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Mercury from amalgam exposure levels vary individually based on the number of fillings and habits such as gum chewing, grinding of the teeth, hot liquids, and mouth breathing. Using an average of ten to twelve fillings in an average size adult, the daily exposure is thought to be 1 to 13 micrograms per day. Compare this to the MRL (Public Health Service) of .14 and the EPA Reference Dose of 6. It is clearly above the MRL by 8 to nearly 100 times and therefore needs continued scientific scrutiny for its potential health effects. Based on existing science, the exact risks for this level of mercury exposure have not been determined.

Mercury from amalgam is inhaled and ingested. It enters the body and has been found in blood, urine, feces, brain, liver, kidneys, and organs of unborn children of amalgam bearing mothers. While mercury amalgams potential harm exists it has not been proven to create that harm. Suspicion must be confirmed or denied by careful and continued research. Mercury from amalgam is the major source of mercury exposure from environment and diet in most amalgam bearers. What is also unknown is how mercury in addition to other pollutants may contribute to disease status.

By not having any more amalgams placed when faced with the need for fillings you can reduce your future or present exposure to mercury. This is consistent with the highest public health standard for mercury hygiene for the general public. But what dental consequences can occur? Today's ceramic-filled (composite) resins still do not have the proven durability of amalgam. However, their properties and technical applications have improved dramatically and for an increasing number of dentists are becoming the restoration of choice over amalgam. In other words, amalgam now has stiff competition in terms of durability with the new resin systems. Composites are superior however in appearance as well as the ability to conserve tooth structure. Gold and porcelain fillings offer more than three times the durability of composite but increase the cost per tooth three times as well.

The decision to remove existing serviceable amalgams is a more difficult one. Since there are no tests to determine if this is necessary the decision rests with the individual. A dentist cannot tell you to remove these fillings. The patient should not remove amalgams in anticipation of a change in their health. The reported anecdotal changes of some individuals need to be studied scientifically to show their value, if any, to a particular conditions resolve.

A patient must understand the risks involved in amalgam removal procedures, an informed consent release is always required. Any time an operative procedure is performed on a tooth several things can happen. 1. Sensitivity to hot, cold, and biting 2. Loss of sound tooth structure. 3. Nerve involvement - needing treatment with root canal or extraction. 4. More frequent replacement of the filling leading to the need for a crown. 5. The obvious and not so obvious cost of replacement and care for the complications.

Mercury vapor is release during the removal process but protective procedures can reduce this exposure to almost nil.

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