Dental fillings

Dental fillings are used to restore worn or damaged teeth and treat tooth decay. Dental amalgam (metal alloy) is a strong, inexpensive material that is commonly used for filling teeth, especially the molars (back teeth). In recent years, alternative tooth-coloured filling materials have also become more common and affordable.

Improvements in oral health mean the need for fillings generally is on the decline. Thorough and regular cleaning of your teeth and a healthy diet can help to eliminate dental decay and avoid the need for fillings. Regular dental check-ups will make sure any problems are identified and treated early.

Filling materials

Dental fillings are used to restore teeth and treat tooth decay, especially in the molars (back teeth). These teeth do most of the heavy chewing of the food we eat, so wear and tear is inevitable. A dentist or oral health professional uses a drill and other instruments to remove the decay. The hole is cleaned and dried, and then sealed with a filling material. Types of filling material include:
· Dental amalgam
· Tooth-coloured fillings.
Other forms of tooth restoration, such as gold or ceramic crowns, are an expensive alternative to amalgam and tooth-coloured filling materials.

Dental amalgam

Dental amalgam (often called ‘silver fillings’) is an inexpensive and highly durable material commonly used for filling teeth, especially those that are subject to a lot of wear and tear such as molars.

Modern dental amalgam is a metal alloy that is generally made up of mercury, silver and tin, with small amounts of copper and zinc. It is pliable when first mixed and can be moulded into a tooth cavity, reducing the amount of natural tooth that needs to be removed in order to fit the filling.

Cosmetic filling materials

Tooth-coloured (white) fillings have been used in front teeth for cosmetic reasons for many years. Recent improvements in filling materials for back teeth mean these are now more affordable and widely used as an alternative to dental amalgam as well.

However, while the white fillings may look better when they are first placed, these materials have many limitations when placed in back teeth. Therefore, they are sometimes not the first material of choice for a large filling in a back tooth.

Mercury in dental amalgam

Concerns have been raised about the use of dental amalgam because it contains mercury. While high levels of mercury are harmful to human health, the metal alloy in modern dental amalgam has low mercury content. Repeated international reviews of the scientific evidence have been unable to link the use of dental amalgam directly with ill health.

The current advice from the National Health and Medical Research Council of Australia is that, for most people, these low levels of mercury exposure will not affect their general health. There is also no clinical evidence to support any connection between amalgam fillings and cancer.

Some European countries, such as Sweden, have been trying to phase out the use of amalgam dental fillings for environmental reasons. Although mercury occurs naturally in the environment, incorrect disposal of materials like dental amalgam can add to mercury levels in the environment that concentrate in the food chain.

Situations when amalgam use should be avoided

People who are advised to avoid getting new amalgam fillings or having existing ones removed or replaced (where possible) include:
· Pregnant women – mercury may cross the placenta and enter the bloodstream of the fetus.
· Women who are breastfeeding – mercury may be passed to the baby through breast milk.
· Children – growing and developing teeth are more sensitive to the effects of any chemical substances in the environment, including mercury.
· People with kidney disease – high levels of mercury exposure can affect the kidneys, so exposure to mercury should be minimised for people with kidney disease.
While there is currently no scientific evidence directly linking amalgam with either ill health or birth defects, these recommendations have been made for precautionary reasons.

Replacing amalgam fillings

Deciding to have your amalgam fillings replaced is your choice and should be made in consultation with your dentist or oral health professional. If you are considering having them replaced, it is important you consider the following:
· Replacement can be expensive.
· Replacing your filling often causes more of the natural tooth to be lost.
· Mercury levels rise in the body immediately after an amalgam filling is replaced, due to handling of the amalgam.
· During replacement of your amalgam filling, exposure to mercury can be reduced by using a rubber shielding device called a ‘dental dam’.
· Extra suction during the removal of a filling can also reduce exposure to mercury.
· Dentists or oral health professionals can cut away the amalgam filling rather than drilling it out, which can also help reduce mercury exposure.

Where to get help

· Your dentist or oral health professional
· Your doctor
· Your public oral health service
· Community dental clinic Tel. 1300 360 054
· The Royal Dental Hospital Melbourne, General dental enquiries Tel. (03) 9341 1000 or 1800 833 039 (from rural Victoria) Monday to Friday, 8:30am to 5pm; Emergency Service Tel. 1300 360 054 Monday to Friday 8.30am to 9.15pm; weekends and public holidays, 9am to 9.15pm
All children who are 12 years and under are eligible for priority public oral health services. Children receive general oral health advice as well as dental check-ups and treatment. For eligibility, Tel. 1300 360 054 Dental Health Services Victoria.

Things to remember

· Modern dental amalgam is a strong, inexpensive metal alloy commonly used to restore teeth and treat tooth decay.
· Dental amalgam has low mercury content and is considered safe for most people.
· Alternative tooth-coloured filling materials are also available. Discuss your treatment choices with your dentist or oral health professional.

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• Dental care - common conditions - 0 to 5 years.
  

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Last reviewed: November 2011

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Dental_fillings?open">Dental fillings - Better Health Channel</a><br/>
Dental fillings are used to restore teeth and treat tooth decay. Modern dental amalgam(metal alloy) or silver fillings are durable, cheap and low in mercury. Some people should not use amalgam fillings including pregnant and breastfeeding women, children and people with kidney disease. Alternative tooth-coloured filling materials have become more common and affordable.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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