Level 17, 111 Elizabeth Street, Sydney NSW 2000
Level 17, 111 Elizabeth Street, Sydney NSW 2000
Holistic Treatment · Evidence-Based
Dental amalgam, the 'silver' filling, is approximately 50% mercury by weight. Mercury vapour is released from these fillings in small amounts throughout their life, and the World Health Organisation lists mercury among the ten chemicals of major public health concern (WHO, 2024). Two things are true at once: the major dental associations find no proven link between amalgam fillings and chronic disease in the general population, and the world's regulators are phasing amalgam out anyway, with a global end date of 2034. This page lays out both positions with sources, because the decision about your own fillings should be yours, made on the real evidence.
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Roughly half of every amalgam filling is elemental mercury, alloyed with silver, copper, tin and sometimes zinc. The mercury is bound in the set material, and small quantities escape over time as vapour, driven by three things: friction (chewing and grinding), heat (hot food and drinks, with vapour elevated for up to 90 minutes afterwards) and corrosion as the filling ages. Around 80% of inhaled mercury vapour is absorbed through the lungs, and the body stores mercury preferentially in the kidneys, liver and brain. None of this is contested. The question is whether these small, chronic exposures cause harm in the general population.
The Australian Dental Association's current policy states that the preponderance of evidence does not link amalgam restorations with chronic or degenerative disease, kidney disease, autoimmune disease, cognitive dysfunction or adverse pregnancy outcomes in the general population (ADA Policy 6.18, reviewed February 2026). The FDI World Dental Federation holds a similar position, adopted at its 2021 Sydney General Assembly. These are serious bodies reading a large evidence base, and any honest page on this subject starts by saying so.
The same period has produced a steady accumulation of precaution from regulators rather than dentists:
WHO (2024) lists mercury among the ten chemicals of major public health concern and notes that exposure 'even to small amounts' may cause serious health problems, targeting amalgam phase-down measures in 90% of countries by 2030.
The US FDA (2020) identifies seven higher-risk groups: pregnant women, women planning pregnancy, nursing mothers, children under six, people with neurological disease, impaired kidney function or mercury sensitivity, and advises them to discuss alternatives with their dentist.
NSW Health (GL2020_015) directs that alternative materials be favoured for pregnant and breastfeeding patients, patients with severe renal disease and children under 15.
The ADA's own policy advises dentists to minimise amalgam use in children, pregnant or breastfeeding women and people with kidney disease.
The Minamata Convention, which Australia ratified with effect from March 2022, has moved from phase-down to a full global phase-out by 2034, agreed at COP6 in November 2025.
A fair reading of both sides: the associations say the population-level evidence does not prove harm; the regulators say the material is a neurotoxin with better alternatives available, and are retiring it. Both can be true. What no serious body now argues is that amalgam should remain the default filling material, and no new amalgam has been placed at SHDC since 1987.
Dental amalgam is one of the significant sources of mercury entering wastewater, which is why every Australian dental practice must run an amalgam separator and dispose of removed amalgam as regulated toxic waste. The environmental logic is a large part of why the Minamata Convention exists, and it applies regardless of where you land on the health question.
"I am partway through postgraduate study in evidence-based health care, so I will not tell you amalgam has been proven to cause disease, because that is not what the population evidence shows. I also will not put a material that is half mercury into a patient when excellent alternatives exist, and neither will the rest of the world after 2034. Both of those sentences are evidence-based. You are entitled to hear them together."
DR LEWIS EHRLICH — PRINCIPAL DENTIST
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If your amalgams are intact and you are comfortable
Current guidance is that sound fillings do not need removal without a clinical reason. Monitoring them at your regular examinations is a legitimate choice.
If a filling is cracked, corroded or has decay beneath it
It needs replacing regardless of the mercury question, and the replacement should be done under the SMART protocol.
If you are in one of the FDA's higher-risk groups
Discuss alternatives for any new fillings with your dentist, and raise timing questions about existing amalgams with your dentist and GP together.
If you have weighed all of the above and want your amalgams out
That is an informed choice we respect and support, safely.
Does SHDC pressure patients to remove amalgam?
No, and we regard practices that manufacture fear around intact fillings as doing patients a disservice. Our role is the evidence, the protocol, and your decision.
Is drilling amalgam out more dangerous than leaving it?
Unprotected removal creates the highest exposure of the filling's life, which is the entire reason the SMART protocol exists. Protected removal is a routine, well-controlled procedure.
Can amalgam removal cure health conditions?
We make no such claim. Removal eliminates the largest source of dental mercury exposure; it is not a treatment for any disease, and anyone promising otherwise is ahead of the evidence. If you have a health condition you believe relates to mercury, that investigation belongs with your medical practitioner.
A comprehensive new patient consultation gives you the full picture — your specific situation, your options, and a plan that reflects your values and health goals.
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Dr Lewis Ehrlich
Principal Dentist — Sydney Holistic Dental Centre
Dr Lewis Ehrlich is a principal dentist at Sydney Holistic Dental Centre and is currently completing postgraduate study in evidence-based health care. He has practised holistic dentistry for over a decade and leads the practice's patient education programme.
Sources
WHO (2024). Mercury and health fact sheet. who.int/news-room/fact-sheets/detail/mercury-and-health
US FDA (September 2020). High-risk group recommendations on dental amalgam. fda.gov
NSW Health (2020). GL2020_015 Dental Amalgam Clinical Use and Disposal.
FDI World Dental Federation (2021, Sydney). Safe use and phase down of dental amalgam.
ADA (2025). Global amalgam phase-out set for 2034, Minamata COP6.
