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Background

Dental amalgam is a dental filling material used to fill cavities caused by tooth decay. It has been used for more than 150 years in hundreds of millions of patients.

Dental amalgam is a mixture of metals, consisting of liquid mercury and a powdered alloy composed of silver, tin, and copper. Approximately 50% of dental amalgam is elemental mercury by weight.

Dental amalgam fillings are also known as "silver fillings” because of their silver-like appearance.

When placing dental amalgam, the dentist first drills the tooth to remove the decay and then shapes the tooth cavity for placement of the amalgam filling. Next, under appropriate safety conditions, the dentist mixes the powdered alloy with the liquid mercury to form an amalgam putty. (These components are provided to the dentist in a capsule as shown in the graphic.) This softened amalgam putty is placed in the prepared cavity, where it hardens into a solid filling. (Source: US FDA)To learn more about dental amlagam click here.

Dental amalgam is a product regulated by the US Food and Drug Administration (FDA). On July 28, 2009, FDA issued a final rule that: (1) reclassified mercury from a class I (least risk) device to class II (more risk) device; (2) classified dental amalgam as a class II device; and (3) designated a special controls guidance document for dental amalgam. Summary of Changes to the Classification of Dental Amalgam and Mercury provides more information regarding how the US FDA classifies dental amalgam.

FDA does not regulate the disposal of dental amalgam. The disposal of dental amalgam is regulated by the Environmental Protection Agency (EPA) and state and local authorities. In 2008, the EPA published a detailed study of dental amalgam.

On September 16, 2009, EPA published a final rule that limits emissions from medical waste incinerators. Mercury amalgam also accumulates on dental supplies, such as cotton swabs and gauze, and these materials are usually deposited in the regular trash. In local areas where trash is incinerated, the mercury in this trash can be released via air emissions. To avoid such mercury air emissions, dental offices should properly dispose of captured amalgam solid waste by sending it to a dental waste recycler.

The American Dental Association (ADA) has also issued best management practices for amalgam waste. The ADA Council on Scientific Affairs has also issued a statement on dental amalgam.

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