Proponents argue that amalgam fillings are toxic, but they are not used as often as thought
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A group of dentists, dental hygienists and lobbyists petitioned the Rhode Island Medicaid office to ban coverage of dental amalgam fillings.
Proponents argue that dental amalgam exposes people to mercury, a neurotoxin that, depending on the level of exposure, can damage a person’s nervous system, kidneys and lungs.
“Now is the time for EOHHS to protect the public from mercury exposure in the Rhode Island Medicaid dental program,” says a petition filed by Consumers for Dental Choice, a Washington, DC-based advocacy group, and Last Green Valley Dental Consulting and Mentoring of Foster, Rhode Island, JanuaryS Secretary, RichardH, Charhoh, JanuaryS, RichardH, CharOHH.
Dental amalgam, an alloy consisting of about half a mixture of silver, copper, tin and zinc and half mercury, has been used by dentists since the 19th century (because of their silver color, amalgam fillings are sometimes ambiguously referred to as “silver” fillings). Mercury is a naturally occurring element and people are exposed to it from the air they breathe as well as from dietary sources such as fish.
Amalgam fillings are inexpensive, easy to apply and durable, making them an attractive alternative to more expensive composite resin dental fillings. But controversy over the use of amalgam fillings has been there since the beginningwith some raising concerns about the dangers of mercury vapor exposure, while others affirming its safety. Anti-amalgam advocates also argue that using the substance reinforces economic inequality, as it is a cheaper option and insurers may not cover more expensive ones.
Is dental amalgam harmful to you?
In 2019, the US Food and Drug Administration published a 186-page literature review on the health effects of dental amalgam. It found that there is some exposure to mercury from amalgam, particularly during import and export, but “no clearly increased risks of adverse systemic effects (eg, neurological, renal) in the general population or dental professionals.”
“Available evidence from studies from the US and other developed countries based on actual mercury measurements in large study populations reveals possible increases in mercury in biofluids due to either occupational (dental) or non-occupational exposure to dental amalgam. “Available reports of manifestations attributed to mercury, such as tremors or other neurological conditions, did not conclusively demonstrate that the results in question were caused by mercury from dental amalgam.”
The review noted that there are some limitations to the research – for example, whether mercury exposure came mainly from amalgam or diet – and called for more work to be done on the subject.
Still, the The FDA warns that certain populations – children under 6 years of age, pregnant women, nursing mothers, people with neurological damage or kidney dysfunction, and people with sensitivity to dental amalgam metals – may be at higher risk of adverse effects from mercury exposure.
Other countries have adopted a stricter approach to dental amalgam. The European Union has banned its use and export from 2025. In November, the United Nations Convention on Mercury – of which the United States is a member – banned the worldwide production and trade of dental amalgam starting in 2035.
How Common Are Amalgam Fillings in Rhode Island?
Amalgam fillings — at least those covered by Medicaid — are not as common in Rhode Island as advocates claim they are, but they are still placed in some children.
In 2025, Rhode Island’s Medicaid program spent $89,000 – or about 4% of its total spending on dental restorations – on dental amalgam fillings for children, according to data released by EOHHS.
Among adults, 29% of all Medicaid-covered fillings in Rhode Island were amalgam — though it’s unclear whether any of them were placed in pregnant women or other people designated as high-risk by the FDA.
