For many years, the dental world relied on a very specific material to fix cavities: silver-colored mercury amalgam. It was the standard of care for a long time because it was durable, relatively inexpensive, and easy to use. However, as our understanding of dental materials and human biology has evolved, so has our perspective on keeping mercury amalgam fillings in the mouth.
When dental patients come to see me at San Diego Dental Center in La Mesa, they often arrive with a specific goal: they want their old silver fillings gone. They’ve done their research, they understand that dental mercury isn't a substance they want in their bodies, and they are ready for a change. The question I hear isn’t "Should I remove it?" It’s "How can we do this without making things worse?"
I want to bring awareness to the fact that the removal process is just as important as the decision to remove the filling itself. Simply grinding out an old filling without the right protective measures can actually increase your mercury exposure. My goal is to guide you through how we handle mercury amalgam removal with clinical precision and what we build in its place once the tooth structure is safe.
I believe in being honest and upfront with my patients. If amalgam fillings are broken, worn down, or have new tooth decay hiding beneath them, they are a high-priority concern. In those cases, it is important to remove the material as soon as possible to save the tooth structure.
However, removing perfectly intact dental amalgam fillings is a judgment call. I don't believe in an approach where we rush to remove mercury fillings on day one. Instead, I help you weigh the potential risks and benefits. We look at the age of the filling, the structural integrity of the surrounding enamel, and your overall health care goals.
Metal and tooth structure don't always play well together over time. My job is to help you decide when the risk outweighs the benefit of leaving the amalgam alone.
The question of whether dental amalgam is safe has been debated for decades. Organizations like the American Dental Association and the World Health Organization have provided various perspectives on the contribution of mercury to the human body burden. The medical community continues to study the health effects of heavy metals.
Current scientific research and dental research suggest that mercury vapor is released in small amounts during biting and chewing forces. Over time, this contributes to the mercury levels in the body. For some, allergic reactions or concerns about public health and mercury waste lead them to seek out mercury-free dentists.
The most critical moment for the safety of dental patients and dental staff is the moment we begin the filling removal. When a dentist grinds away a mercury filling, the friction creates heat. This heat can release mercury vapor, which is a primary health risk. Because I take safe mercury removal seriously, we follow a rigorous mercury amalgam removal technique.
In our dental office, we utilize protective gear and protective measures often associated with the SMART protocol (Safe Mercury Amalgam Removal Technique). This ensures that mercury particles and particulate matter are contained.
Rather than grinding the entire filling into a fine powder, which creates the most mercury vapor, I use a small-diameter drill to cut the filling into several large pieces. Then, I gently lift those sections out. This minimizes the filling removal time and keeps the amalgam particles large and easy to catch.
Beyond the concerns of dental mercury, there is a mechanical reason I often recommend amalgam removal. Metal is rigid. Your natural teeth actually have a slight flex to them. Over time, mercury amalgam fillings act like a wedge.
Every time you bite down, the metal puts pressure on the walls of your tooth. Because metal expands and contracts with heat and cold at a different rate than your enamel, it eventually creates tiny cracks. In my prosthodontics practice, I see many patients who come in with a tooth that has suddenly split in half. Usually, there was an old silver filling in the middle of that tooth acting as a wedge for twenty years.
Once we have mercury fillings removed, we are left with a void. This is where the transition to oral medicine and biocompatible materials begins. We aren't just putting in another plug. We are restoring the tooth structure using high-strength composite resin or ceramics.
These biocompatible materials are designed to bond directly to your tooth. Unlike metal fillings, which just sit in the hole, these modern restorations fuse with your tooth, reinforcing the remaining structure. This results in both aesthetic and functional results that look and feel like your natural teeth.
I often hear from patients concerned about the mercury filling removal cost. While amalgam removal requires more time and specialized equipment, including an amalgam separator to protect public health by keeping mercury waste out of the water supply, it is an investment in your overall health.
The removal cost can vary based on the size of the filling and the type of restoration needed to restore the tooth. However, ignoring a failing filling often leads to more expensive treatments later, such as dental crowns or dental implants.
As a prosthodontist, I look at the long-term outcomes of your dental treatment. We take into account occupational medicine standards to protect our dental staff and you. My goal is to reduce your body burden and provide a smile that is structurally sound.
We are careful to manage mercury particulate throughout the treatment room. From the nasal cannula you wear to the amalgam separator, every step is designed for safe removal.
There is a wonderful aesthetic benefit to having your mercury fillings removed. But the real reward is the peace of mind. You no longer have to worry about hidden cracks or the mercury levels in your mouth.
If you are curious about your old silver fillings, let’s have an honest conversation. I will use high-magnification cameras to show you exactly what I see. We will prioritize the fillings that are causing damage and create a plan that fits your life. Taking the step to remove mercury amalgam fillings is a significant decision for your oral health, and I am here to ensure the removal process is handled with the surgical precision and care you deserve.
The first step towards a beautiful, healthy smile is to schedule an appointment.
Please contact our office by phone or complete the appointment request form. Our scheduling coordinator will contact you to confirm your appointment.
Call us Today (619) 462-8550
San Diego Dental Center proudly serves patients from La Mesa, La Jolla, El Cajon & the entire San Diego, CA area.
Office Hours
Monday: 9am - 4pm
Tuesday: 8am - 4pm
Wednesday: 8am - 4pm
Thursday: 8am - 4pm
Friday: 8am - 2pm
