Should you get your mercury amalgam fillings removed, and who should?

If you have silver fillings, it’s natural to wonder whether the mercury in them means they should come out. A filling in good condition usually can stay, while damage, decay beneath it or a medical reason may change that, and some people should avoid getting new amalgam fillings. Choosing a material for a new filling is a different decision from removing one that is already doing its job. 

What you will learn in this article: 

• A healthy amalgam filling usually does not need removal just because it contains mercury. 

• Damage, decay or a medically necessary reason may change that decision. 

• Some people should avoid new amalgam fillings when possible and appropriate. 

• Removal has trade-offs, including temporary mercury exposure and loss of tooth structure. 

Want to know whether your fillings need attention? Schedule an appointment with an Aspen Dental provider for an exam and a discussion of your options. 

What are mercury amalgam fillings? 

Often called silver fillings because of their color, dental amalgam combines mercury with metals such as silver, tin and copper. Mercury helps bind the mixture into a solid material that can withstand chewing. These fillings can release small amounts of mercury vapor, including during chewing. Research supports their safety for most people.¹ 

That does not mean every person or every tooth has the same needs. Your dental provider considers your health history along with the condition of your teeth. 

Should you remove an amalgam filling that is in good condition? 

No, not when the filling is sound. The U.S. Food and Drug Administration (FDA) does not recommend removing a filling that is in good condition with no decay beneath it, unless a healthcare professional considers removal medically necessary. Taking out an intact filling can sacrifice healthy tooth structure and temporarily increase exposure to mercury vapor.² 

Your provider needs to weigh a reason to replace it against the effects of the procedure itself. 

Ask what the exam shows before deciding. Is there a problem with the filling, the surrounding tooth or the tissue nearby? Or is the concern simply that the material contains mercury? Those questions lead to different conversations about treatment. 

When might an amalgam filling need replacing? 

There are reasons an old filling may need attention that have nothing to do with a general concern about mercury. The FDA ties its removal guidance to the filling’s condition and to whether there is decay beneath it, so what your exam shows matters.² Ask your provider to explain what they found and what restoration they recommend. A problem with one filling does not automatically mean all your silver fillings need replacing. 

A known allergy or sensitivity to mercury or other amalgam components can also affect the decision. The FDA advises people with a sensitivity or allergy to discuss removal and replacement with their dentist or physician.² Tell your provider about a previous reaction to dental materials and any testing you’ve had. They can assess whether the filling is involved and whether removal is medically necessary. 

Who should discuss alternatives to new amalgam fillings? 

The FDA recommends that people in certain groups avoid new amalgam fillings if possible and appropriate.² Those groups include: 

• People who are pregnant or planning pregnancy 

• People who are nursing 

• Children, especially those younger than six 

• People with neurological impairment 

• People with impaired kidney function 

• People with known sensitivity or allergy to mercury or other amalgam components 

These groups may be more susceptible to mercury's effects, and evidence about their risks is limited. This recommendation does not mean their intact fillings should be removed to prevent disease. Removal still requires an individual assessment of medical necessity.² 

Share relevant health changes before new dental work. If you're unsure whether a condition affects your options, ask your dental provider and physician to discuss it with you. 

What should you know before amalgam filling removal? 

Before treatment, ask why removal is recommended and what will replace the filling. You should understand the expected benefit, the alternatives and the cost before deciding. 

Guidance summarized by the American Dental Association recommends high-volume suction when amalgam is removed or polished, and suction with water spray when it is ground. A dental dam may also be used, but evidence that it reduces mercury exposure is limited.³ None of these measures makes unnecessary removal beneficial. 

The replacement choice also deserves attention. Appearance, durability, placement conditions and cost can all influence which material fits your needs. Ask how the proposed option suits that particular tooth, rather than assuming one material is best for every filling. 

Talk with your local dental provider about checking your existing fillings and reviewing any health concerns before you decide on replacement. 

Should you get your mercury amalgam fillings removed, and who should? FAQs 

Will removing silver fillings improve fatigue or headaches? 

Not necessarily. The FDA says a direct link between mercury from amalgam and harmful health effects has not been established, and it advises against removing intact fillings to prevent a disease or health condition unless a healthcare professional considers it medically necessary.² Fatigue and headaches have many possible causes, so discuss persistent symptoms with your physician rather than assuming removal will resolve them. Bring your concerns to your dental provider too, so any proposed treatment has a clear reason and realistic expectations. 

Does a recommendation to reduce amalgam use mean my fillings are unsafe? 

Not by itself. Efforts to reduce amalgam use aim to protect both human health and the environment, and the National Institute of Dental and Craniofacial Research says current evidence does not show that mercury exposure from dental amalgam is harmful to health.¹ In July 2026, the U.S. Department of Health and Human Services announced that the Centers for Medicare and Medicaid Services had urged state Medicaid programs to phase out coverage of mercury-containing fillings.⁴ Policy on future use is a different question from whether an existing filling needs removal, which depends on the filling’s condition and your health history. 

Can I request tooth-colored material when a filling needs replacement? 

Yes, you can discuss that preference before treatment. Tooth-colored options such as composite resin and glass ionomer are commonly used, though they may not last as long as amalgam in back teeth, where biting forces are high.² Ask which option suits that tooth and whether your plan covers it. A preference for a different appearance does not by itself establish a medical need for removal. 

Sources 

¹ National Institute of Dental and Craniofacial Research: “Ask the Expert: What Do I Need to Know About Silver Fillings?” https://www.nidcr.nih.gov/health-info/dental-fillings/ask-expert-what-do-i-need-know-about-silver-fillings 

² U.S. Food and Drug Administration: “Information for Patients About Dental Amalgam Fillings.” https://www.fda.gov/medical-devices/dental-amalgam-fillings/information-patients-about-dental-amalgam-fillings 

³ American Dental Association: “Amalgam.” https://www.ada.org/resources/ada-library/oral-health-topics/amalgam 
 
⁴ U.S. Department of Health and Human Services: “Trump Administration Encourages States to End Mercury-Containing Dental Fillings.” https://www.hhs.gov/press-room/trump-administration-encourages-states-end-mercury-containing-dental-fillings.html