The 80th element of the periodic table is no stranger to controversy. A unique and bizarre substance, it maintains a metallic liquid state under ordinary conditions and vaporizes upon contact with only moderate heat, earning it the alias quicksilver, not to mention a considerable measure of awe. Throughout history it has at turns been venerated and feared: In ancient China it was regarded as a giver of eternal life, and it was used by the Greeks in ointments and by the Egyptians in cosmetics. It takes its very name from the Roman god of speed and agility.
But as more is learned about mercury’s highly toxic properties and its harrowing effects on the environment and human health, its modern reputation is rife with infamy. Pregnant and breastfeeding women are issued dire warnings not to eat fish that may contain high levels of mercury. Parents agonize over whether to have their families immunized with mercury (thimerosal)-preserved vaccinations. And increasing consumer awareness, coupled with the widespread speculation that mercury exposure can trigger copious systemic health problems including neurological developmental disabilities like autism and ADHD, have led to escalating, often passionate debates on the practicality of the metal’s current applications.
In recent years, one of mercury’s most common uses—as the primary component in dental amalgam fillings—has come into focus as an easily preventable source of exposure, despite the longevity and benefits of the material’s employ and its unwavering support by nearly every national professional dental association, along with the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC). In fact, for over 150 years, dental amalgam has been the most preferred solution of dentists for cavity fillings and restorations, but with continued development—and constant improvement—of alternative materials, more dentists and their patients are weighing the risks and benefits and saying no to amalgam.
Quicksilver, not silver
Those metal fillings in your mouth might look like silver, but in truth, the material commonly referred to by dental professionals as silver amalgam is an alloy made up of a whole gang of ingredients. Along with a small amount of silver, there may be tin, copper, zinc, and other metals, but highest on its list of ingredients (roughly half of the recipe, in fact) is liquid mercury. When those components are combined, what results is a highly durable, particularly low-cost, and—its proponents claim—stable material that is easy to handle and well suited for repairing our mouths, a claim they say is backed by 150 years of continued use and a lack of scientific evidence to the contrary.
Indeed, according to the American Dental Association (ADA), dentists place more than 100 million amalgam fillings every year. The widespread acceptance of dental amalgam, however, may have more to do with a general lack of awareness than consensus—or even evidence—of its safety: Despite its highly prevalent use, polling as recent as 2006 indicates that nearly half of Americans are unaware that mercury is the primary metal in amalgam. And more than 90 percent think dentists should be required to inform patients of alternatives, which in many places is not current practice. As well, a large body of evidence has called into question the safety of the constant exposure to mercury-based metals, not only for patients but also for dentists, their technicians, and their staff.
Across the country, a growing number of practices have renounced the use of amalgam altogether. In the Hudson Valley, a handful of dentists who are way ahead of the curve haven’t relied on use of the material in cavity restorations for decades, following their convictions in spite of at-times tremendous professional pressure to tow the amalgam line.
Why mercury-free dentistry?
“If you got a hundred dentists in a room and brought up the question of mercury safety,” says Bruce Kurek, DDS, founder of the Center for Advanced Dentistry in Highland, “you would see a very passionate and emotional debate. I don’t offer mercury fillings here under any circumstances, and I haven’t in over two decades. The reason I stopped [using amalgam] is simple: Mercury is toxic.”
While concern over the dangers of mercury-based amalgam stayed his conviction, what’s important to Kurek is that his patients have the information to make a knowledgeable decision about their own care—even, he says, if that means referring them to a practitioner who will repair their teeth with amalgam. But, he adds, that has never happened. “Over the course of many thousands of patients that I’ve treated, I’ve never had anybody say, ‘No, doc, I prefer mercury.’ Even when they know the alternative will cost a little bit more, when people understand how toxic mercury can be, it’s a no-brainer.”