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Reasons Why Dental Amalgam Fillngs Should Be Phased-Out: Environment Concerns


It is important to look at the potential harmful effects of dental amalgam on a person’s health but another – and often overlooked – side-effect of dental amalgam use is its impact on the environment.

Taken as individual dentists, dental amalgam use may not pose such a significant damage to the environment but as a whole profession, the cumulative use of dental amalgam is a cause for alarm. In 2008, the US - EPA approximated that 122,000 dental offices placed or removed dental amalgam, this roughly equals to 3.7 tonnes of mercury released into the environment.  In the Philippines, the Environment Management Bureau of the Department of Environment and Natural Resources (EMB-DENR) estimated that dental amalgam use in the country totals to 4,435 - 17,741 kilograms of mercury, leading the agency to conclude that dental amalgam use is one of the major sources of mercury pollution in the country.

“Silver” fillings

As dentists, we are familiar with the positive aspects of dental amalgam. It is a durable and an affordable filling material but with mercury as a primary component, it has its downsides, which sadly outweighs the benefits.

Mercury is a potent neurotoxin and constant exposure to its fumes causes damage to an individual’s nervous, respiratory, reproductive, and cardiovascular systems. Infants, children, and women of childbearing age are particularly vulnerable to its effects as mercury fumes can easily leak into the bloodstream.  Numerous studies have already shown that dental amalgam fillings leach and placing or removing it produces mercury wastes.

From vapours released (mixing dental alloy) to particles (excess mercury from sculpting or removing) and to sludge (mercury contaminated wastewater coming from dental offices); these all contribute to mercury levels in the air, land, and water.
It is important to note that mercury is persistent and that it bioaccumulates. Meaning, the toxin is long lasting and can accumulate to levels that are harmful to people, the wildlife, and the environment.


Recently, dentists were pinpointed as a major source of mercury pollution in the water. The International Academy of Oral Medicine and Toxicology (IAOMT) stated that “water treatment facilities are designed to filter human wastes but not heavy metals”. Excess mercury is either incinerated or used as fertilizers, thus contaminating the environment. Likewise, people with dental amalgam fillings excrete mercury in their faeces, further adding to the volume of mercury wastes in the water.


Dental amalgam use also leads to high mercury levels in the air. Research done in the US showed considerable mercury levels in the air vents of dental offices. IAOMT-Philippines and environment group BAN Toxics! conducted a similar research in the Philippines and came up with the same conclusion: dental offices, universities, and even dental suppliers emit high levels of mercury.

The True Cost of Dental Amalgam

Supporters of dental amalgam argue that the cost of alternative filling materials is exorbitant and low-income families will not be able to afford it. However, looking at the implications of dental amalgam use on the environment, people’s health, and the cost of putting up infrastructure and purchasing equipment for the safe handling and disposal of dental amalgam is more costly.
Philippine representatives in the international community did well by promoting and supporting a phase-out of mercury (including dental amalgam) use in the country by signing the Minamata Convention on Mercury.

Protecting our future

It is important to note that mercury vapour has always been present in the environment but because of the use of various industries and sectors, the levels of mercury in the environment have grown significantly and out of control.

The adaption of the Minamata Convention on Mercury and a restricting of A0 21 to include dental amalgam are positive steps in safeguarding our environment and the next generation’s future. As members of the health profession, we should stand as vanguards and protect citizens – particularly the vulnerable sectors against mercury and other toxins.

The Environmental Impacts of Dentistry.
Mercury Assessment for the Philippines.EMB-DENR. 2008
Rubin PG, Yu M-H, “Mercury vapor in amalgam waste discharged from the dental office vacuum units.” Arch Environ Health 51(4):335-7, 1996 Jul-Aug.

The Real Cost of Dental Mercury,

Reasons Why Dental Amalgam Fillings Should Be Phased-Out: Health Concerns

There are risks involved with placing dental fillings but none more perilous than using dental amalgam or silver fillings. Composed of different type of metals and with mercury as a major component, the safety of dental amalgam fillings is contentious.

The International Academy of Oral Medicine and Toxicology in the US and its Philippine chapter have been working tirelessly in bringing this issue to concerned officials and the public. Northern European countries have already dropped dental amalgam but a larger part of the world remains adamant or ill informed.  The cause may be due to the lack of clear policies or due to strong opposition from the dental sector itself.

