Dental Amalgam

Learning Objectives

After completing the course, you’ll be able to:

Amalgam Fillings: Do Dental Patients Have a Right to Informed Consent?

  1. Recount the history of amalgam fillings and controversy swirling around their use over the past 150 years.
  2. Describe the current research being done regarding the safety of amalgam fillings.
  3. Discuss informed consent as it may apply to amalgam fillings in dental practice.

Dental Amalgam Use and Benefits

  1. List 7 circumstances where the use of dental amalgam is indicated.
  2. List 3 instances where dental amalgam is contraindicated.
  3. Provide at least 4 reasons as to why it is inappropriate at this time to recommend any restrictions on the use of dental amalgam.

Consumer Update: Dental Amalgams

  1. Discuss the investigative efforts of the U.S. Public Health Service to determine the safety of amalgams used in dental restorations.

Dental Materials Fact Sheet

  1. Discuss with the patient the risks and benefits of various dental materials taking into account patient’s susceptibility to sensitivity and allergic reactions to certain materials.
  2. Compare 4 direct restorative dental materials (amalgam, composite resin, glass ionomer cement and resin ionomer cement) with respect to various factors for use in dental restorations.

Dental Amalgam

  1. Compare 4 indirect restorative dental materials (ceramic porcelain, fused-to-metal porcelain, gold alloys, nickel or cobalt-chrome alloys) with respect to various factors for use in dental restorations.
  2. Implement in your dental practice 4 specific recommendations made by the ADA regarding the use of amalgam fillings.

Can a Dentist Ethically Remove Serviceable Amalgam (Silver) Fillings?

  1. Make an appropriate response in the event a patient asks the dentist to remove patient’s serviceable amalgams.
  2. List 5 things a dentist should do before removing serviceable amalgam restorations from the non-allergic patient at the patient’s request.

Dental Amalgam–Patient Teaching

  1. Inform the patient with scientific data of the safety and durability features of amalgam fillings.

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.

Table of Contents

Chapter 1: Amalgam Fillings: Do Dental Patients Have a Right to Informed Consent?

  • Introduction
  • History of Amalgam Fillings
  • Mercury Toxicity
  • Patient Exposure to Mercury from Amalgam Restorations
  • Mercury Toxicity from Amalgams
  • Current Research
  • Amalgam and the Environment
  • Pima County, Arizona Dentists Suspended
  • EPA Takes Action in Connecticut
  • Do Patients Have the Right to Know?
  • Class Action Suit Against ADA179
  • Legislative Efforts to a Solution
  • Conclusion
  • Notes

Dentists Sue State Licensing Boards Over First Amendment Rights

  • Dental Amalgam
  • Use and Benefits
  • Highlights of the Report on Dental Amalgam
  • Composition of Amalgam Alloy

Consumer Update: Dental Amalgams

Predictions for the Future of Dental Amalgam

Dentists Are The Biggest Mercury Polluters, A New Study Finds

Dental Materials Fact Sheet
Dental Materials Fact Sheet (DMFS)_Frequently Asked Questions

  • What is the Dental Materials Fact Sheet?
  • What if I disagree with the DMFS, do I still have to provide it to my patients?
  • I don’t place amalgams, or I do only orthodontics – am I exempt? The majority of my patients are Hispanic. Is the DMFS going to be provided in Spanish or any other language?

Dental Materials Fact Sheet

Position of the Academy of General Dentistry

  • What is dental amalgam?
  • Is mercury in dental amalgam safe?
  • Why do dentists use dental amalgams?
  • Why don’t dentists use alternatives to amalgam?
  • What about patients allergic to mercury?
  • Are staff occupationally exposed?
  • What are other sources of mercury?

Study Finds No Link Between Amalgam and Decrease in Mental Abilities

American Dental Association Recommendations

Position of Health Canada

Health Canada Position Statement on Dental Amalgam

Dental Amalgam–Patient Teaching


Position of the British Dental Association

  • What is amalgam?
  • Can mercury from amalgam fillings reach the rest of the body?
  • Do dentists say that amalgam is safe?
  • But mercury is toxic, isn’t it?
  • Who regulates dental filling materials?
  • How much of our day-to-day mercury intake comes from dental fillings and how much comes from other sources?
  • How can patients find out about mercury exposure?
  • Is it possible to remove mercury absorbed into the body?
  • Chelation has side effects of its own. How should amalgam fillings be removed?
  • Should amalgam be used during pregnancy?
  • Should amalgam be used for children?
  • Is there any group for whom amalgam should not be used?
  • Should amalgam fillings be kept below a safe maximum related to body weight?
  • What do other governments and health bodies say?
  • Should dentists explain current concerns about amalgam safety when suggesting its use?