Amalgam
Nearly all Scientists agree that mercury amalgam fillings lead to an expose of a daily dose of mercur. Disputed is the level and effects of the chronic exposure. Several Studies conducted in the 1990′s concluded that the most likely health effects are mainly hypersensitivity and allergy against components of the Amalgam Alloy. Some Governments: Germany, Austria and Canada advised not to place amalgam in individuals such as pregnant women, children, those with renal dysfunction, and those with an allergy to metals.
A study conducted by the Life Science Research Office in 2004 analysed studies relating to dental amalgam published after 1996. It was agreed to use the urinary mercury concentration (HgU) as most reliable marker for mercury exposure. The study concluded that people with dental amalgam were unlikely to reach the level of urinary mercury concentration where adverse effects are seen from occupational exposure (35 µg HgU).
The study showed that the study participants had on average HgU’s below 4-5. Chewing Gum in cases where more amalgam filings are present seem to increase the urinary mercury concentration up to 24.8 µg HgU.
It is important to note that the World Health Organization states that urinary mercury concentration or the concentration of mercury in blood or hair DOES NOT correlate with the severity of symptoms displayed by some amalgam filling bearers.
The WHO stated that there was NOT enough evidence to refute claims like
an increased risk of autoimmune disease, however it stated that many broad and non-specific illnesses related to dental amalgam are not supported by the data.
The German scientist Mutter, concludes in his trials that removal of dental amalgam leads to permanent improvement in a relevant number of patients with chronic complaints.
Our Approach to Amalgam fillings:
Taking into account that the greatest exposure to mercury exists during the PLACEMENT and the REMOVAL of Amalgam fillings we DO NOT recommend the removal of intact Amalgam fillings. We do NOT place any new Amalgam fillings either. What are the alternatives?
Amalgam Alternatives and their ‘Biocompatibility’:
Composite Fillings (tooth colored ‘white’ fillings)
A very popular filling material is ‘Composite Resin’ which contains the chemical ‘bisphenol A’ (Bis GMA) which is not without controversy. Especially in larger fillings a risk of release of bisphenol A might exist. We therefore tend to use Composite fillings only in small or medium size cavities.
Composite Filling
Glasionomer Fillings
A sodium-calcium-aluminio-fluoro-silicat glass powder and a polyacryl acid liquid mixed together will form a gel like substance which sets within 2-4 minutes. Glasionomer filings release fluoride which can aid the repair of carious lesions. Useful as long term temporary restorations or in children.
Compomers
A ‘mix’ between Glasionomer and Composite Materials. Useful in children as it is much easier and quicker to use as Composite. However the filling material is not as longlasting as Composite.
Ceramic Inlays and Onlays
Ceramic Inlay and Onlay’s are tooth coloured fillings fabricated outside of the mouth. These glass -porcelain like fillings have to be cemented by the dentist. These materials have the highest Biocompatibilty as the release of any chemical is very limited an the material is considered to be the ‘safest’ dental material, However these advantages can be offset against the higher cost and the sensitivity to preparation and cementation technique.
Gold Inlays and Onlays
We mention Gold Alloy Inlays, Onlays or Crowns at last but these Inlays are one of the oldest way to restore teeth. Gold alloys are a very biocompatible materials as this very durable material is well tolerated by the human body and does not cause allergic reactions.