Most sound silver (amalgam) fillings can stay where they are. At Absolute Dental, we replace one if it has failed, if testing confirms an allergy, or if you still want it out after hearing the risks and benefits. If it does come out, we use extra steps to keep mercury vapour and particles low.
Updated . It explains the topic in general and can’t diagnose you.
What amalgam is
Liquid mercury bound with silver, tin and copper (WHO, 2024).
Australian position
Acceptable where clinically indicated. Sound fillings aren’t removed for vague symptoms unless you’re fully informed (ADA Policy 6.18, 2026).
Reasons to replace
Failure, a confirmed allergy, or your informed choice.
During removal
A rubber dam, strong suction and water spray.
Health fund
Fillings are often covered under extras. Check your limits.
Is it safe to leave amalgam fillings in?
For most people, yes. The Australian Dental Association’s position is that capsulated amalgam remains an acceptable filling material, and that the weight of evidence doesn’t link amalgam in the general population to chronic disease, autoimmune disease or vague symptoms such as tiredness (ADA Policy 6.18, 2026). A review in the Australian Dental Journal described amalgam’s mercury release as low-level, called the health evidence hard to interpret, and urged dentists to explain the evidence to patients and respect what they decide (Spencer, 2000).
For children, pregnancy, breastfeeding and kidney disease, the ADA advises placing less new amalgam (ADA Policy 6.18, 2026).
When does replacing a filling make sense?
Replacing an amalgam filling makes sense when there’s a clear reason, such as:
the filling has cracked, worn down or started leaking, or there’s decay underneath;
the tooth around it has cracked and needs more support;
an allergy to amalgam, or something in it, has been confirmed by testing;
you’ve heard the risks, benefits and alternatives, and you still prefer it out.
How is mercury exposure kept low during removal?
Mercury exposure during removal is kept low by controlling vapour and particles. Drilling out an amalgam filling can release both, so the method matters (Spencer, 2000). We use a rubber dam (a thin sheet that isolates the tooth), strong suction close to the tooth and a steady water spray to keep things cool. Taking the filling out in chunks, so less of it is ground down, is another common step. The ADA sets expectations for mercury hygiene and amalgam waste (ADA Policy 6.18, 2026), and publishes clinical handling guidance (ADA mercury and amalgam resources).
Before your visit, your dentist will explain the steps used for you and how many fillings it’s sensible to replace at once.
What replaces an old silver filling?
Most old silver fillings are replaced with tooth-coloured materials. Small and medium cavities usually get composite resin. Bigger repairs, or teeth that have been weakened, may suit a ceramic onlay or crown, sometimes made the same day with CEREC. Durability is part of the choice, because a composite filling in a back tooth tends not to last as long as the amalgam it replaces (Worthington et al., 2021). Each removal also takes a little healthy tooth with it and can irritate the nerve (ADA, teeth.org.au), so a replacement should have a reason you’re comfortable with.
Keep It Or Replace It?
This table sets out the usual advice in each situation. Your dentist will look at each filling on its own.
Situation
Usual advice
Why
Sound filling, no symptoms
Usually keep it
Replacing sound amalgam hasn’t been shown to improve general health (ADA Policy 6.18, 2026)
Not for most people, according to Australian guidance. The ADA accepts capsulated amalgam where it’s clinically indicated and says the evidence doesn’t tie it to long-term illness across the population (ADA Policy 6.18, 2026). A proven allergy or serious kidney disease changes the picture.
Amalgam is liquid mercury bound with silver, tin and copper (WHO, 2024). A review in the Australian Dental Journal described its mercury release as low-level, called the health evidence hard to interpret, and urged dentists to explain the evidence to patients and respect what they decide (Spencer, 2000).
For children, pregnancy, breastfeeding and kidney disease, the ADA advises placing less new amalgam. Most sound fillings can stay where they are. We’d suggest replacing one when it has failed, when a confirmed allergy calls for it, or when you still want it out after hearing the risks and benefits. If a filling worries you, ask us to look at it and explain what we see. You’re not being difficult by asking.
