You look in the mirror and see them. Those dark silver spots on the chewing surfaces of your back teeth. You have heard whispers about mercury in dental fillings. Are they safe? Should you have them removed? The topic can feel confusing with so much conflicting information online.

Dental amalgam, commonly called silver fillings, is a mixture of metals. It contains approximately 50% mercury, combined with silver, tin, and copper. The mercury acts as a binding agent that holds the other metals together in a durable, putty-like material that hardens over time.

When the filling hardens, the mercury is chemically bound within the amalgam structure. It is not sitting loose inside your tooth. The chemical bonds change its properties, which is why the mercury in amalgam behaves differently from elemental mercury.

Major health authorities around the world have examined the safety of dental amalgam extensively. The World Health Organization, the US Food and Drug Administration, the British Dental Association, and the European Commission have all concluded that dental amalgam is safe for general use in adults and children over six years old.

These conclusions are based on decades of scientific study. The levels of mercury released from intact amalgam fillings are extremely low, well below the thresholds associated with any known health effects. Millions of people have had these fillings for over 100 years without documented systemic health problems.

There are some exceptions to the general safety consensus. Pregnant women should ideally avoid new amalgam fillings during pregnancy, as a precaution. People with known mercury allergies should not receive amalgam. Patients with severe kidney disease may also be advised to avoid amalgam due to reduced ability to excrete mercury.

These are specific medical situations, not general reasons for everyone to avoid or remove amalgam fillings. If any of these apply to you, discuss them with your dentist.

Here is the honest answer: probably not, unless there is a problem with the filling itself. Removing a healthy amalgam filling involves drilling it out, which temporarily releases more mercury than leaving it intact. If the filling is sound, the removal process offers no health benefit.

However, if your filling is cracked, worn, or decayed around the edges, replacement makes sense. Your dentist can then use tooth-coloured composite or ceramic materials instead, which many patients prefer for aesthetic reasons.

The decision to replace should be based on the condition of the filling, not fear about mercury content. Your dentist can examine your fillings and advise whether any need attention.