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Dental amalgams contain mercury, tin, silver, copper, and sometimes other metals in various combinations. The use of dental amalgam has probably been the practice of dentistry’s greatest controversy since its inception in 1815 by Dr. J. P. Gage to replace decayed teeth with an attractive material that would last forever! Today, research shows that dental amalgams create tremendous “stress” inside your body due to their effect on your immune system and their toxicity to brain cells.

These risks amalgam has for your health. In this article, I summarize the latest scientific findings – simple & for everyone to understand.

Nearly no other material for dental fillings is as widely used and at the same time as controversial as amalgam.

  • Around 85 percent of all adults have one dental filling or another…
  • ..and a good 40 percent of all dental fillings are made of amalgam.

Once and again one hears and reads very different facts & advice.

To get to the bottom of the topic once properly, I have conducted extensive research and compiled in this article everything worth knowing about amalgam for you.

Among other things, I address the following topics:

As you can see, amalgam fillings are a very extensive chapter in dentistry. I am convinced that you will find answers to all your questions here.

What is amalgam?

Before I start talking about the use of amalgam in dentistry, I would first like to clarify what amalgam is all about.

  • Many patients still think amalgam is the name for a specific metal, but that is not true.
  • The word amalgam comes from Latin and stands for a connection of several metals

filling amalgam

The well-known black fillings are made of several metals.

These are usually the heavy metals silver, tin, copper, and mercury, which are mixed together and undergo a chemical reaction to form what is known as amalgam.

Composition of amalgam

The amalgam used in Germany is usually 50 percent mercury (the other half is composed of silver, tin and copper).

The mercury used in particular has been the trigger of much debate about the harmful side effects of amalgam.

Why is mercury dangerous?

Pure mercury is deadly to humans even in small amounts. Several grams are enough to cause health damage.

Warning: The mercury that is present in amalgam dental fillings, however, is bound in the mixture with the other metals and is far below the harmful limit.

However: The mercury evaporates from the amalgam very slowly over the years. The resulting vapors have various risks that can adversely affect the body.

amalgam risks

The most frequently mentioned negative characteristics here are:

  • The formation of free radicals that can affect organs and tissues in the body
  • Sulfur binding – binding to sulfur groups can block important metabolic enzymes

So amalgam fillings build up in the body and can cause discomfort – at least that’s the opinion of critics.

The fillings lose more than half of the mercury

Studies show that after ten years, amalgam fillings have only half of the mercury they originally used.

So, as the mercury in the amalgam filling dissolves over the years and enters the body in the process, it can be responsible for various diseases

What these are and what symptoms can occur, you can read further down in the text.

Before that, however, I would like to clarify why the material is used in the first place (because the dangers of mercury have been known for decades).

Why are amalgam fillings used at all?

The amalgam mixture has several properties that have long established it as the perfect filling material in dentistry worldwide:

visit the dentist when in pain

Amalgam is popular mainly because of its durability & its affordable price.

  • For one thing, the compound – before it hardens – is easily malleable, making it an ideal fit for the hole.
  • Once the amalgam hardens, the filling is very resistant and long-lasting.
  • In particular, where great chewing pressure occurs, amalgam provides perfect conditions to replace the dental material

Fact: Amalgam is one of the oldest and most commonly used materials to fill holes in teeth.

For this reason, there are also many scientific studies that have examined the use and possible side effects of amalgam and certified it as harmless (more on this below)

How is an amalgam filling placed?

If your dentist has discovered a major hole in your tooth due to decay, he will almost certainly suggest that you close it with an amalgam filling.

However, he proceeds as follows:

  1. First, the dentist clears the affected tooth of decay and debris such as tartar. If it is a deep hole, a local anesthetic or general anesthesia is used.
  2. The dentist then prepares the tooth so that the filling sits as well as possible and adheres to the enamel in the long term.
  3. Now he inserts the freshly mixed amalgam mixture into your tooth and the material immediately begins to harden.
  4. Once the filling is in the tooth the dentist starts working on it so that it fits as closely as possible to your other teeth. Blue paper is often used in this process to check the exact bite.
  5. Once the dental filling has hardened, you can put your tooth back in as usual.