No. Australian guidance doesn’t support that view, and we don’t share it. The Australian Dental Association says the weight of evidence doesn’t link amalgam in the general population to chronic disease, autoimmune disease or vague symptoms such as tiredness (ADA Policy 6.18, 2026).
That doesn’t mean exposure doesn’t matter. Drilling out an amalgam filling releases mercury vapour and particles, which is why removal uses extra steps (Spencer, 2000), and why the ADA advises placing less new amalgam for children, in pregnancy and breastfeeding and in kidney disease. A review in the Australian Dental Journal called the health evidence hard to interpret and urged dentists to explain it and respect patients’ decisions.
If you feel unwell, see your GP. Persistent symptoms deserve a proper medical assessment, and swapping fillings isn’t a treatment for them. We won’t tell you your teeth are the cause of illness elsewhere in your body. Replacement makes sense when a filling has failed, when an allergy is confirmed, or when you choose it knowing the trade-offs. Ask us anything you’ve read, and we’ll go through it with the evidence in front of us. Our holistic dentistry overview sets out where we draw the line on claims like this.
Nobody can promise that. Taking out sound fillings hasn’t been shown to improve general health, and the ADA advises against it for vague symptoms unless you’ve been told the risks and benefits (ADA Policy 6.18, 2026). If you feel unwell, see your doctor as well.
Tiredness, aches and poor concentration have many causes, and a doctor can look for them. Each time a filling is replaced, a little healthy tooth goes with it, and the nerve can be irritated, so there should be a clear reason. What we can do is check each filling, tell you which are sound and which are failing, and explain what we find.
If you still want a sound filling out after hearing the risks, benefits and alternatives, that’s your decision, and we’ll do it with the extra steps described in our guide. We won’t suggest it as a treatment for tiredness or other illness, and we can’t promise you’ll feel different afterwards. Removing a sound filling isn’t urgent, so take the time you need and get a second opinion if you’d like one.
A rubber dam is a thin sheet that isolates the tooth. Strong suction close to the tooth takes away vapour and particles, and a steady water spray keeps things cool. Taking the filling out in chunks, so less of it is ground down, is another common step. The ADA sets expectations for mercury hygiene and amalgam waste (ADA Policy 6.18, 2026) and publishes clinical handling guidance (ADA mercury and amalgam resources).
No method makes exposure zero, and we won’t say it does. The steps keep it low. Before your visit, your dentist will explain the steps used for you and how many fillings it’s sensible to replace at once. Tell us if you’re pregnant or breastfeeding, have kidney disease, or if the patient is a child, because the ADA advises less new amalgam in those situations. A sound filling can wait while you decide.
Elective removal is usually put off. The ADA advises keeping amalgam use low during pregnancy and breastfeeding, and removal itself creates some exposure (ADA Policy 6.18, 2026). A broken or painful filling still needs care, so we’ll plan it with your doctor.
Tell your doctor or midwife about any dental problem, too. We don’t give general advice on pregnancy and medical treatment, and we’ll suggest your doctor for anything that sounds medical. Whatever you decide, you’ll hear the benefits, risks and alternatives first, and nothing goes ahead without your agreement. If you’re breastfeeding, the same ADA advice applies, so ask us about timing.
It depends on your policy, and we can’t promise a rebate. Fillings are often covered under extras, subject to your policy, annual limits and waiting periods. Funds can treat replacing a sound filling differently from repairing a failed one, so ask your fund before you decide.
Ask us for the item numbers and an estimate to check with your fund. Eligible claims can be made on the day through HICAPS with participating funds. For a sense of scale, CHOICE reported in March 2023 that an Australian Dental Association fee survey to 1 July 2022 gave an average of $220 for a two-surface back-tooth filling (item 532), with a range of $171 to $305. That is a national survey figure, not this clinic’s fee.
A replacement that needs an onlay or a crown costs more, and some items have separate fees. Medicare doesn’t cover most dental services. Ask what’s included in each quote and what you’ll have left to pay. A sound filling isn’t urgent, so you can take the quote away and think it over.
The guidance below supports the statements on this page. Each link was checked in October 2026. This is general information and can’t replace an assessment by a dentist or doctor who knows your health.
