I am always asked this question, especially after my patients come across some article on the internet about the negative effects of Mercury fillings. So perhaps we can take some time and address this issue.

The issue of using amalgam (which contains mercury) as a filling material is an age old debate. In my opinion that should not be a debate at all in this 21st Century but there are dentists who still insists on using amalgam fillings. In my practice I have stopped using Mercury fillings for over 25 years! I strongly feel that toxic effects of mercury, even though it is not in a free form and hence harmless (as claimed by the manufacturers), causes disturbance to our health.

The first point I want to make is this. If you have a new cavity and it needs filling, always opt for non-mercury-based fillings.

Having said that, does that mean I have to remove all my old amalgam fillings and replace them? No! The answer is not straight forward. It depends on many factors, and of course the best person to advice you will be your trusted dentist. He/she will consider the various factors and help you make a decision. Not all amalgams need to be replaced. At least not for now, if they are already in your mouth.

The reasons you may NOT want to replace old amalgam fillings for the moment.

1. If the amalgam fillings were placed less than 5 years and are not causing any problems. If they are more than that time (5-10 years) it is still OK to have it in place especially if it is not giving any problem.

2. If the amalgam is a small filling and it is not causing any discoloration to the tooth enamel.

3. If the amalgam is a big filling and still holding but removal will cause damage to the tooth structure.

4. If the amalgam is functional but beginning to cause discolouration of the tooth BUT removal and replacement of the filling will need a root canal treatment and crown! In this case you still need to replace it but can opt to do it when you start to have problems.

There could be other reasons to hold on to that amalgam filling as possibly advised by your dentist. Seek his/ her advice on the matter.

The reasons to replace old amalgam fillings are :

1. If the amalgam is in your mouth and it is cracked or incompetent due to wear and tear

2. If the amalgam is in your mouth for more than 10 years

3. If the amalgam filling is causing discolouration of the enamel as seen by a blackish hue on the sides of the tooth

4. If the amalgam filling is sensitive and painful on chewing or if it is cracked.

5. If there are unexplained headaches or neck pain! Old big amalgams could be leaking mercury that could cause this.

6. If you experience other symptoms like general tiredness and a weak constitution. These and many other vague symptoms with an undiagnosed cause. If you have any of these symptoms, it is best you look it up on the internet to see if there is a connection to you amalgam fillings.

But please don’t be alarmed or overreact and think you have unexplained symptoms and then readily conclude that these symptoms you have are caused by your old amalgam fillings. You must consider the possibility that there could be other causes and that must be explored first with your medical doctor.

So, coming back to the question, Do you have to replace the old amalgam fillings?  Here is my suggestion.

 First you decide if you want to be mercury free. Read about it on the internet and decide for yourself. What type of person are you with regards to health? Are you the type who is concerned about carcinogenic or neurotoxic substances even in permissible amounts in your food? Do you feel your body is more sensitive to these ‘unhealthy’ elements compared to other people. If you are that sort of person, then you want your teeth also to be mercury free.

Second, seek your Dentist’s opinion. He/she will advise you the best cause of action based on your tooth’s situation.

Finally, make a decision taking into your account your beliefs as well as the dentist’s suggestion. This procedure, if you decide to it, should be a planned procedure as there is no hurry. Work around your time and budget to execute replacement once you have made up your mind.