Amalgam Fillings: Safe or Dangerous for Children’s Health?

Introduction to metal fillings 0:00

Hello, I'm Dr. Michelle and today I'm going to cover a little bit of a controversial subject. Are metal fillings safe for children? Let's talk about what these metal fillings even are. They are known by a few names. They can be called silver fillings, amalgam fillings, I like to call them mercury fillings, What are they exactly? These fillings are a combination of different metals. So all of these fillings have 50% mercury. You heard that right, 50% mercury. The other 50% is a combination of silver, copper, a whole bunch of other different metals.

When combined together, they create a hard filling material. Now, this filling material was developed in the 1800s and it was really an amazing advancement in dentistry. All of a sudden, instead of pulling every tooth that had a big hole, they could plug this material in and the tooth could stay in the mouth for a while longer.

Why amalgam fillings were used in children 0:52

For children, it actually was very good as well for a few different reasons. Number one, You could get it wet while placing the filling and it would still work okay because when we're working on kiddos, they're wiggly. They're moving around. Their tongues are trying to figure out what we're doing. They don't really enjoy being there. It's sometimes difficult to make it really dry on the tooth when we're placing a filling. We'll talk about that in a moment why that's important. The second reason is that they're pretty durable.

They're going to last until that baby tooth comes out. The third reason is they're quite inexpensive. It's the least expensive material to put in a child's tooth. For this reason, they have been used frequently in children. Is this a problem? Yes, this is a problem for that one little word called mercury. Research is now showing that that mercury is released from the tooth 24-7. It's released as the child is chewing on the tooth. It's released as they drink something cold and then eat something hot.

It's released all the time and mercury is particularly toxic to the nervous system. So this is the brain. This is all of the nervous system channels that are going throughout the body. Can you see why that might be problematic for a child?

Mercury concerns and safer alternatives 2:06

Their brain is developing. And if they have mercury released during these developmental years, it can and will affect that growth and development. There have been research studies that have shown that even mercury levels that are in mom because of fillings will affect IQ in children. So this isn't okay. Thankfully, we now have alternatives. We have alternatives that are good. They're biocompatible. They're not going to have the same issues as these mercury fillings. So are these fillings still placed in children today?

Yes, they are in the United States. In a lot of countries, they've actually been banned in children. But in the United States, it's just been recommended not to use them. And pregnant women are children under the age of six. So then I always say, if not them, why anyone? And a big part of this is the financial issue. It's more expensive to place other types of fillings. This is why I work so hard to help you understand the nutritional components of dental decay, the oral hygiene habits that are going to help your children never have tooth decay.

It's so important. But rest assured, there are alternatives today. So the alternative that really we use commonly is a composite resin filling. Why is this perhaps a disadvantage in a child? It has to be dry, bone dry on the tooth for that composite resin restoration to work very well.

Composite resin and glass ionomer options 3:34

We do have a second option called a glass ionomer. We actually don't use glass ionomer restorations here at Total Care Kids in Ortho. Why? Because they contain fluoride and continue to release fluoride. So we work very hard to make sure the teeth are very dry and we place composite resin restorations. We do it routinely, day in and day out. It's absolutely possible. So make sure you're asking your provider about this. This brings up the next potential source of metal that could be in the mouth, and that is metal crowns.

So if the decay on the tooth is extensive, if it's already affecting the nerve, if there's a toothache, cold sensitivity, that sort of thing on a baby tooth, more than likely they're going to need a crown on the tooth. Baby teeth are quite small. Cavities progress quickly. So before you know it, half the tooth's gone and there's no way to put a filling in that anymore. There's no more tooth left to hold it in. So a crown is recommended. There's two types of crowns. One is a metal containing crown called stainless steel.

So the good news about this is it is a very what's called inert or non-reactive metal. Stainless steel is used in a lot of our cookware and things like that.

Stainless steel and zirconia crowns 4:46

So stainless steel is the kind of metal that these crowns are made of. It is not mercury containing. So it's not the same concern as we have with the amalgam fillings. I want to make sure you're understanding that amalgam fillings and stainless steel crowns are not the same thing. Stainless steel crowns do not have mercury in them. So this is also a cost-effective way to treat advanced tooth decay in a child is to put a stainless steel crown on the tooth. What if you don't want any metal at all?

Thankfully we have options for that now too. We can provide zirconia crowns. These are non-metal. They're all porcelain. They're hard and they're white so they look like a tooth. Why would you not place zirconia crowns in every situation? Well, they are more costly. That's the first thing. And the second one is sometimes they actually are difficult to place in really tight, small mouths and situations. We here at Total Care Kids in Ortho strive to always use zirconia crowns if we have a need for a crown.

And we can do it most of the time. So make sure you're talking to your provider about your preferences. Just say, I don't want metal at all. Now, there's actually a third reason we may use metal in the mouth. That is for space maintenance. So if a tooth is lost early because of decay, because of trauma, for other reasons, if a tooth is lost early and we have to hold the space for the permanent tooth to come in later, we may use a stainless steel space maintainer. This is the same metals that are used in orthodontic treatment, orthodontic care.

So that is a time when you may need metal in your child's mouth. Again, it's stainless steel. It's non-reactive. Are there alternatives to that even for space maintenance?

Space maintainers and final recommendations 6:32

It's tricky. We're still trying to figure that one out. So the main thing you need to understand is there really isn't a use for mercury-containing fillings in children's mouths. anymore. Please put your foot down, say that's not what I want for my child, please give me an alternative. Can you use composite resin restorations or can we do zirconia crowns? It's absolutely possible and we have found that there is enough research pointing to problems with mercury and growth and development but there is no reason to compromise on that ever again.

If you are local, we would love to see you here at Total Care Kids in Ortho. This is what we talk with parents about every single day. We would love to support you. If not, go check out our directory at livingwellofdrmichelle.com. Find someone that's close to you and use this information to empower you to make better choices and more confident choices for your children and their dental work so that they can be well and live well.