If your silver filling is sound and the tooth is healthy, it usually doesn’t need replacing. The ADA’s policy is that sound amalgam fillings shouldn’t be removed for non-specific or perceived health complaints unless you’ve been told the risks and benefits (ADA Policy 6.18, 2026).
- No evidence shows that replacing sound amalgam improves health outcomes (ADA Policy 6.18, 2026).
- Replace a filling when it has failed, you have a confirmed allergy, or you choose to after hearing the risks.
- If one does come out, extra steps limit vapour and particles.
What does the evidence say?
Amalgam is a mixture of metals, including silver, copper and tin, with mercury. It releases very small amounts of mercury, and some is absorbed by the body (ADA Policy 6.18, 2026).
The ADA says the weight of evidence doesn’t link amalgam fillings with chronic or autoimmune disease, kidney disease, cognitive problems or non-specific symptoms in the general population (ADA Policy 6.18, 2026). An Australian review called the evidence hard to read and advised dentists to keep patients informed and honour their choices (Spencer, 2000).
The ADA sets stricter limits for some people. Dentists are asked to minimise new amalgam for children, in pregnancy and while breastfeeding, and for anyone with kidney disease (ADA Policy 6.18, 2026).
Why are fewer dentists placing amalgam now?
The Minamata Convention on Mercury is an environmental treaty. In November 2025 its members agreed that 2034 will be the date after which making, importing and exporting dental amalgam stops. Use stays allowed where a dentist judges it necessary (ADA Policy 6.18, 2026; Australian Government, Minamata Convention).
That’s about protecting the environment. It doesn’t change the ADA’s advice on sound fillings.
When does replacement make sense?
- The filling has cracked, worn or leaked, so food and bacteria are trapped (healthdirect, fillings).
- Decay has formed underneath, or the tooth itself has cracked.
- A confirmed allergy to amalgam, or to a part of it, makes replacement reasonable (ADA Policy 6.18, 2026).
- You choose it after hearing the risks, benefits and alternatives (ADA Policy 6.18, 2026).
If none apply, keeping an eye on it is a sound choice. Replacing a filling means drilling, and that removes a little more healthy tooth.
How is one removed carefully?
Drilling out a filling releases vapour and particles. The precautions dentists use to limit exposure include a rubber dam to isolate the tooth, high-volume suction and water spray.
If you choose replacement, we explain the steps and the new material first. We can’t promise zero exposure. We can promise to tell you what we’re doing and why.
Composite can replace amalgam, though in back teeth it may need replacing sooner (Worthington et al., 2021). Read our guide to mercury-safe amalgam removal.
Sources
- Australian Dental Association. Policy Statement 6.18 – Safety of Dental Amalgam (amended April 2026)
- Spencer AJ. Dental amalgam and mercury in dentistry. Australian Dental Journal. 2000. PubMed 11225523
- Australian Government, Department of Climate Change, Energy, the Environment and Water. Minamata Convention on Mercury
- healthdirect (Australian Government). Dental fillings
- Worthington HV, et al. Direct composite resin fillings versus amalgam fillings for permanent posterior teeth. Cochrane Database of Systematic Reviews. 2021. PubMed 34387873
Where To Read Next
Want more on this topic? This page goes further, and it lists questions to bring to your visit.
Mercury-Safe Amalgam Removal Guide