Short answer: yes — with the right precautions, removing an old silver (mercury amalgam) filling is a routine, safe procedure, and protective steps measurably cut the mercury you’re exposed to. But “can be removed safely” isn’t the same as “should be removed”: the FDA advises against taking out a healthy, intact filling just to prevent illness.
And no, mercury fillings aren’t banned in the U.S. — yet. The European Union stopped using them on January 1, 2025, and in November 2025 the countries in the Minamata Convention agreed to end dental amalgam worldwide by 2034. Our office is 100% mercury-free, so patients ask me about this constantly. Here’s the honest version.
Dr. B’s quick take
- Cracked, leaking or decayed silver filling? Replace it, with protective steps. That’s not elective — the tooth needs it.
- Intact filling, no decay? The FDA doesn’t recommend removal for prevention. We talk it through tooth by tooth, no pressure either way.
- Pregnant or nursing? I postpone elective removal until later, because removal itself briefly raises mercury vapor exposure.
What’s actually in a silver filling
Dental amalgam is about 50% mercury by weight, mixed with silver, tin and copper (FDA). Once it’s set, a filling releases small amounts of mercury vapor, and more when it’s ground, drilled or polished. That last part is the whole reason removal technique matters.
The FDA’s 2020 recommendations say removing an amalgam filling “potentially exposes you to a temporary increase in mercury vapor” (FDA, 2020). Temporary is the key word — and how big that spike gets depends a lot on how the dentist works.
What the research says about safe removal
One of the clearest studies here is small but well designed. Swedish researchers removed all the amalgam fillings from 28 people in a single session — 18 with a rubber dam (a thin sheet that isolates the teeth) and 10 without — using water cooling and high-volume suction in both groups (Berglund and Molin, Dental Materials, 1997).
- Without a rubber dam, mercury in blood plasma and urine rose significantly after removal.
- With a rubber dam, there was no significant rise, and the plasma peak the next day was significantly lower than in the no-dam group.
- One year later, both groups had mercury levels well below where they started: on average 52% lower in plasma and 76% lower in urine.
Two honest caveats: it’s 28 people, and lower mercury levels aren’t the same thing as a health benefit — the study didn’t test that. But it shows exactly what I’d expect: removal causes a short-term exposure, isolation shrinks it, and once the amalgam is gone, the body’s mercury levels drop.
How we remove old silver fillings at All Smiles
- Evaluate first. We examine each filling and take X-rays. Not every silver filling needs to come out right away.
- Isolate the tooth. The tooth is isolated so particles and vapor stay away from the rest of your mouth.
- High-volume suction, running the whole time. It pulls vapor and particles away at the source.
- Section it out — don’t grind it down. We cut the filling into chunks and lift them out, with plenty of water cooling, instead of drilling the whole thing into dust. Less heat and less grinding mean less vapor.
- Clean up thoroughly, then rebuild the tooth with bonded tooth-colored composite or a ceramic restoration matched to your shade.
You may also hear about the SMART protocol (Safe Mercury Amalgam Removal Technique) from the IAOMT, a group of mercury-free dentists, which adds steps like external air for the patient and full coverings (IAOMT). Whatever office you choose, ask exactly which steps they use. A good dentist will happily walk you through it.
Behind the scenes, there’s an environmental piece too: since a 2017 EPA rule, U.S. dental offices that place or remove amalgam must run an amalgam separator so mercury doesn’t go down the drain (EPA).
Should your silver fillings come out?
Here’s where I differ from offices that recommend pulling out every silver filling on day one. The FDA says intact fillings “should not be removed for the purpose of preventing any disease” unless a health professional considers it medically necessary (FDA). Every removal also takes a little healthy tooth with it. So I sort fillings by what the tooth needs:
| Your situation | What I usually recommend |
|---|---|
| Filling is cracked, leaking or has decay under it | Replace it — the tooth needs treatment either way |
| Tooth is cracked or a cusp has broken off | Replace with an onlay or crown that protects the tooth |
| Filling is intact, no decay, no symptoms | Monitor; elective replacement only after we talk through trade-offs |
| Pregnant, planning pregnancy or nursing | Postpone elective removal; treat true problems with protective steps |
| Known mercury allergy, kidney or neurological condition | Coordinate with your physician; no new amalgam (FDA high-risk group) |
The FDA’s higher-risk list — people it recommends avoid new amalgam when possible — includes pregnant women and those planning pregnancy, nursing mothers, young children, people with a mercury allergy, and people with neurological impairment or kidney dysfunction (FDA, 2020).
When were mercury fillings banned?
