Should you remove amalgam fillings?

Options available in Dubai to remove controversial dental fillings

Are dental amalgam fillings responsible for severe health concerns? Jenny Hewett investigates.

Unless you were born in the nineties and speak hipster, it’s more than likely you’ll have had at least one amalgam filling placed in a molar at some stage. Now considered unsightly, amalgam fillings are made up of silver, tin and copper and contain up to 50 percent mercury, a highly poisonous toxin that can be harmful in large doses.

It’s a topic that has divided public opinion for years, but decades of medical research by the World Health Organisation, among others, maintains that there is still no evidence to suggest that amalgam fillings lead to mercury poisoning and chronic diseases, such as cancer, kidney disease and auto-immune disease.

But if you’re still not convinced, the option to remove them, a procedure which fits into the field of aesthetic dentistry, is more accessible in Dubai thanks to some having a little more cash to spend and the availability of good health insurance. Last month a UK woman made news, having been diagnosed with the sudden onset of multiple sclerosis and discovering her symptoms matched those of mercury poisoning. She had her amalgam fillings removed and is now back to full health. Her story has re-opened the discussion about whether or not we should replace our amalgam fillings. The view from most dentists here is that if it ain’t broke, don’t fix it.

Dr Maximilian Riewer, medical director of sleek dental surgery Dubai Sky Clinic, who has just opened an even slicker new branch in JLT, says there’s nothing for Dubaians to worry about. ‘People should not panic because they have amalgam fillings or rush to get them removed. Amalgam has been on the market for 150 years. There have been many studies about it, but still today there is not one case where we can say 100 percent that mercury was causing a problem,’ he says.

While there are a couple of replacements available these days, Dr Maximilian insists that there is no reason to replace an amalgam filling that is still in good working order, other than for aesthetic value. ‘If you have an amalgam filling that is more than 20 years old, then your dentist should definitely check on it to see if it is cracked, chipped or if there is any decay under the filling. If so, then it is definitely time to remove these amalgam fillings. But if the amalgam filling is just ten years old and still perfect, don’t touch it, leave it where it is. From the medical side, there is no need to remove it,’ he says. ‘The mercury only vaporises in the mouth when you fill it or remove it and as long as the amalgam filling is in the mouth, everything is fine. The release of mercury in such a small quantity, it cannot harm you,’ he says.

But in a culture where value is increasingly being placed on aesthetics over function, more and more people in Dubai are turning to replacement composite fillings or ceramic inlays. ‘This is our daily bread. Our generation all have amalgam fillings and they did a great job 20 or 30 years ago, but now we’re going more into appearance,’ says Dr Maximilian.

So what are the options for those wanting to banish silver fillings for good? ‘There are several. We can do something directly in the mouth, that’s called a composite filling and that’s not complicated. It’s a cost effective option and it looks nice and can be done in one sitting,’ he says. ‘If you want to invest a little bit more money and want to have something much longer lasting and customised for you, you should get ceramic or porcelain inlays or restorations. They cost more because they’re made by a dental technician and take two visits to place,’ Dr Maximilian says.

It is during these replacements that Dr Maximilian says utmost care must be taken to ensure safe removal of the fillings to minimise the exposure to mercury. ‘When we remove a mercury filling we use a rubber dam, which isolates the tools with the amalgam filling and we can easily remove the filling without any contamination for your body. People should not be scared or alarmed,’ he says.

Environmental concerns are also high on the agenda when it comes to amalgam fillings. ‘When we remove the amalgam there is a lot of mercury released and this goes into our drainage and water systems. Good doctors have what’s called an amalgam separator in the dental unit to make sure there is no contamination of water. In Scandinavian countries, they have completely banned the use of amalgam for environmental and health issues,’ he says. With Dubai ramping up its environmental agendas, perhaps the UAE could be next.
From Dhs490 to Dhs790 for composite fillings; from Dhs2,800 per tooth for ceramic inlays. Dubai Sky Clinic, Level 21, BurJuman Business Tower, Bur Dubai. Other locations: Level 27, Swiss Tower, Cluster Y,
JLT, (04 704 8000).

The procedure

Dr Max greets us at the impressive BurJuman clinic early in the morning, raring to go. We have two amalgam fillings that need removing, one which has leaked into the cracks of the tooth. Using the latest rubber dam technology, he makes two holes in a circular rubber sheet in order to isolate the teeth and provide a barrier to ensure there is no contamination. The flexy device fits into the gums of your mouth, holding it wide open and within seconds, the amalgam has been removed and the dam is taken out. We’re impressed with the new natural look of our teeth and, most impressively, we’re in and out within half an hour. Ensure you book an appointment after 10am, when you get two hours free parking.

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