Amalgam alternatives – what is driving the change?

amalgamKemdent explains what’s driving the move away from amalgam and what to look out for when choosing between the alternatives available.

Amalgam has been used in dentistry since the 1800s, when it was first established as a strong, durable and versatile restorative material.

Though its exact origins are debated among sources, there’s no denying that it became the go-to solution for filling teeth around the world.

However, it has fallen out of favour in recent times. This is due to potential concerns regarding mercury content as well as rising aesthetic demands.

Although amalgam remains in circulation for some patients, clinicians are tasked with finding suitable alternatives in more and more situations.

Having a reliable product on hand that we can trust to maintain treatment quality standards is essential.

No longer the favourite

There are a few reasons why amalgam is no longer the stand-out preferred restorative dental material.

Containing a small amount of mercury, the material emits mercury vapour into the air. This bonds to methyl to create methylmercury.

This is harmful for humans to inhale as we easily absorb it into the bloodstream and organs. Or it can travel through the system into the brain (Park and Zheng, 2012).

Wider environmental impacts of methylmercury include contamination of aquatic wildlife. Here it accumulates as it passes up the food chain.

Not only is this toxic to creatures of the sea, but there is potential for humans to consume fish containing harmful mercury levels. Though we need more conclusive evidence to determine the dangers presented (Park and Zheng, 2012; Balshaw et al, 2007).

The Environment Quality Standards Directive regulates mercury levels in fish in order to protect humans from secondary mercury poisoning.

It’s important to note here that the amount of mercury in a single amalgam restoration is minimal. Rather, it is the cumulative impact of dental amalgam that creates most risk.

A mandatory stand down

In light of the evidence available regarding the negative effects of dental amalgam, the government has introduced a mandatory (albeit gradual) move away from the material.

As of June 2019, the Department of Health and Social Care released the ‘Dental amalgam: plan to phase down use in England‘ document. This mandates the avoidance of amalgam fillings for specific patient groups, including children under the age of 15 and pregnant women.

Though less decisive, a European Commission Scientific Committee opinion states that, while further research is needed into the neurotoxicity of mercury from dental amalgam, other materials should be considered for deciduous teeth.

It adds that clinicians should pay particular attention to the restorative material chosen when treating pregnant women.

Patient supported

In many cases, patients often support the move away from amalgam. Greater awareness of environmental factors means that some will appreciate solutions that don’t pose any sort of threat to the planet and its wildlife.

A bigger driving factor for more patients, however, is likely aesthetics. Despite the many advantages amalgam offers, a natural-looking appearance has never been one of them.

While not an issue several decades ago, aesthetics has become a priority for many in today’s world. Societal pressure, personal ambitions and the desire to boost self-confidence combine to form highly aesthetic patient expectations for any type of dentistry.

As such, many individuals will seek a restorative solution that blends with their dentition far more than the traditional silver of an amalgam filling.

For dental practitioners, this patient demand offers another powerful incentive to utilise amalgam alternatives in everyday practice.

Quality and efficiency

When selecting a suitable restorative material, we must consider several factors.

Clearly, we require a safe and highly aesthetic solution. However, it is also critical for a material that is easy to work with. And to support a fast and efficient clinical workflow.

This is particularly important in dentistry today. Not least due to the many pressures of delivering quality care. But also given the additional challenges presented by the pandemic.

As practices continue to battle the backlog of patients created by lockdowns and widespread social restrictions, everyday life has become busier than ever.

Speed without compromise is therefore essential for every GDP and their team. With enhanced infection control protocols, it is also hugely beneficial for clinical procedures to support exceptional safety standards as well.

Restorative materials may only be a small part of the story. But they are still an important part for practitioners looking to optimise every aspect of their workflow.

The Kemdent Diamond Rapid Set Glass Ionomer Cement (GIC) capsules are an ideal solution. Singularly packaged for quick, simple and hygienic application, the material is uniquely formulated for maximum durability and minimal chipping for non-load-bearing class I and class II restorations, deciduous teeth, the sandwich technique or core build ups.

Kemdent Diamond Rapid Set GIC capsules support everyday speed and efficiency. Alongside exceptional clinical outcomes. Making them an ideal alternative to amalgam in many cases.

The natural choice

For a restorative material that doesn’t harm the environment or threaten aquatic life, helps to meet patients’ aesthetic expectations and streamlines the professional workflow, clinicians need to look beyond amalgam.

Extensive research and development in the field has led to some viable alternatives. So now it’s up to dental professionals to make the most of them.


For more information, please visit www.kemdent.co.uk.

References

Balshaw S, Edwards J, Daughtry B and Ross K (2007) Mercury in seafood: mechanisms of accumulation and consequences for consumer health. Rev Environ Health 22(2): 91-114

Park J and Zheng W (2012) Human exposure and health effects of inorganic and elemental mercury. J Prevent Med & Pub Health 45(6): 344-52

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