Dental Amalgam Fillings

Dental Amalgam Fillings

A tooth with a cavity is at risk and represents a potential danger for the oral health. Indeed, decay can spread from one tooth to another and cause various infections, including gum infection. To avoid this, the cavity has to be treated and since a tooth cannot regenerate itself, it has to be restored artificially to preserve its functionality. What are the restorative materials used in dentistry?

The different restorative materials

A variety a materials can be used for dental restoration. Some are stronger, others have more aesthetic appeal. To restore teeth, dentists use:

  • Amalgam;
  • Resin composite;
  • Gold;
  • CEREC;
  • Ceramic crowns;
  • Inlays;
  • Veneers.

Here are some interesting facts about amalgam:

  • Because it withstands high pressures, amalgam is a good choice for repairing cavities in posterior teeth.
  • It ensures a tight seal in teeth with a high risk of recurrent tooth decay associated with their position.
  • The durability of dental amalgam is higher than composite resins.
  • Few people have allergies to this restorative material.

The amalgam consists of mercury, silver, copper and tin.

Advantages of amalgam tooth fillings

  • Inexpensive;
  • More durable than white fillings (amalgam can last 20 years).


  • Can stain the gums irreversibly (grey stain);
  • Metallic taste;
  • Dissolution of metal ions in the saliva can cause a burning sensation on the tongue and in the mouth;
  • Does not stick to the tooth surface;
  • Unlike composite resins, can cause a fracture of the healthy part of the tooth around the amalgam.

Safety of amalgam restorations

The use of amalgam for tooth restoration raises many questions. Some worry about the effect of this material on health. In fact, dental amalgams contain several metals including mercury and silver in the form of alloy powder. On the other hand, they do not contain lead (as suggested by the former name “plombage” used in french). However, some dentists voluntarily decide not to use amalgam as a restorative material.

Distinction between amalgam and composite resin when it comes to your dental bill

If you must choose between amalgam or composite resin restoration, it is better to inquire about the cost of each of these options beforehand.

For those who are covered by the RAMQ for the reimbursement of dental fillings, it does not cover all composite restorations. Someone who chooses the composite resin for an ineligible tooth will have to pay the full cost of the restoration.

In addition, many insurers cover only a certain percentage of the amalgam restoration and only on some teeth.

Mercury toxicity

The toxicity of mercury in amalgam restorations is a source of concern for several people.

Here is some information about it (text from the website of the « Ordre des dentiste du Québec »):

« Dental amalgams release mercury vapours, especially when we chew. Scientific studies have shown that the actual amount of metallic mercury released is well below the toxic threshold.

In fact, we all absorb other forms of organic mercury from the environment every day, from the air, water and some foods, like fish.

Health Canada does not feel that a complete ban on dental amalgam is justified, and neither is the removal of existing sound amalgam fillings. Furthermore, there is no evidence that dental amalgams are causing illness in the general population. »

No study was able to show that amalgam causes kidney problems or neurodegenerative disorders. The use of amalgam is limited in some countries, including Germany, Denmark, Norway and Sweden.

Dental instruments and equipments used during amalgam restorations

In order to restore partially or completely a tooth with amalgam, several instruments and equipments are needed. The amalgam restoration is normally done by the dentist himself, but can also be performed in part by the hygienist, under the supervision of the dentist.

As in any dental treatment, the instruments and materials that come in contact with the mouth are sterile (free of contaminants). Several pieces are single-use (disposable after use). Your dental assistant is responsible for sanitizing the room and sterilizing the instruments before your arrival. Dental clinics are subject to control measures and regular inspections as the standards are very strict on this subject in Quebec. If you have any worry, do not hesitate to ask the professionals of your clinic, they can answer your questions about the asepsis protocols.

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