Safe removal of silver fillings

01 — Why it matters

Why the removal method matters

Silver-colored amalgam fillings are about 50% mercury by weight. An intact amalgam filling releases very small amounts of mercury vapor, and that release increases when the filling is drilled. Removing an amalgam filling the usual way — simply grinding it out — can create a burst of vapor and fine particles right at your mouth and nose.

At a glance

Dr. B performs a safe removal protocol for silver fillings, using protective steps similar to those recommended by holistic (biological) dentistry organizations. The goal is simple: take the amalgam out while keeping your exposure — and our team’s — as low as reasonably possible.

Our safe amalgam removal protocol

• Rubber dam isolation — a thin barrier isolates the tooth so fragments aren’t swallowed.
• Sectioning (“chunking”) — the filling is cut into large pieces and lifted out, which produces far less vapor than grinding.
• Water spray and high-volume evacuation — keeps the filling cool and captures vapor and particles at the source.
• Air filtration — room air cleaning runs during the procedure.
• Biocompatible replacement — the tooth is restored with tooth-colored composite (BPA-free on request) or a metal-free ceramic restoration for larger areas.

Who might consider replacing amalgam fillings?

Many amalgam fillings can stay in place safely for years. Replacement is worth discussing when a filling is cracked, leaking or has decay underneath; when the tooth next to it is breaking; or when you’d simply prefer metal-free dentistry. In 2020 the FDA recommended that certain higher-risk groups — such as pregnant or nursing women, young children, and people with some neurological or kidney conditions or a known mercury allergy — avoid new amalgam when alternatives are available. The FDA did not recommend removing intact fillings in good condition, and neither do we unless there’s a dental reason or it’s your informed choice.

Staged removal

Rather than replacing every filling at once, we usually work in stages — often two or three fillings per visit, grouped by area of the mouth. Staging limits exposure during any single appointment, keeps visits comfortable and makes it easier to spread the cost across benefit years.

What replaces the amalgam?

Small to medium fillings are replaced with composite resin that bonds to your tooth and matches its color. When a lot of tooth structure is missing — common under large old amalgams — a ceramic onlay or crown may protect the tooth better. We’ll show you photos of each tooth and explain the options.

Insurance and cost

Dental insurance often covers replacing a filling that is broken or decayed. Coverage for elective replacement of intact fillings varies. Before we start, we’ll give you a written estimate for each stage with your benefits applied. Insurance & financing.