Dental news articles have reported a reduction in the use of amalgam for dental care by dentists over the past 20 years with new restorative techniques.

In the past, The Wealthy Dentist surveys have consistently shown dentists split on the topic of placing amalgam, with about half of dentists remaining loyal to placing amalgam fillings.

In our most recent survey the amalgam dental care trend holds steady with 58% of dentists responding that they still place amalgam.

“Amalgam is still a great restoration,” said one dentist, “and a good service for the patient.”

How frequently dentists place amalgam varies widely —

27% place multiple amalgams per day, or over 300 per year.
12% place about 10 amalgams per year.
8% place about 1 amalgam per day, or at least 200 per year.
6% place 1 amalgam per week, or 50 per year.
5% place 2 amalgams per week, or about 100 per year.

Here are some further dentist comments–

Support placing amalgam:

“It’s easier to work with amalgam versus composite on posterior teeth.” (Arizona dentist)

“A well-placed amalgam can be the difference for a patient who has financial concerns and cannot afford a casting or resin.” (Pennsylvania dentist)

“I offer it for patient’s finances and in difficult areas.” (South Carolina dentist)

“Amalgam is an efficient, cost effective, long lasting restoration if done correctly.” (Massachusetts dentist)

“I certainly place more composites and all-ceramic inlays and onlays when it is necessary. Amalgams are good restorations for non-visible/non-esthetic areas and when the restoration will be small. We allow the patient to decide amalgam or composite in that situation. Sometimes they tell us their financial situation dictates amalgam over composite.” (Ohio prosthodontist)

“I live in rural America and crowns are not financially feasible for many; so I shovel a lot of alloy!” (Wisconsin dentist)

“It’s the best restorative material to use in some instances.” (Tennessee dentist)

“The most inexpensive restorative material- coefficient of thermal expansion close to tooth structure is key to why it lasts so long compared to composite resin; ease of placement and manipulation is best of all direct restorative materials.” (Indiana dentist)

“They last and last and last!” (Texas dentist)

Against placing amalgam:

“Why would I place amalgams in people’s teeth when I can’t throw them down the drain. It seems that fish get more protection than humans.” (General dentist)

“My thoughts about all things that go into the body are: If there is a question about the safety of a product — don’t use it. I hear many questions about the safety of amalgams. There are other dental care products I can use until the questions are answered.” (Texas dentist)

“Amalgams cause the teeth to fracture.” (California dentist)

“I stopped altogether in 1995 when resins became usable as a replacement. Primary reason was I feared a potential class action type suit against any dentist using the material. Pretty pathetic but in this litigious society you have to CYA.” (New Jersey dentist)

“I wouldn’t put it in my dog! I can’t throw it in the garbage legally, but I can place it in your mouth?” (New York dentist)

“We have better materials. We don’t need to use a restorative that was developed in the 1890’s just because it’s easier and cheaper. If it were introduced as a new material today it would never make it or even be allowed. It just doesn’t make sense to use it. Yes, they mostly last “forever,” but at the expense of the tooth.” (General dentist)

“If the scraps are a danger to my assistant, how can I justify placing one in anybody’s mouth?” (California dentist)

“Interesting that the government has rules on the collection and disposal of amalgam as a hazardous waste from the dental suction system BUT feels there is no problem placing the material in someone’s mouth??? Go figure!” (Connecticut dentist)

“I don’t place them, and haven’t since the beginning of my career. However, it’s not because I think they are inferior or toxic. On the contrary, I believe amalgam is a great material. It’s just that composite is a great material when placed properly, AND it looks better.” (Texas dentist)

The ADA states that dental amalgam is a safe, affordable and durable material containing a mixture of metals such as silver, copper and tin, in addition to mercury, which binds these components into a hard, stable and safe substance for dental care.