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There are many unanswered or unclear questions about amalgam fillings. In the following article, I will try to summarise and explain the current health and legal situation regarding amalgam fillings and when they need to be replaced.
What is amalgam?

Amalgam is an alloy made of mercury and other metals (silver, tin, copper, zinc) that has been used in dentistry as a filling material for a long time, but the European Union wants to ban it partially from 2018 and completely by 2030. As an important step, they want to phase out imports of amalgam from 2025. It is important to stress that there is no obligation to replace existing fillings. By its nature, it is toxic not only to humans but also to our environment. In Europe, 40 tonnes of mercury are used every year exclusively for the production of amalgam. Similar alloys were already used as filling material in the 1840s. Contrary to popular belief, patients with amalgam fillings are at minimal risk, as only a small amount of the mercury is released into the body. Dental workers, on the other hand, are at much greater risk from the mercury vapour that evaporates during the procedure. Amalgam is a well-functioning material from a dental point of view, but because of aesthetic concerns and the risk to workers, the profession has moved to so-called aesthetic fillings.

I am often asked the question whether and when the “old black filling” (referring here to the slightly unaesthetic amalgam filling) should be replaced.

The answer is obviously not clear here either. Although we no longer use amalgam, fillings made from it can still function well after many years. If the amalgam filling seals well, is not chipped and there is no secondary decay in the tooth, the filling does not need to be replaced.

Obviously, today, with the development of dental materials, aesthetics has become an increasingly important factor when it comes to treatment. Amalgam fillings tend to be large and their blackish, metallic colour is often disturbing for patients, even though they are mostly found in back teeth. In such cases, we will of course replace these fillings on request, but you should be aware that even this seemingly simple process carries a number of risks. This is why I usually advise my own patients not to have them replaced for aesthetic reasons alone, as long as they have no medical problems with the filling.

Risks of replacing amalgam fillings

As I mentioned earlier, amalgam fillings are usually large, so replacing the filling may leave the tooth more sensitive and damaged.In a lucky case, the resulting discomfort will disappear after 1-2 weeks, otherwise it is not uncommon to have to have a root canal treatment on the affected tooth due to the damage.Another common problem is that amalgam discolours healthy enamel over time, and this greyish discolouration persists even after the filling is replaced. With larger fillings, the tooth may weaken, crack or even break, leading to further complications and treatments.

Summary

In conclusion, I believe that if the filling is not functionally unsatisfactory and no secondary caries develops in the filled tooth, it is not recommended to replace amalgam fillings for aesthetic reasons only

This article is for information only and is not a substitute for regular dental consultations and check-ups!

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A figyelmesség, tisztaság és profizmus mindig is kiemelt fontosságú a munkánk során. Az ilyen visszajelzések rengeteget jelentenek nekünk! Köszönjük! ❤️

☎️ Pest: +36 30 4 210 210
📍 1157 Budapest, Nyírpalota út 95.

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📍 1026 Budapest, Pasaréti út 7.

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