Composite (resin) Advantages: Composite is a mixture of plastic resin. These Gold is extremely strong. Fillings made of gold fillings are also called plastic or “white fillings.” alloy will last a long time. This type of material may be either self-hardening www.ct.gov/deep/mercury or may be hardened by exposure to blue light. Gold alloy may have porcelain fused to the 79 Elm Street outside surface to make it tooth colored. Hartford, CT 06106-5127 Composite is used for fillings, inlays and veneers. Sometimes it is used for replacing parts of broken No toxic or environmental effects have been teeth. identified to date. Fillings: Advantages: Disadvantages: The Choices You Have These fillings are the color of natural teeth. Gold has a high cost, more than all other Composite may be used on either front or back materials. teeth. More than one dental appointment is needed to Fillings are usually done in one visit. complete these fillings. Composite is a relatively strong material. Fillings are gold colored if not covered with

Disadvantages: Porcelain This type of filling can break and wear out more Porcelain is a mix of glass-like materials. easily than metal fillings, especially in areas of Sometimes it is called ceramic. It is used for tooth heavy biting forces. As a result, composite colored crowns, bridges, . Fillings fillings may need to be replaced more often than made of porcelain are made in a dental lab and sent metal fillings. back to the dentist to cement into place.

Compared to other fillings, composite fillings are Advantages: sometimes difficult and time-consuming to place. They cannot be used in all situations. These fillings are tooth-colored. and Other Filling Composite has a moderate cost. It costs more They may be used alone or fused to gold alloy to Materials than amalgam. make them tooth colored. A chemical called Bisphenol A can be released Porcelain usually lasts a long time. from composite fillings. This chemical has hormone-like activity. Current studies cannot tell No toxic or environmental effects have been identified to date. Choices in Restorative Materials if this is a health problem. No government has recommended limits on its use. (fillings): Advantages, Disadvantages and Concerns Allergic reactions are rare. Disadvantages:

Amalgam Glass Ionomer Porcelain is somewhat brittle and may fracture. The word “amalgam” means a mix or blend. It can Glass ionomer is a glass product. It is used for small More than one dental appointment is needed to be a mixture of mercury with another metal or mix or temporary fillings. It is also used as a cement for complete the filling. dental crowns. It is usually not used on the chewing of metals. Porcelain has a high cost, similar to gold surfaces of back teeth. Dental amalgams include mercury, , and . About 40% to 50% of the filling material is Advantages: mercury. They have been called “silver fillings” These fillings are the color of natural teeth. A Patient Education/Information Brochure because of their silver color when they are first created by the Maine Department of Human placed. It is usually used on back teeth. It is one of Glass ionomer contains fluoride. This helps Services, Bureau of Health and, with their the oldest filling materials and has been used for prevent further decay. permission, adapted for the State of over 150 years. Connecticut, January 2006 Fillings are usually done in one visit. Advantages: . Disadvantages: Amalgam is very strong and lasts a long time. These fillings will not last as long as other Fillings are usually done in one visit. materials.

This is the least expensive type of filling Glass ionomer is not recommended for use on The Connecticut Department of Energy and material. the chewing surfaces of back teeth. Environmental Protection is an Affirmative Action/Equal Opportunity Employer that is Disadvantages: This material has a moderate cost, like a composite. committed to complying with the Amalgam fillings give off mercury vapor. The requirements of the Americans with vapors can then be inhaled and enter your body. Allergic reactions are very rare Disabilities Act. Please contact us at (860) 418-5910 or [email protected] Current studies cannot confirm if this mercury if you: have a disability and need a causes health problems. Gold or Gold Alloy communication aid or service; have limited Gold or gold alloy fillings are a mix of gold and proficiency in English and may need Mercury used in these fillings can add to the information in another language; or if you mercury pollution problem. other metals such as silver and copper. This material is used for crowns, bridges, inlays and wish to file an ADA or Title VI Amalgam has a silver color that can get darker onlays. Fillings made of gold alloy are made in a discrimination complaint. over time. dental lab and sent back to the dentist to cement into place. In rare cases there are allergic reactions to amalgam.

