It should come as no surprise to any dentist that poor mercury hygiene can lead to serious neurological problems. The literature has many articles describing the hazards of mercury to dental personnel.1,2 Fortunately, due to the educational efforts of the ADA and the technological advance of precapsulated amalgam, the level of mercury that dentists are exposed to has dropped sharply and continues to be reduced.2,3
My article dealt only with the false allegations of mercury toxicity, not with the physical properties of amalgam fillings. But the research does not support those who claim that amalgam is an inferior filling material. Letzel and colleagues4 showed that amalgam fillings can provide satisfactory performance for more than 12 years. This is true even for large fillings that replace a significant amount of tooth structure.5
My 30 years of clinical practice is also the opposite of Dr. Trester’s experience. I often see 20- and 30-year-old amalgams in excellent condition and hardly ever see decay or fractures under those fillings that I have to remove in order to make a crown or a fixed bridge.
Should we ignore the scientific evidence we don’t like and adopt "clinical experience" or an "artistic" interpretation to diagnose and treat our patients? I certainly hope not. As health care professionals, we must be able to see the weakness of testimonials and anecdotes and adopt an evidence-based analysis of the subject, not solely trusting our feelings or desires.
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