Can dental amalgam be safely used with every patient?
No, there are patients who are sensitive to the components of amalgam, just as there are individuals who are sensitive or allergic to other chemical substances or even foods such as milk or bread. It has been estimated that the prevalence of mercury sensitivity in the general population is approximately three per cent (JADA, Vol. 122, Aug. 1991, p. 54).
Dentists may consider the use of composite fillings or other restorative materials in individual cases. Dentists routinely take a number of considerations into account in selecting a restorative material, including tooth size, location and the individual’s condition and medical and dental history. For example, alternatives may be considered for individuals who are immunologically compromised, or who suffer from a neurological condition.
Health Canada suggests that alternatives should be considered for patients with impaired kidney function. Although dental amalgam itself is not linked to such conditions, there is evidence that total body burden of mercury is of particular concern with these patients. Amalgam may similarly be contraindicated for workers with known occupational exposure to heavy metals or for individuals with greater than average exposure to mercury because of a diet, which is primarily seafood.