About this Brochure To be careful, Canada and several countries in Eat a balanced diet low in sweet sticky foods. In 2002, the Connecticut State Legislature passed a Europe recommend limits on the use of mercury law telling the Connecticut Department of amalgam. They advise that pregnant women should Limit sugary sodas and fruit drinks. Environmental Protection to develop best not have amalgam fillings placed in or removed Visit your dentist at least once a year for a management practices for the handling of dental from their teeth. Some of these countries issue the regular dental check-up. amalgam. The purpose of these best management same warning for nursing women and people with practices is to ensure that mercury from dental kidney problems. Some countries advise limits on Use fluoride to help strengthen . amalgam does not threaten human health or the using amalgam fillings with young children and environment. As part of the revised Dental Office people with braces. The US Public Health Service Make sure children get dental sealants on their Best Management Practices, all Connecticut dental thinks such advice is not needed. They say amalgam molar teeth. offices who use amalgam, must provide a copy of fillings are safe for most people. No country says this brochure to their patients to help explain the people who do not have signs of mercury effects Talking with Your Dentist about Getting a Tooth advantages and disadvantages to human health and should have their fillings removed. Filled the environment of the use of mercury amalgam When you visit your dentist and need to have a fillings and other filling materials used in dental Environmental Concerns tooth filled, let your dentist know about any procedures. This brochure explains the possible Some countries limit the use of amalgam fillings to changes to your health since your last visit. For effects that the use of such fillings may have on help reduce mercury pollution. Waste is made when example: your dental health, general health or the new fillings are put in teeth or when fillings are Are you pregnant or nursing? environment. This brochure is intended to assist you removed. This waste contains mercury. It can in making choices regarding your dental and total pollute the environment. Your dentist can reduce Do you have any allergies? health needs that are right for you. this pollution by using traps and filters to collect the mercury for recycling. Amalgam fillings cause our Do you soon plan to have braces? Mercury is a heavy metal. It is found in nature. body’s waste (urine and feces) to have mercury. Are you taking any medications? What for? Mercury is found in different forms. Too much When these mercury-containing wastes enter mercury in your body can hurt you. Many years of sewers, they can add to the pollution of our waters. Do you have any kidney problems or a family burning coal along with using mercury in batteries, history of them? thermometers, fluorescent lights, electrical Once mercury enters our waters, it can change to Do you have any other health conditions or switches, and other products have caused too much methylmercury. This builds up in fish. Many New specific health concerns? mercury to get into the environment. England states, including Connecticut, have issued Safe Eating Guidelines on eating fish due to The State of Connecticut is concerned about the mercury pollution. Mercury used in is not Sharing these facts with your dentist may affect the effects of mercury on human health and our the major cause of our mercury pollution and choice you make for a filling material. If you have environment. Connecticut’s policy is to reduce how resulting fish warnings. It does add to the problem. questions or concerns about these materials or the much mercury is released into the environment. Wildlife that eat fish, such as eagles, loons and kinds of fillings you already have, you should read Connecticut is a leader among states in removing otters, are also at risk of harm from mercury this brochure and talk with your dentist. mercury from products. pollution. No matter what material is used, a filling is not like Because amalgam fillings mostly contain mercury, What you can do… a natural tooth. Filling materials are man-made and we are concerned about possible effects on human The best thing you can do is avoid the need for any as such they are foreign materials to your body. health and the environment. fillings by preventing in the first place. Whenever something foreign is put into your body, Because of efforts to prevent tooth decay, most there is the chance of side effects. All dental This booklet will tell you more about: amalgam fillings placed in teeth these days are to materials may cause an allergic reaction in sensitive replace old ones. Knowing that you may have people. For every filling material, there are a few Mercury in amalgam fillings alternatives to amalgam fillings is another way to people who are allergic to it. This is why your Health and environmental concerns with using reduce the amount of amalgam that ends up in the dentist needs to know about your allergies. amalgam fillings environment. This brochure is to help you understand your choices for fillings. It is also to If you need to have a tooth filled (restored), there Cavities and dental decay and what you can do to help you know what you can do to prevent tooth are different kinds of materials that can be used. avoid fillings decay and avoid the need for any fillings. Your dentist will talk with you about the kind of

Talking with your dentist about getting a tooth filling material that is best for you and for the tooth About Cavities and Dental Decay that needs to be filled. Each kind of material has filled A cavity is a hole that forms in a tooth. It is the advantages and disadvantages. You should know Choices you have for filling materials result of dental decay. what these factors are so that you can make an Decay starts when there is a breakdown in tooth informed choice. Amalgam Fillings and Mercury enamel. Unlike other kinds of injuries to your body, Amalgam fillings are also called dental amalgams a cavity will not heal by itself. Not all dental decay What you choose depends on your needs and the or mercury amalgams. They are 40 to 50 percent results in cavities. Early decay can be stopped and best way to repair the cavity in your tooth. There mercury. These fillings give off mercury vapor. even reversed with proper care. are other factors that may affect the choice of filling How much vapor is given off depends on how many material. These include the location of the filling fillings you have. It also depends on how much time Dental cavities need to be treated by a dentist. If and biting forces in the area of the mouth where the you spend chewing, grinding your teeth, and you need a filling, there are different materials and filling is located. drinking hot liquids. Mercury vapor can be inhaled treatment choices that you and your dentist can and enter the bloodstream. It can then be carried consider. Because there are advantages and For many years, the only choices for fillings were throughout the body. For people with a number of disadvantages to all filling materials, preventing metals. These are a mixture or “amalgam” of fillings, this can be the major way mercury gets into dental decay from ever starting is very important. mercury and silver alloys, or gold alloy. In the past their body. Any mercury from amalgam fillings we 20 to 30 years, other materials have been developed swallow is very poorly absorbed and mostly does Preventing Dental Decay for fillings. These are “tooth colored” rather than not enter our bloodstream. Over the past 30 years, successful preventive silver-colored and gold. They include composite measures have helped reduce dental disease (tooth resin, glass isonomer and porcelain. Health Concerns decay). Preventing decay is the best way to protect There is a lot of debate about health effects from the your oral health and your overall health. If you can The rest of this brochure will outline the alternatives mercury in amalgam fillings. Current studies cannot keep decay from starting, you won’t need fillings, that you have and help you make the right choice confirm if amalgam fillings cause health problems. and you’ll be helping to protect the environment. for you.

Some people have allergic reactions to mercury. Too much mercury can damage the kidneys, nerves, Follow these steps to help prevent dental disease: and the brain. The brains of babies and infants that are starting to form and grow are most at risk. Brush and floss your teeth every day. The final choice is yours.