The Truth About Silver Fillings: What You Need to Know Before You Decide

The Truth About Silver Fillings: What You Need to Know Before You Decide

By Dr. Dean Carlston

1. Still Have Silver Fillings? You’re Not Alone.

I meet patients every week who still have silver (amalgam) fillings from years ago—some going back 20 or 30 years.  If they’ve held up this long, they’re often hesitant to change them.  But here’s the truth: what we knew then is not what we know now.

2. What Are Silver Fillings Made Of?

Amalgam fillings are a mix of metals: about 50% mercury, combined with silver, tin, copper, and other materials. They were once considered the gold standard for durability—and they do last. But mercury is a heavy metal that can vaporize over time, especially when you chew or grind.

3. Are Silver Fillings Dangerous?

This is where it gets personal. Some people are more sensitive to mercury than others. Studies show that small amounts of mercury vapor are released from amalgam fillings, particularly when heated (from hot drinks), brushed aggressively, or during grinding.

Potential risks include:
- Chronic fatigue or brain fog in sensitive individuals
- Allergic reactions
- Cracks or fractures in the surrounding tooth due to expansion and contraction of the metal
- Difficulty with accurate dental imaging due to reflection

For some patients, these fillings are harmless. For others, they’re a hidden source of inflammation.

4. The Structural Problem No One Talks About

Beyond the mercury debate, there’s a mechanical issue with silver fillings. They don’t bond to the tooth—they’re packed in tightly. Over time, this wedge-like pressure can cause microfractures in the surrounding tooth structure. I’ve seen molars crack down the middle decades after getting an amalgam filling.

5. Should You Remove Silver Fillings?

It depends. I don’t recommend taking out all your amalgam fillings just because you have them. But I *do* recommend replacing them if:
- The filling is cracked or leaking
- The tooth is sensitive or showing signs of decay beneath the filling
- You have unexplained health symptoms and are working with a functional or integrative physician
- You simply want a more biocompatible or aesthetic solution

When removal is necessary, we use special protocols to protect you from mercury vapor and safely replace the filling with tooth-colored material.

6. What Do We Use Instead?

Modern dentistry offers strong, safe alternatives:
- **Composite Resin**: Tooth-colored, bonds to the tooth, minimally invasive
- **Porcelain Inlays/Onlays**: Long-lasting and natural-looking
- **Zirconia Restorations**: Ultra-strong, metal-free

Each has pros and cons, and I’ll guide you toward the one that fits your bite, your budget, and your goals.

7. My Personal Approach to Mercury Fillings

I believe in balancing safety, science, and patient comfort. If your silver fillings are intact and symptom-free, we monitor them. If they’re damaged or causing concern, we remove them carefully, using protective barriers, suction, and air filtration. Your health always comes first.

8. My Final Thoughts

You deserve to know what’s in your mouth—and whether it’s helping or harming you. If you’re unsure about your silver fillings, come in for a simple evaluation. I’ll give you honest feedback, without pressure.

We treat people, not just teeth. And that means listening to your concerns, reviewing the facts, and helping you make the choice that feels right for *you*.