Dental Amalgam
Understanding dental amalgam, its composition, and current status.
Dental amalgam is a metallic restorative material composed of a mixture of mercury (approximately 50%) with a powder alloy containing silver, tin, copper, and sometimes zinc. It has been used in dentistry for over 150 years and remains one of the most durable and cost-effective filling materials, particularly for posterior teeth subjected to high chewing forces. Amalgam's advantages include excellent longevity (often lasting 15-20 years or more), superior strength in large cavities, self-sealing properties that reduce microleakage over time, and technique simplicity. It is less sensitive to moisture during placement compared to composite resins, making it suitable for challenging clinical situations. However, amalgam use has declined significantly due to aesthetic concerns (silver-gray color), environmental considerations related to mercury, and the advancement of tooth-colored alternatives. Several countries have restricted or phased out dental amalgam use due to environmental mercury concerns. The Minamata Convention on Mercury encourages a phasedown of dental amalgam. Modern dentistry increasingly favors composite resin, glass ionomer, and ceramic restorations as alternatives.