Dental fillings are used to repair teeth and treat tooth decay. Usually, either amalgam (‘silver’) or tooth-coloured fillings are used. Modern amalgam fillings are long-lasting, cheap and safe for most people. However, suitable alternatives are recommended for use during pregnancy, breastfeeding, for children and people with kidney disease.
Dental fillings are used to repair worn or damaged teeth and treat tooth decay.
Dental amalgam is a strong, inexpensive, silver-coloured material routinely used for filling teeth. In recent years, alternative tooth-coloured filling materials have also become more common and affordable.
It is important to remember that cleaning your teeth regularly and having a healthy diet can help to prevent dental decay and avoid the need for fillings. Regular dental check-ups will make sure any problems are identified and treated early.
Fillings are used to treat decay
When filling a tooth that has decay, a dentist or other oral health (dental) professional uses a drill and other instruments to remove the decay. The hole is cleaned and dried, and then sealed with a filling material.
Common types of filling material include:
- dental amalgam fillings (also known as ‘silver’ fillings)
- tooth-coloured fillings.
Dental amalgam in fillings
Dental amalgam is commonly used for filling teeth, especially those that are subject to a lot of wear and tear, such as the molars (back teeth).
Modern dental amalgam is a metal alloy (metal mixture), generally made up of mercury, silver and tin, with small amounts of copper and zinc. It is can be easily moulded into the hole in the tooth, so less of the natural tooth needs to be removed in order to fit the filling.
Tooth-coloured fillings have been used in front teeth for cosmetic reasons for many years. Recent improvements have made tooth-coloured fillings more affordable, and they are often used as an alternative to dental amalgam. However, tooth-coloured fillings may not always be suitable. For example, the filling material may not be the best choice for a large filling in a back tooth.
Mercury in dental amalgam
Some people are concerned about the use of dental amalgam because it contains mercury. While high levels of mercury are harmful to human health, the level of ‘free’ mercury (mercury that could get into the body) in set amalgam fillings is so small that it is not enough to have any effect on health.
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 (AHMRC) in Australia is that, for most people, these very 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 build up in the food chain.
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 breastmilk.
- 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.
All children aged 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, contact Dental Health Services Victoria.
Replacing amalgam fillings
Deciding to have your amalgam fillings replaced is your choice. You should discuss the options with your dentist or other oral health (dental) professional.
Things you should know if you are thinking about having amalgam fillings replaced include:
- Replacement can be expensive.
- Replacing a 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.
- using a rubber shielding device called a ‘dental dam’
- using extra suction during the removal
- the oral health professional cutting away the amalgam filling, rather than drilling it out.
Where to get help
- Your dentist or other oral health professional
- Your doctor
- Community dental clinics Tel. 1300 360 054 to find your local clinic
- The Royal Dental Hospital of Melbourne:
- General enquiries or to make an appointment Tel. (03) 9341 1000 or 1800 833 039 (outside Melbourne metro) Monday to Friday, 8:30 am to 5 pm.
- Dental emergencies Tel. 1300 360 054 Monday to Friday 8.30 am to 9.15 pm, weekends and public holidays 9 am to 9.15 pm
- Australian Dental Association Tel. (03) 8825 4600
Things to remember
- Modern dental amalgam is a strong, inexpensive material, which is used to repair teeth and safe for most people.
- Other filling materials are also available. Discuss your treatment choices with your oral health professional.
- A healthy diet and regular brushing can prevent the need for fillings in teeth.
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Last reviewed: December 2014
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