Dental amalgam is one of the oldest materials used in oral health care.

Dental amalgam results

from mixing equal parts of an alloy powder (57% to 46%) composed of tin, silver, copper,
and sometimes smaller amounts of zinc, indium or palladium and elemental liquid mercury
(43% to 54%).
As a restorative material, dental amalgam has a large number of advantages:

- is durable

- has a good long-term clinical performance

- can often be repaired

- of all restorative materials, is least sensitive technique

- if placed under ideal condition can be long lasting

- can be applicable to a broad rance of clinical situations

- the dentist can easily manipulate it

- is economical

- compared with other materials, there is minimal placement time

- the newer formulations have greater long-term resistance to surface corrosion

However, as a restorative material, dental amalgam also has disadvantages:

- it has poor esthetic qualities

- potential of local allergic

- there is some destruction of sound tooth tissue

- there is concern about the possible mercury toxicity

- “ditching” leading to replacement may result from long-term corrosion at tooth-

restoration
 - marginal

- galvanic response potential exists

Within the scientific community, there is ongoing debate whether the mercury in dental
amalgam is safe. Based on the majority of people which have amalgam fillings the answer
appears to be ‘yes’, however there have not been any studies to prove that amalgam is 100%
safe.

Studies have shown that small amounts of mercury vapour that is inhaled from the amalgam
fillings are partially absorbed into the blood (Clarkson, 2003). Biologically speaking,
mercury has no benefits. It passes the barier between blood-brain readily and in sufficient
quantities may cause neurologuc dysfunction. This latter reaction has been shown to partially
distrupt liver and kidney functions (Osborne and Swift, 2004). Experiments done on squirrel
monkeys which have been exposed during gastation to air with 1000μg Hg/m3 caused
congenital malformations while the offspring that was exposed to 100μg Hg/m3 did not. There
is ongoing medical and scientific debate over the acceptable, tolerant and safe level of total
mercury exposure from amalgam, diet and other sources.

Some research (Sandborgh-Englund et al, 1998) has suggested that the removal of amalgam
restorations from the patients that have neurological disease (multiple sclerosis for example)
has immedite health benefits. Patients with true hypersensitivity reactions to malgam were
found to also be sensitive to other dental materials such as composite resins (Alanko et al,
1996).

Some researchers have postulated that the general population is at no unacceptable risk from
the mercury from the dental amalgam (Dodes, 2001 and Jones, 1994). Consumer Reports in
US Dental Organisations in 1991 have pointed aut that „given their solid track record…
amalgam fillings are still your best bet”. It has been noted that people are exposed to more
total mercury from air, water and food that from the minuscule amounts of mercury vapor
generated from amalgam fillings. Therefore, there is no scientific evidence that serious risks
in humans may result from exposure to mercury fro amalgam, except for the small number of
allergic reactions. To back this up, in February of 1999, the Australian National Health and
Medical Research Council published a report on dental amalgam and mercury which
concluded that dental amalgam continues to be a very useful fillings material. NHMRC stated
that even though low levels of mercury are relased from dental amalgams, except for the rare
cases of contact hypersensitivity, there is no convincing evidence of adverse health effects.

Despite the lack of concrete evidence on the risks of mercury, some countries such as
Sweden, Canada, Germany and Austria have partial or complete restrictions on the use of
amalgam in dental restorations (manly because of environmental mercury pollution).