Tip:In the first two hours, however, you should not eat solid food. After about 24 hours, the amalgam is completely hardened.

Dangers of an amalgam filling

As described earlier, a small percentage of mercury enters the body over the years when an amalgam tooth filling is placed.

amalgam filling dangerous

Mercury actually accumulates in the body, but…

This process has ensured that amalgam fillings in teeth have very often been described as harmful to health.

In particular, alternative medical practitioners and naturopaths classify amalgam as harmful – and warn of (allegedly) widespread amalgam poisoning.

Possible health risks mercury can cause

Critics of amalgam fillings cite that various symptoms of illness can occur after many years.

The most common of these are:

  • Headache
  • Fatigue or
  • dizziness

Current research, however, largely rules out amalgam as a trigger of these diseases.

Because the process of mercury absorption is slow and steady, it is very difficult to prove a negative effect on the organism.

Mercury uptake studies

Amalgam mixtures have been used as filling materials in dentistry for many centuries, and there are countless studies showing that their use in most patients is absolutely risk-free.

Accordingly, the amount of mercury absorbed by the body through fillings is the same as the levels of mercury found in nature, for example in the air or when eating fish.

amalgam fish

The body absorbs unbound mercury (e.g., in wild-caught fish) much more readily than that bound in amalgam.

Scientific studies at a glance

In 2014, a scientific advisory committee to the EU Commission took a closer look at the health risks of amalgam.

  • This study concluded that mercury in dental fillings poses a rather low risk
  • No clear relationship was found between health complaints and amalgam quantity in the mouth.

However:If improperly disposed of, mercury could cause indirect health complaints (e.g., if it accumulates in the environment or groundwater).

In Germany, however, this is virtually impossible – high standards for dental practices apply in this country, and removed amalgam must be disposed of properly.

Other studies on the harmfulness of amalgam paint a similar picture

A Canadian professor has calculated that an adult with ten dental amalgam fillings has just two percent of the permissible limit for mercury in the body.

According to Prof. Stefan Halbach of the Helmholtz Research Center Neuherberg Halbach, the usual amalgam concentration is “far below the critical range for health.”

scientific studies on amalgam fillings

Scientific studies on amalgam fillings give the all-clear.

Even an earlier study of about 5000 participants failed to find a clear link between the number of amalgam fillings and the occurrence of symptoms.

A final question: Would German health insurance companies actually allow amalgam to be used if it were harmful in the long term?

In the long run, it would clearly be more expensive (I won’t even mention the suffering it causes here)

Can amalgam still cause discomfort?

On the Internet, numerous people describe their symptoms (citing amalgam fillings as the reason).

  • How can it be when numerous studies see no connection between amalgam & health complaints?
  • As is so often the case, the complaints can also be psychological in nature – without having a real physical basis.

Science calls this psychogenic amalgam intolerance (a kind of negative placebo effect).

Often then only a removal of the fillings helps to alleviate the discomfort.

Infobox: Amalgam allergy

A few people suffer from a true amalgam allergy.

  • The symptoms then occur quite quickly & very clearly (and do not appear years later).
  • However, such an allergy is quite rare – in pretty much all cases, other causes are more likely.

And: Alternative materials such as plastic cause significantly more allergic reactions than amalgam.

Do not underestimate your health complaints

If you also suffer from your amalgam filling, then of course it doesn’t make much difference to you whether the reasons are physical or psychological.

Because you will still feel the unpleasant symptoms.

dentist treatment anxiety patient

Be sure to approach your dentist if you are suffering from discomfort.

You may already be helped by the knowledge in this article – a serious risk to your health is virtually ruled out according to the latest findings in dentistry.

For some sufferers, however, only removing the fillings will help.

In a scientific study conducted by the Technical University of Munich, this brought noticeable relief.

Summarized: Even if the discomfort caused by amalgam is only psychological – the perceived consequences remain the same for those affected. Take your body seriously and consult your dentist.

New laws on the use of amalgam

As many people feel discomfort despite the scientific facts, the number of amalgam fillings is steadily decreasing.

