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End of amalgam tooth fillings: EU stops mercury in the mouth
Updated on January 1, 2025Reading time: 3 min.
Amalgam tooth fillings have been controversial for years. From now on the use of dental amalgam is almost forbidden, mainly because of the mercury content.
The possible health consequences of amalgam tooth fillings have been discussed for several years. With the start of the new year, the use of dental amalgam is now largely banned – but not for direct health reasons. Rather, the EU decision is about better banishing the toxic mercury contained in amalgam from the environment.
The ban only applies to new fillings; it does not concern the removal of existing ones. If the dentist considers it medically necessary to use dental amalgam due to high caries activity, this is still permitted.
Until now, an amalgam filling was considered the only health insurance benefit for those with statutory health insurance for the treatment of a tooth damaged by caries. In the future, self-adhesive fillings such as so-called glass ionomer cements, which can be applied without additional adhesives, will now be free of charge, as the umbrella association of statutory health insurance companies (GKV) announced.
The EU is thus implementing resolutions of the so-called Minamata Convention of 2017, an international treaty to protect against mercury emissions. The aim is to reduce the use of mercury in products and thus reduce its release into the environment.
Products containing mercury, such as dental amalgam and mercury-containing lamps, represent the largest remaining intentional use of the substance in the EU. The manufacture, import and export of such lamps will be phased out from 2026. In the past, mercury was also used in batteries, fluorescent tubes and thermometers, among other things.
Amalgam is a mixture of substances that consists of around half mercury and other metals such as silver, tin and copper. It has been used for dental fillings for well over 100 years. The material is inexpensive, durable and easy to shape. It is particularly suitable for larger defects in posterior teeth with high chewing stress.
Mercury is a metal that occurs naturally in the environment worldwide. For example, it is a typical component of hard coal, as the Federal Environment Agency says. The mercury present in the air, water and sediment layers of bodies of water in Germany goes back to centuries of coal burning and, especially in certain river sections, to the former discharge from industrial plants.
The substance is toxic to humans and animals and is fatal in large quantities. Mercury exposure can damage the central nervous system, lungs, kidneys and immune system. Since it is difficult for the body to excrete it, ingested mercury accumulates in the body.
In addition to eating fish, dental amalgam is the
Main source. The mercury is released – in very small quantities – from the fillings. The potential absorption is higher when inserting or removing a filling if the substance can be released in vapor form. Experts advise that anyone who has an amalgam filling should not have it removed without cause – such as a gap between the filling and the tooth.
According to the Federal Environment Agency, in addition to amalgam dental fillings, fish and other marine animals are a significant source of mercury intake. As the number and size of fillings increase, the load increases.
According to studies, the amount consumed in Germany is usually too small to be harmful. Several analyses, including one published in 2007 by the Robert Koch Institute (RKI) and one published in 2008 by the Technical University of Munich, came to the conclusion that there is no scientific evidence of a connection between amalgam fillings and chronic diseases. There is also no scientific evidence of a cancer risk from amalgam fillings, according to the German Cancer Research Center (DKFZ).
Alternatively, certain plastics, non-metallic alloys made from ceramics and metal alloys made from precious metals such as gold are used. The use of dental amalgam has declined sharply in recent decades – often because people find the gray fillings unsightly. In 2022, only 2.4 percent of plastic restorations were billed through statutory health insurance companies, according to the German Society for Dentistry, Oral and Maxillofacial Medicine (DGZMK).
To date, there are hardly any results from long-term studies on the possible health risks of the plastics used. In addition, dental fillings without amalgam are sometimes still considered less durable.