Is Mercury in My Fillings Dangerous? What to Know About Amalgam

If you have silver-colored fillings, you have amalgam fillings. And if you have amalgam fillings, you have mercury in your mouth, right now, as you read this.

That’s not a reason to panic, but it is worth understanding, because the research on amalgam safety is more nuanced than most patients are ever told.

Dental amalgam is approximately 50% mercury by weight, combined with silver, tin, and copper. It has been used in dentistry for over 150 years and has been the subject of ongoing debate for nearly as long. As a biological dentist in North Austin, our office is mercury-free and mercury-safe, meaning we don’t place new amalgam fillings, and we remove existing ones using strict safety protocols designed to protect you, our team, and the environment.

Here’s what you should know.

What Is Dental Amalgam?

Dental amalgam is a mixture of metals used to fill cavities. It’s durable, inexpensive, and has been the default filling material in conventional dentistry for generations. The problem is that approximately half of it is elemental mercury, the same substance regulated as a hazardous material in virtually every other context.

Mercury doesn’t stay inert in the mouth. Research has consistently shown that amalgam fillings release mercury vapor, particularly during chewing, grinding, and drinking hot liquids. That vapor is absorbed through the lungs and mucous membranes and enters the bloodstream.

What the research shows: A study published in Clinical Chemistry and Laboratory Medicine found that people with dental amalgam fillings have measurably higher levels of mercury in their blood than those without. This is not disputed, the question is whether those levels are high enough to cause harm, and for whom.

Is Mercury from Fillings Actually Harmful?

This is where it gets complicated, and where the honest answer is: it depends.

The FDA and most conventional dental organizations maintain that amalgam fillings are safe for most adults. In 2020, however, the FDA updated its guidance to recommend that certain high-risk groups avoid amalgam fillings when possible. Those groups include:

• Pregnant women and women planning to become pregnant
• Nursing mothers
• Children under 6
• People with kidney impairment
• People with neurological conditions
• People with known mercury allergies or sensitivities

If you fall into any of these categories and have existing amalgam fillings, that FDA guidance matters. And even outside these groups, the biological dentist’s position is simple: why use a material that contains a known neurotoxin when safer, equally effective alternatives exist?

What Are the Symptoms of Mercury Toxicity?

Mercury is a neurotoxin, it preferentially affects the nervous system. Chronic low-level mercury exposure from dental fillings doesn’t typically cause the acute poisoning symptoms associated with high-dose exposure. Instead, it may contribute to a more diffuse constellation of symptoms that are easy to attribute to other causes:

• Chronic fatigue and brain fog
• Memory issues and difficulty concentrating
• Headaches and migraines
• Tingling or numbness in hands and feet
• Mood changes, irritability, anxiety
• Muscle weakness or tremors
• Immune dysregulation, frequent illness, autoimmune flares
• Kidney stress (mercury is also excreted through the kidneys)

None of these symptoms are specific to mercury, they overlap with dozens of other conditions. But if you have multiple amalgam fillings and multiple unexplained symptoms, it’s worth considering the connection. Many patients report significant improvement in how they feel after safe amalgam removal, though we are careful not to make promises, as results vary.

Should I Remove My Amalgam Fillings?

This is the question we get most often, and the honest answer is: not necessarily, and not urgently, for most people. An old, intact amalgam filling that is not cracked or deteriorating releases less mercury vapor than one that is being drilled out improperly. This is why the how of removal matters enormously.

Reasons to consider removal include:

• The filling is old, cracked, or deteriorating, a degrading amalgam releases more mercury
• You are pregnant, planning pregnancy, or nursing
• You have unexplained chronic symptoms that have not responded to other treatment
• You are working with a functional medicine or integrative health practitioner on heavy metal detoxification
• You simply don’t want mercury in your body and have the means to have it removed safely

Reasons to wait or not remove include:

• The filling is intact and you are otherwise healthy, removing it exposes you to mercury vapor during the procedure
• You have not planned for proper detox support before and after removal
• Cost and timing are prohibitive, safe removal is a process, not a single appointment

What Is the SMART Protocol?

SMART stands for Safe Mercury Amalgam Removal Technique, developed and endorsed by the International Academy of Oral Medicine and Toxicology (IAOMT). It is the gold standard for amalgam removal and is specifically designed to minimize your mercury exposure during the removal process.

At Bruno Integrative Dentistry, every amalgam removal follows the SMART protocol. This includes:

• Sectioning the filling into chunks rather than grinding it out, this dramatically reduces the amount of mercury vapor and particulate released
• High-volume evacuation, a powerful suction system placed immediately adjacent to the tooth captures mercury vapor and particles at the source
• Rubber dam isolation, a barrier placed around the tooth to prevent amalgam particles from being swallowed
• Nasal oxygen or air supply, so you are breathing clean air, not mercury vapor, during the procedure
• Protective coverings for your skin and clothing
• Air filtration, our operatory uses HEPA and activated charcoal filtration during all amalgam removal procedures
• Pre- and post-procedure support, we discuss nutritional support and, when appropriate, coordination with a functional medicine practitioner for chelation or detox support

What Replaces the Amalgam?

Once the amalgam is safely removed, the tooth is restored with a biocompatible alternative. At our office that means:

• Composite resin, BPA-free, tooth-colored composite that bonds directly to the tooth. Ideal for smaller fillings.
• Ceramic inlays or onlays, for larger restorations, a ceramic (porcelain) inlay or onlay is more durable than composite and completely metal-free
• Ceramic crowns, when a tooth has been significantly weakened by the amalgam filling or decay beneath it, a full ceramic crown may be recommended

All of our restorative materials are chosen for biocompatibility, no metals, no BPA, no unnecessary chemicals. We also conserve as much natural tooth structure as possible, consistent with our biological dentistry philosophy.

Frequently Asked Questions

How many appointments does amalgam removal take?

We typically remove amalgam fillings one quadrant (one quarter of the mouth) at a time, spacing appointments several weeks apart. This reduces the total mercury exposure in any single visit and gives the body time to begin clearing mercury between sessions. The number of appointments depends on how many fillings you have.

Will my insurance cover amalgam removal?

Most dental insurance plans cover the cost of the filling replacement (composite or ceramic) but not the “upgrade” from amalgam to composite specifically for safety reasons. Coverage varies widely, our team will review your benefits and give you a clear picture of expected costs before any treatment begins.

Is it safe to remove amalgam fillings during pregnancy?

No, we do not recommend amalgam removal during pregnancy. Even with SMART protocol protections, the removal process involves mercury exposure that is best avoided entirely during pregnancy. If you are planning to become pregnant, we recommend completing amalgam removal before conception, with adequate time for your body to clear mercury before pregnancy begins.

Do I need to detox after amalgam removal?

Detox support after amalgam removal is something we discuss with every patient individually. The basics, adequate hydration, fiber, vitamin C, chlorella, are reasonable for most people. For patients with high amalgam burden or existing symptoms, coordination with a functional medicine practitioner for a more structured detox protocol may be appropriate.

How do I know if my fillings are amalgam?

Amalgam fillings are silver-gray in color. If you have silver-colored fillings, they are amalgam. White or tooth-colored fillings are composite resin or ceramic and contain no mercury. If you are unsure, we can identify your existing restorations during a new patient exam.

Ready to Discuss Your Amalgam Fillings?

Whether you’re ready to move forward with removal or simply want more information, we’re happy to have the conversation. A new patient exam includes a full review of your existing dental work and an honest discussion of what we find.

Call us at (512) 372-8484 or book online. You may also want to read about our approach to alternatives to root canal treatment or our biological dentistry philosophy.