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My question is whether it's best to replace amalgam fillings with newer, composite fillings. My concern is the constant, low-level of Hg leaching into the body. I understand that removing them will release more Hg into the body, but expect that, in the long term, there will be less Hg exposure.

From this paper, we see that many folks in the USA face the same issue.

From this paper there is a statistically significant correlation in blood serum and urine concentrations of Hg and number of amalgam fillings.

From this paper it amalgam fillings increase a woman's chance of getting Alzheimer's by 13%.

This study reports

In 10 healthy persons all amalgam fillings were replaced with gold inlays. Blood and urinary levels were measured on 10 occasions during a 4-month period before and a 12-month period after amalgam removal.

A large number of supplementary biochemical analyses did not show any influence on organ functions or any differences between the groups before or after the amalgam removal. Amalgam fillings considerably contributed to the plasma and urinary mercury levels.

Mercury levels in plasma and urine after removal of all amalgam restorations: The effect of using rubber dams reports

All amalgam restorations were removed from 18 subjects during a single treatment session in which a rubber dam was used and from 10 subjects when a rubber dam was not used.

one year later, the mercury levels in plasma and urine had sunk significantly below the pre-removal levels for both groups.

The study showed that dental amalgam had a statistically significant impact on the mercury levels found in plasma and urine in the patients tested, and that the use of a rubber dam during removal of all amalgam restorations significantly reduced the peak of mercury in plasma following removal.

(I do not have access to the rest of this paper.)

What is the current state of our knowledge as to how the reduction in systemic Hg concentrations after amalgam filling removal impacts (brain) health? Looking for pointers to more recent studies, larger cohorts, and discussing impact on organs -brain in particular.

Carey Gregory
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Don Slowik
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  • Thank you, much better. I edited it further to depersonalize it. Asking for personal medical advice is strictly off topic here, so questions have to be about everyone, not your decision. – Carey Gregory Sep 07 '21 at 03:56
  • @CareyGregory Thanks. That makes sense. Hopefully the answers will be useful to anyone facing this decision. – Don Slowik Sep 07 '21 at 12:08
  • Re: Maqbool et al DOI link seems to be broken (https://doi.org/10.2478/10004-1254-65-2014-2543 ) In any case, it seems to be an opinion piece. – Armand Sep 13 '21 at 22:32
  • Your Kingman et al reference (http://jdr.sagepub.com/content/77/3/461) seems well done, and relevent to AARP age cohort (age 50+) US males, although ones with a lot of dental work -- many fillings (20 amalgam surfaces each on average) and missing some teeth (25 natural teeth remaining on average). In their model a no-amalgam background level of 0.7 ug/L urine mercury is increased by 0.1 ug/L per amalgam surface. – Armand Sep 13 '21 at 22:51
  • Your Sun et al Taiwan study does not claim a causal connection, just an association that is quite weak on average for women and consistent with 0 for men. As Taiwan has seen rapid economic development over the last 50-60 years, dental care for its inhabitants has likely changed substantially over the years and so differences in amalgam use among the age cohorts are a likely confounder. – Armand Sep 13 '21 at 22:55
  • Molin et al is behind a paywall, so we cannot evaluate its data, if any.

    Berglund and Molin is behind a paywall, so we cannot evaluate its data, if any.

     – Armand Sep 13 '21 at 23:00
  • Based on the Kingman et al paper, it seems like the real question is "Of what significance are small to moderate increases over a baseline 0.7 ug/L urine mercury level?" The authors mention a likely consensus then of a threshold-based model of mercury's effects, but I don't know what the thinking is 20 years later. – Armand Sep 13 '21 at 23:03
  • University of Rochester Medical Center (https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=mercury_urine) indicates "Urine levels of mercury less than 10 mcg/L are considered normal." (mcg = ug). – Armand Sep 13 '21 at 23:09

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