Short version: in the European Union, January 1, 2025. Worldwide, the end date is 2034. In the United States, there’s no federal ban as I write this in October 2026. Here’s the timeline:
| Date | What happened |
|---|---|
| June 2017 | EPA requires U.S. dental offices that place or remove amalgam to capture it with amalgam separators (EPA) |
| July 1, 2018 | EU stops amalgam for baby teeth, children under 15, and pregnant or breastfeeding women, except when strictly necessary (EU Regulation 2017/852) |
| September 24, 2020 | FDA recommends higher-risk groups avoid new amalgam when possible, and advises against removing intact fillings for prevention (FDA) |
| January 1, 2025 | EU bans dental amalgam for all patients, except when strictly necessary for a patient’s specific medical needs; exports banned too (European Parliament summary, Regulation 2024/1849) |
| November 7, 2025 | Minamata Convention parties agree in Geneva to phase out dental amalgam worldwide by 2034 (UN Environment Programme) |
| February 9, 2026 | U.S. Indian Health Service announces it will stop using amalgam in its facilities by 2027 (ADA News) |
The American Dental Association still supports amalgam use “based on the clinical judgment of the dentist” and says no properly designed study has shown long-term health effects (ADA News, 2026; ADA statement). Amalgam is cheap, durable and forgiving to place, which is why it lasted so long. The shift away from it is driven by environmental mercury, patient preference and better tooth-colored materials.
If it were my tooth
If I had a cracked or decayed silver filling, I’d replace it now, with isolation, suction and sectioning — no question. If I had a solid, decades-old filling with no decay, I’d leave it alone for the moment, check it every visit, and replace it when it starts to fail or when I’m doing other work on that tooth anyway. And I’d never let anyone talk me into replacing every filling in one rushed visit out of fear.
What I would do is make sure no new mercury goes in. That’s the easy part — we don’t place amalgam fillings at all.
Cost and insurance
When a silver filling is broken or decayed, replacing it is usually covered like any other filling, crown or onlay. Some plans pay only the amalgam rate for back teeth, so if there’s a difference for tooth-colored material, we tell you up front. Replacing an intact filling purely by choice is often not covered. We accept every Medicare Advantage plan and any PPO, and we verify your benefits before treatment.
Want the full picture of how we work? See our holistic and mercury-free dentistry page, our family dentistry page and crowns and onlays. We’re on West Dixie Highway in North Miami, a short drive from Miami Shores, Biscayne Park and North Miami Beach.
Questions patients ask me
How do I know if I have mercury fillings?
If a filling looks silver or dark gray, it’s almost certainly amalgam. They also show up bright white on dental X-rays. At your exam we’ll map every filling and tell you which ones are failing.
Should I remove all my mercury fillings at once?
I don’t. We start with the fillings that are broken or decayed, and plan the rest by need. Spreading the work out also lets us take our time with isolation and suction on each tooth.
Do I need a detox after amalgam removal?
I don’t sell detox programs, and I’d be cautious about products that promise to pull mercury out of your body. If you have health concerns about mercury exposure, talk with your physician, who can order the right tests.
Are mercury fillings banned in Florida?
No. As of October 2026 there’s no federal or Florida ban on dental amalgam. Each dentist decides what to place — and we’ve chosen mercury-free materials only.
Are tooth-colored fillings as strong as silver ones?
Modern composites hold up well for small and medium fillings. For a large filling or a cracked tooth, a ceramic onlay or crown often lasts longer and protects the tooth better. We’ll tell you which fits.
Is it safe to remove fillings while pregnant?
If a filling is broken or decayed and causing problems, we treat it with protective steps. Elective replacement of healthy fillings, I postpone until after pregnancy and nursing, since removal briefly increases mercury vapor exposure.
Sources
- U.S. FDA — Information for patients about dental amalgam fillings (recommendations of September 24, 2020)
- Berglund A, Molin M. Mercury levels in plasma and urine after removal of all amalgam restorations: the effect of using rubber dams. Dent Mater, 1997
- IAOMT — Safe Mercury Amalgam Removal Technique (SMART)
- U.S. EPA — Dental effluent guidelines (amalgam separator rule, 2017)
- Dental Council of Ireland — Code of practice on dental amalgam (summarizes EU Regulations 2017/852 and 2024/1849)
- European Parliament — Summary of Regulation (EU) 2024/1849 on dental amalgam
- UN Environment Programme — Minamata Convention COP-6 agrees to end use of dental amalgam by 2034 (November 2025)
- ADA News — Indian Health Service to end dental amalgam use by 2027 (February 2026)
- American Dental Association — Statement on use of dental amalgam in the U.S.
This article is general information, not medical advice. Decisions about removing fillings should be made with your dentist, and with your physician if you have a medical condition.