With the passing of the Minamata Convention on Mercury, countries are now obliged to phase-out or phase-down the use and placement of dental amalgam fillings. Part of this process is educating professionals and the public sector about the hazards posed by dental amalgam fillings.  

There are a number of reasons for the urgent removal of dental amalgam fillings but one crucial point is the health and safety risks involved with using and placing dental amalgam.  Studies done by IAOMT and other independent researchers have found the following:

1.    Mercury fumes can leach into the body. Mercury in dental amalgam fillings release fumes when chewing or drinking hot/warm beverages.

2.    Effects on pregnant women and children.  To avoid problems, women are advised to minimize or completely stay away from certain seafood to avoid mercury poisoning.  However, mercury tainted fish is not the only culprit; research also established that breast-feeding mothers with dental amalgam fillings have high levels of mercury in their milk.

3.    Other health effects. While women and children are vulnerable, mercury can also cause damage on other members of the population. Mercury is a potent neurotoxin and constant exposure to its fumes not only damages the nervous, reproductive and immune systems but also leads to cardiovascular problems, allergies, kidney ailments, and chronic fatigue.

4.    Constant exposure of dentists and dental staff. Dentists and their staff are likewise vulnerable to mercury fumes. Routine handling of dental amalgam releases fumes and exposes both dentists and assistant.  Further, IAOMT-Philippines’ recent research with environment group BAN Toxics! revealed that dental clinics that use dental amalgam fillings have high levels of mercury in the air.

IAOMT-Phils is working with the Department of Health (DOH) and other organisations in raising awareness on this public health issue. It has been a long and often, tiring work but public and concerned agencies are now realising what needs to be done.


IAOMT-Philippines Conducts Mercury-Free Dental Outreach Programme


The International Association of Oral Medicine and Toxicology (IAOMT) in the Philippines and Gota de Leche, the country’s leading foundation for undernourished children, are teaming up to deliver a series of oral health lectures and free dental treatments to Gota de Leche beneficiaries this second half of 2014.

Aimed to promote oral health awareness, the four-month dental outreach is set to expound on the importance of proper nutrition and oral health care; a much-needed intervention in a country beset by oral health problems. Based on Department of Health (DOH) figures, a staggering 87 percent of the population suffer from caries or gingivitis and that even more alarming is that 97 percent of six-year-old children show signs of tooth decay.

Where day-to-day living takes priority, Ms Anna Leah Sarabia, Director of Gota de Leche shared that oral health is the least of their beneficiaries concerns and that the assistance of IAOMT-Philippines will help fill that gap.

Dr Lillian Lasaten-Ebuen, Executive Director of IAOMT-Philippines shared that perfect health cannot be achieved if oral health is neglected. As various studies have shown that diseases such as heart disease, diabetes, and even Alzheimer’s can be attributed to germs and bacteria that thrive in the mouth. “We are not only dealing with caries or gum disease. Such dental ailments can lead to more pressing health issues.”

Dr Ebuen cited recent evidence suggesting that women and their pre-natal oral conditions can influence their pregnancy as bacteria in the mouth can cause premature births or low birth rates. As a firm believer in prevention, Dr Ebuen further stated that, “Education and awareness will help reduce risks and the need for intrusive dental treatments.”

Together with other volunteer dentists, Dr Ebuen and IAOMT-Philippines will provide check-ups, cleaning, and mercury-free treatments. “We would like to emphasize that our outreach programmes are mercury-safe, meaning we don’t use dental amalgam fillings (silver fillings) which are toxic and dangerous.”

Amalgam supporters argue that the mercury used in silver fillings are safe but a study published in 2011 noted that breast-feeding mothers with dental amalgam fillings influence the levels of mercury in their milk thus exposing infants to mercury. As such, the study recommended a shift away from using dental amalgam fillings to avoid unnecessary mercury exposure. [1]

Dr Ebuen adds, “Gota de Leche is a highly respected charitable institution and their dedication to providing assistance to those who need it are in line with our organization’s values. Working with them on this venture is an opportunity for us to reach out to children and women - sectors that are most vulnerable to toxins such as mercury.”

The Mercury-Alzheimer's Connection

Even low levels of mercury exposure can lead to degenerative diseases like Alzheimer's. Click the video link for more info.


Exposure to Dental Mercury

Through this detailed infographic, IAOMT demonstrates how the use of dental amalgam fliings can expose dental staff, patients, and everyone else to mercury vapours.

occupational exposure to dental mercury

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