WHAT IS AMALGAM?

Amalgam is a special mixture of metal powders such as silver (Ag), copper (Cu), zinc (Zn) and tin (Sn) mixed with mercury (Hg). The reaction that occurs when the amalgam powder is soaked with mercury is called amalgamation.

AMALGAM FILLING

Amalgam is a filling material used in dentistry since ancient times. However, today, the mercury contained in amalgam has been replaced by resin-based filling materials both locally, systemically and aesthetically. We can say that composite filling materials, also known as white filling among the people, have replaced amalgam in the long term.

Broken, colored, secondary decayed amalgam fillings should not be left in the mouth of the person and must be replaced. Various systemic disorders (tachycardia, GI diseases, etc.) have been observed in people with too many amalgam fillings in their mouths, and it has also been reported that these diseases disappeared when amalgam fillings were replaced. This may be due to the amount of free mercury in the amalgam filling and the passage of this mercury into the oral environment.

AMONG THE FACTORS THAT PROVIDE THIS SITUATION;

1. Frequency of eating
2.  Chewing gum habit
3. Frequent intake of hot food and drinks
4. The acidity of food (acidity in food can increase the abrasion of the filling).
5. The habit of grinding teeth, especially at night.

In people who are allergic to amalgam, amalgam fillings should be removed once, but not more than twice, the cavity should be closed with a healing paste and waited for 4 weeks, and after the complaints have decreased, they should be filled with a non-allergenic filling material.

A second local effect of amalgam is “Galvanic Current” which can be caused by another metal or amalgam in the mouth. Galvanic current is defined as the emergence of an electric current between two different metals with the effect of saliva. Galvanic current causes a metallic taste in the patient’s mouth and a flash-like pain due to sudden electrical discharge. It also causes the formation of white lesions on the oral mucosa (such as lichen.) No maximal or minimal value is given for these symptoms. These findings vary from patient to patient, according to their personal perception and degree of flow.

HOW SHOULD AMALGAM FILLING REMOVAL BE?

Before the amalgam filling is removed, the patient should be given vitamin C in tablet form at the dose recommended by the physician or intravenous vitamin C should be administered. Because the desire of mercury to bind to vitamin C in the blood is higher than the desire to bind to body tissues.

A closed room should be selected before amalgam filling removal.

Before the amalgam fillings are removed, a rubber cover called rubber dam, which reveals only the tooth where the amalgam filling will be removed and which we use to isolate the whole mouth, should be applied to the tooth and the tooth should be isolated from the oral tissues.

A saliva absorber should be placed under the rubber dam and any fluids that may leak under the rubber dam should be removed.

An alternative breathing source should be provided for the patient (such as an O2 tube).

A highly absorbent surgical aspirator should be used by the assistant.

An ionizer should be available in the environment to isolate the mercury vapor released during amalgam filling removal and a strong suction aspirator or vacuum device should be available to prevent the spread of mercury vapor to the environment during the procedure.

The physician, patient and assistant should wear protective gowns, cap and goggles, and in addition, the physician and assistant should use carbon fiber masks specially provided for amalgam filling removal.

After the amalgam filling is removed from the cavity, the rubber dam should be carefully removed.

After the amalgam filling is removed, the patient should be rinsed with metal-binding mouth solutions, and if necessary, the physician should clean the inside of the mouth with special solutions. The remaining small metal residues can also cause heavy metal accumulation in the body and cause systemic disorders in the future.

More than 2 amalgam fillings should not be removed at a time, because the toxicity of mercury vapor released during amalgam filling removal is very high. If a large number of amalgams are to be removed, at least one month should be left between appointments.

AMALGAM FILLING REMOVAL IN PREGNANT WOMEN

Due to the high toxic effect of mercury released during amalgam filling removal, amalgam filling removal is not preferred in pregnant women unless there is a very urgent situation (acute pain, abscess, etc.).

WHAT IS DENTAL AMALGAM, MERCURY?

Millions of dentists worldwide routinely use amalgam as a filling material for decayed teeth. This material, often called “silver fillings”, contains 45-55% metallic mercury. Mercury is a known neurotoxin that can harm humans, especially children, pregnant women and fetuses. In its 2005 World Health Organization (WHO) report on mercury, the WHO stated that “In addition to causing lung damage, mercury can have harmful effects on the nervous, digestive, respiratory, immune, and kidney systems. Negative health effects of mercury exposure can include tremors, visual and hearing impairment, paralysis, insomnia, emotional instability, developmental deficits during fetal development and attention deficit and developmental delays in childhood. ” can be experienced.

DENTAL AMALGAM SIDE EFFECTS AND MERCURY-RELATED REACTIONS IN FILLINGS

The table below is a short list of some of the symptoms most commonly associated with inhalation of elemental mercury vapors:

Symptoms most commonly associated with inhalation of elemental mercury vapors;

• Acrodynia or similar symptoms such as emotional instability, loss of appetite, general weakness and skin changes
• Anorexia
• Cardiovascular problems, frequent changes in heart rate, tachycardia (abnormally fast heartbeat)
• Cognitive/neurological impairments, memory loss, decreased mental functioning, difficulties with verbal and visual processing
• Delusions, delusions, hallucinations
• Dermatological conditions, dermographism (skin condition characterized by raised red marks), dermatitis
• Disruption / enlargement of the thyroid gland
• Symptoms such as irritability, abnormal reactions to stimuli and emotional instability
• Fatigue
• Headache
• Hearing loss
• Immune system disorders
• Insomnia
• Neuromuscular changes such as changes in nerve response, peripheral neuropathy, decreased coordination, decreased motor function, polyneuropathy, weakness, muscle atrophy and twitching
• Oral symptoms, gingivitis, metallic taste, oral lichenoid lesions
• Psychological problems/mood changes related to anger, depression, excitability, irritability, mood swings and nervousness
• Kidney problems/proteinuria/nephrotic syndrome
• Respiratory problems/bronchial irritation/bronchitis/cough/ dyspnea (difficulty breathing), pneumonia, respiratory failure
• Shyness (excessive shyness)/social withdrawal
• Tremor
• Weight loss

Not all patients experience the same symptoms or combination of symptoms. Furthermore, in addition to the above symptoms, numerous studies have documented risks for other health conditions associated with dental amalgam. In fact, scientists have linked mercury in amalgam fillings to Alzheimer’s disease, amyotrophic lateral sclerosis (Lou Gehrig’s disease), antibiotic resistance, anxiety, autism spectrum disorders, autoimmune disorders/immune deficiency, cardiovascular problems, chronic fatigue syndrome depression, infertility, kidney disease, multiple sclerosis, Parkinson’s disease and other health problems.