When the European Union adopted a ban on dental amalgam fillings earlier this year, its aim was to eliminate one of the last remaining intentional uses of mercury in Europe. The regulation is part of the Zero Pollution Action Plan, an initiative that includes removing microplastics, chemical pesticides and even noise pollution from the environment.
The ban, which will go into effect at the beginning of next year, can help “avoid the release of approximately 10 tons of mercury into the environment by 2030,” Tilly Metz, a member of the European Parliament who worked on the legislation, said in an email.
The EU is going a big step further than required by the United Nations’ Minamata Convention, a global treaty adopted by more than 140 countries, including the United States, that requires countries to “phase down” the use of dental amalgam. The treaty is named after the Minamata Bay in Japan, where, in the mid-20th century, industrial pollution containing mercury contaminated seafood and sickened thousands of people, some fatally.
While the new EU ban is not focused on the health of the individuals receiving the fillings, millions of people around the world have mercury fillings in their mouths; it’s natural to wonder about what the regulations might mean for your health.
What are mercury fillings?
Dental amalgam fillings, commonly known as silver fillings, have been used in dentistry since the 19th century. They are approximately half mercury and a half blend of silver, zinc, tin, copper or other metals.
More than 100 million Americans have mercury fillings, but they’re being used less and less often. Most new dental fillings in the United States are made of resins and composites that do not contain any mercury.
Dr. Marcelo W.B. Araujo, dean of the School of Dental Medicine at the University at Buffalo in New York, explained that mercury fillings are more durable, easier to place and less expensive than resin composites. “There are a lot of people here in the U.S. that still depend on amalgam restorations to have cavities filled,” he added.
Are the amalgam fillings in your mouth harmful?
Mercury is present throughout the environment, including in the fish we eat and the air we breathe. It exists in different forms, such as the methylmercury in seafood and the elemental mercury found in coal power plant emissions, thermometers and dental amalgam fillings. In any form, though, mercury can be toxic when ingested or inhaled in large enough quantities.
But it’s difficult to study how one source, like dental amalgam fillings, contributes to overall health, said Jack Caravanos, a clinical professor of environmental public health sciences at the NYU School of Global Public Health.
A landmark study in 2006 followed more than 500 children with cavities for seven years. About half the group was given a metal amalgam filling, and the other half received a resin composite. Researchers did annual testing on all the children and found that children with amalgam fillings did show elevated levels of mercury in their urine, but there was no measurable difference in either group’s performance on a battery of tests, including on memory, attention and visual perception.
In 2019, the Food and Drug Administration published a literature review that assessed more than 100 mercury studies. The agency concluded that available research did not suggest that trace amounts of mercury exposure from dental fillings posed health risks to the general population. But it added that the existing research “points to uncertainties” for some people, including pregnant or nursing women, young children and a few other groups.
The American Dental Association said in a written statement that it supported continuing to phase down the use of fillings that contain mercury as part of the Minamata Convention’s effort to reduce mercury pollution in the environment. The group does not call for the immediate and complete phasing out of amalgam fillings: “To date, there has been no properly designed scientific study demonstrating that this material causes any long-term health effects or disease.”
Should you have your fillings removed anyway?
The short answer is no, experts said. While there are a number of dentists in the United States who advertise services to remove amalgam fillings, the American Dental Association says any dentist’s advice to remove existing mercury fillings simply to replace them with alternatives is “unwarranted” and violates the group’s code of ethics and conduct.
In fact, the majority of mercury vapor exposure happens when amalgam fillings are first placed or removed from the mouth, Caravanos said. “If you start drilling it out for the sole purpose of just getting mercury out of your mouth, you’re definitely going to expose yourself,” he said.
He does, however, hope to see EU-style amalgam fillings regulations in the United States. “As a public health, environmental health guy, I would hope there would be a ban,” he said, adding, “I think it’s a little embarrassing that we haven’t gotten there yet.”
This article originally appeared in The New York Times.
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