Many have come to believe that mercury amalgam (silver) fillings are toxic and plan to remove them as soon as possible. What may surprise you is that, from a dentist’s point of view, there are other reasons to remove those old, metal fillings.

HT:  From a dentist’s point of view, why do you want your metal fillings out?

Carey:  Your tooth is a piece of living tissue; it bends a little bit and flexes as you chew.   The metal filling does not move, it remains in the tooth as a solid block of metal, and over time that damages the tooth. 

Metal fillings are easier to place, they are long lasting and they are cheaper.  Because of this they are still widely used.  But over time those fillings, especially the larger ones, start to weaken the teeth. It’s very common to see cracks and fractures under old silver fillings. Those cracks can eventually weaken a tooth until it breaks. 

I see this often in my practice.  People come to me with old amalgam fillings, probably from when they were teenagers. Their teeth will start breaking and then they’ll need a crown or cap.  So you don’t want a metal filling to get too old because it usually means that it’s weakening the tooth.  That’s how people end up with caps and root canals. Certainly after 20 years, you can expect that there will be some damage to the tooth.

HT:  Metal doesn’t hold up too well over time when it’s in a wet environment, right?  It‘s going to corrode.

Carey:  You are chewing all the time.  Silver amalgam fillings usually look corroded when they come out.  Older ones look dark and the edges look rough; you also get some leakage. So they do wear and tarnish.  Another thing that happens is that they will stain the tooth underneath them. When I take out old metal fillings, the tooth under them is often stained dark and sometimes black from the metal leaking out of the filling and being absorbed into the tooth.

HT:  A lot of dentists who are not holistic will remove mercury fillings if you ask them, right?

Carey:  Sure.

HT:  Whether they believe in holistic dentistry or not, they will remove the fillings because they want the job.  As a patient, why shouldn’t I go to an average dentist to have the filling removed?

Carey:  You could. People do that a lot.  What we do is a bit different…we take certain precautions because we believe in them as a routine practice.  The Hippocratic oath says “First do no harm.”  To me this is common sense. One of the basic things we do is use a rubber dam. This isolates the teeth and prevents the metal, including mercury, from being released into your mouth. And we always protect the nose from anything that is airborne.  Particularly when the filling is drilled out, some of it gets into the air.

HT:  You can breathe it in.

Carey:  Yes.  The lungs are very efficient, so we want to protect them.  We protect your eyes too… we give you sunglasses.  We also have a big filtration unit that comes close to where the work is being done.  It sucks the air away and filters it. I like that precaution because it protects the whole room.  We have other filters in the room as well, and access to fresh air ventilation, something rarely found in San Diego dental offices.

HT:  How do you dispose of the mercury when it’s out?  Is that different from any other dentist’s office?

Carey:  What we do that’s different is filter metal out of the water lines before any metal, including mercury, leaves the office. Most offices collect big chunks and small fragments or particles of amalgam. The added filtration unit I have installed removes practically all the metal, including the dust, produced when the fillings are removed.  The water that leaves our office doesn’t contain any metal waste.  It’s an environmental issue that I believe in, a green issue. I don’t want to be releasing extra metal out there, especially mercury. 

HT:  People don’t usually think about the mercury that comes out of their mouth.  I don’t think of how they dispose of anything when I leave the dental office. 

Carey:  Environmentally, mercury is a pretty big issue.  There are so many dental offices across the country that over time it all adds up.  That’s why some communities and some states are putting environmental controls on the use of metals in dentistry and health. 

HT:  I’ve heard some statistics about how dentists’ offices put a lot of mercury into the environment.

Carey:  We are pretty high up there as an industry.  I read somewhere that about 14% of all the metals in the ocean comes from dentistry. It’s reported that over 100 million amalgam fillings are placed and removed every year in the U.S. alone. We are talking about a few tons of mercury, not just a few hundred pounds.

HT:  So, as a holistic dental office, you want to keep metals out of the environment…. 
I read an interview where you talk about the body being considered an ‘environment’ as well.  Now, if someone is on a detox program with high levels of metal in their blood and the doctor says the dental metals have to be removed first, that’s where you come in? 

Carey:  Yes.  Blood and urine tests can measure the metal levels in the body. I recommend that this kind of testing and treatment always be supervised by a trained health practitioner. We often refer patients who are interested in this kind of work. Whether it’s done with nutritional products or as chelation therapy using I.V.’s,  a binding agent will be used to eliminate heavy metals such as mercury from the body.  However most M.D.’s who specialize in this kind of work won’t start while there are still metal fillings in the teeth. They usually want them removed. 

Contact Dr. O’Rielly at his practice in Encinitas,