However, as health regulations continue to tighten and, when in doubt, precaution is paramount, it was agreed in Europe in 2017 to ban the use of amalgam fillings in children under the age of 15 and in pregnant and breastfeeding women from July 2018.

In addition, dentists will only be allowed to use ready-mixed amalgam in the future, so that the mercury content of dental fillings is always the same.

Some countries go further and have restricted the use of amalgam even more. This is the case in Sweden, Norway and Denmark, for example.

Amalgam – all advantages and disadvantages at a glance

+ easy to process– Looks unsightly

Advantages Disadvantages
+ resistant – Mercury enters the body
+ very inexpensive – is difficult to remove
+ long lasting
+ prevents caries development

Aesthetic aspects of an amalgam filling

Many patients today also choose not to have amalgam fillings because the silver-colored fillings are considered unaesthetic.

replace amalgam filling

  • A white plastic filling blends in much better with the natural color of the teeth and is not noticeable at first glance.
  • Especially on the front teeth, white plastic fillings are nowadays almost always used, which are hardly visible.

In addition to the aesthetics & the impact on health, of course, the cost is also important when choosing a filling material.

Cost of an amalgam filling

One of the main reasons for the widespread use of amalgam fillings is their inexpensive production and processing.

  • Health insurance companies only cover the cost of an amalgam filling if there are large holes in the chewing area.
  • Plastic dental fillings or even inlays, on the other hand, are associated with considerable additional costs.

What to do if you have an amalgam allergy?

If you suffer from an amalgam allergy, you can apply to your health insurance company to use only plastic in your dental fillings.

If the allergy is medically proven (!), the health insurance company will cover all costs incurred.

Alternatives to a dental filling with amalgam

For visible teeth (such as incisors or canines), health insurance will pay for a plastic filling.

This is done for aesthetic reasons, not because of a possible hazard.

veneers brighten teeth, but are expensive

Veneers whiten teeth, but they are very expensive.

  • For larger holes, inlays (inlay fillings) or dental crowns can also be used
  • Veneers are also used – however, both variants are significantly more expensive than plastic or amalgam fillings.

And again, allergy tests show that significantly more people are allergic to plastics than to amalgam.

If you want to learn more about the pros and cons of these dental fillings, I recommend this post: composite & plastic dental fillings.

The best prevention is thorough dental care

As controversial as the topic of amalgam is, all experts agree on one thing:

proper gum care

On this page you will find a lot of practical advice about dental care:

  • Familiarize yourself with general dental care tips for healthy teeth & start prevention today.
  • Here you can learn everything about the right toothbrush & recommended models: Electric toothbrushes in the test.
  • Here’s all important info on how to remove discoloration and get white teeth.
  • In this section you will find more help for when common dental problems.

Take a few minutes and do something good for your teeth – it is guaranteed to pay off and save you from expensive dentures and severe toothache.

More questions about amalgam

Finally, here are a few answers to questions that didn’t come up anywhere else in the text.

What should I do if an amalgam filling falls out?

If you have had an amalgam filling fall out, you should make an appointment with your dentist as soon as possible.

The longer the hole in the tooth is left open, the more likely you are to develop bacterial infestation and a thick cheek.

replace amalgam

Replace damaged holes as soon as possible to prevent costly consequences.

When a dental filling is open, harmful bacteria can make for bad teeth & other dental ailments like inflamed gums.

Should I have my existing amalgam fillings replaced with plastic fillings?

Most dentists and medical professionals advise against replacing functional amalgam fillings.

  1. In order to remove the existing amalgam filling, the dentist actually drills it open.
  2. This process releases significantly more pollutants than if you continue to use the filling as usual.

In addition, this procedure damages the natural tooth material (which the dentist is actually trying to prevent through minimally invasive dental treatments)

Not only that, but new dental fillings made of other materials also come at a further cost.


As you can see, there are many aspects to consider when it comes to amalgam fillings.

  • If you have an amalgam filling yourself, however, you should not worry about it for now.
  • The filling material, which has been tried and tested for centuries, is still considered harmless today.

If you are interested in more information about dental fillings, then I can recommend this overview article with all the important information about types, costs & treatment methods: Dental Fillings.