists Passionately Love or Hate Dental Amalgam
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When we asked dentists about amalgam restorations, 66% said they tell patients
that they have other cosmetic options. Another 22% tell patients about
potentially safer options; many of these dentists no longer use any amalgams at
all. However, 12% say they prefer placing amalgams.
Amalgam restorations are "still the best, but ugly," sighed a Texas prosthodontist. Agreed a Michigan dentist, "They perform the best but look the worst of any direct filling material."
Read the dentists' comments for more insight into their thoughts.
The debate over the language used to describe amalgam is a heated one! Though our
dentists seem to prefer the term silver filling, there are lots of other terms
in use. (Read Jim Du Molin's
dental amalgam editorial to learn more.)
For more insight, check out these comments!!
Superior longevity
- "I have 40 year old silver in my mouth and no concerns whatever." (Oregon dentist)
- "Next to gold inlays/onlays, amalgam fillings are the longest lasting and sturdiest posterior restorations that exist." (Virginia dentist)
- "They last much longer than composite since they do not leave voids or shrink. It is a travesty to not offer amalgams at all." (Canada dentist)
- "Amalgam seems to arrest the caries and composite does not." (Mississippi dentist)
Amalgam is affordable
- "Safe, inexpensive and durable!" (New York dentist)
- "It is still a safe, less expensive way to rear decay." (Massachusetts dentist)
- "It's a safe, cost-effective restoration. If it's banned, the cost of dentistry would increase and the poor would be the most to suffer." (New York dentist)
Phony scare
- "The mercury scare is phony. It has been proven safe and effective ad nauseum." (New York dentist)
- "Mercury poison causes mercury poison symptoms. To my knowledge, amalgam fillings never have. They try to blame amalgams on every disease under the sun. Why do people without fillings get the same diseases?" (Kentucky dentist)
- "Potentially safer options? Potentially more dangerous, too. Not all the science is in yet on composite resin." (Kentucky dentist)
Sometimes amalgam is best
- "If you had a tooth-colored filling with the same characteristics as amalgam, few would use composite." (Illinois dentist)
- "In many situations I prefer amalgam. The FDA, CDC and the ADA agree that amalgam is safe. I talk about alternatives, but recommend amalgams when it is the best choice." (New Jersey dentist)
- "They have their place and use...especially subgingival or on interproximal caries where I'm not certain the curing light will set the composite." (New Jersey dentist)
Let the patient choose
- "I give patients the pros and cons of both amalgam and composites. The pros vs. cons involve cost, longevity, and cosmetics. Most women prefer composites; most men aren`t concerned with aesthetics and want amalgams. " (Oregon dentist)
- "Solid restoration for years. No proven medical problems. Some dentists use the hype of mercury to motivate patients towards composite restorations. That being said, after discussion options with patients, most restorations are composites. Place very few amalgams." (California Prosthodontist)
It's malpractice to overstate the danger
- "It is malpractice to tell the average patient who has no allergies to the components in amalgam that these restorations are a threat to their health. Patients have a right to a choice, but that choice needs to be based not on the dentists' bias but on facts." (Pennsylvania dentist)
- "I think they're completely safe and that it's a disservice to our patients to EVER suggest they be removed because they are hazardous. I think it's wrong to perpetuate the idea that they are unsafe." (Texas dentist)
Amalgam cracks teeth
- "They crack teeth and look ugly." (Texas dentist)
- "They are an archaic way of fixing a tooth. More tooth structure is compromised and the advantage of adhesive dentistry is not utilized. I'd never have one placed in my mouth ever!!!" (Texas dentist)
Amalgam is old-fashioned
- "They were great 20th century restorations. Luckily, we are in the 21st century." (Illinois dentist)
- "It was an excellent material for 90 years, but more biocompatible materials are now available" (Georgia pediatric dentist)
- "It should be outlawed." (Nevada dentist)
- "I think the era of amalgam is coming to an end and frankly I worry about the future lawsuit risks to dentists that continue to place them. At least a half a dozen countries in Europe have now done away with amalgam. Don't kid yourself; we are just a stones throw in the US from the same ruling." (Colorado dentist)
"I have not placed amalgams in X years"
- "I stopped doing amalgams 24 years ago. I would not place something in a patients mouth that the government does not allow in their sewer systems." (Pediatric dentist)
- "I have not used it in my practice for the last 10 years and do not believe it has a place in dentistry anymore." (Louisiana dentist)
- "I haven't placed one in almost 30 years and have no intention of ever doing another one!" (Connecticut dentist)
- "I haven't used amalgam in 26 years... Nobody ever left my practice because of that!" (General dentist)
Mercury is poison
- "It's no secret that mercury is a poison. I know of no one who has ever died from mercury fillings alone. I know of no dentists that wake up in the morning with the intention of harming their patients. But what a dentist placing an amalgam is in effect saying is, 'Yes, this is poison, but I'm only going to give you a little bit.'" (Texas dentist)
- "They are a biohazard before they go in and a biohazard after they come out." (Kansas dentist)
- "Problem is: why should we have raw mercury in our offices? If there is a spill you need a Haz Mat team to clean it up and a risk to the staff with possible legal consequences." (California dentist)
- "Remember, smoking used to be a great thing too!" (Connecticut dentist)
Note: Survey sample included 243 respondents.
