Subject : Removal

It is difficult to say what has gone on here without actually seeing you. Rest assured that despite the controversy over amalgam, it will not effect your gums and bones in the manner you describe.
Any accumulation of detritus in the mouth is a potential problem. If you have had a gap around a bridge which you have not been able to keep clean, you could well experience consequential and difficult problems with the supporting teeth. Wherever possible as dentists, we try to eliminate potential stagnation areas.

To get any more specific advice you would need to be seen by the person giving the second opinion.

Hello and thanks for your question. To be recklessly honest, we can't be 100% sure about amalgam, but all  the research shows that for the  overwhelming majority of people, amalgam fillings are not a health risk. That  said, mercury vapour can be released when old amalgam fillings are removed. To  minimise exposure to mercury vapour you should ask your dentist to use plenty of  water
coolant, high volume suction and to isolate the tooth with a rubber dam.  You would also do well to wear protective glasses as mercury vapour may. be absorbed through the cornea of the eyes. For patients who are especially  concerned about mercury vapour toxicity we also provide oxygen via a nose mask,  but this
is probably overkill. People other than dentists are probably better 
qualified to give advise on purging mercury  from the rest of your body. 
 

The current evidence regarding mercury leakage from amalgam fillings is that this is only a tiny and insignificant factor for patients and that there is no health risk associated with them.  Although patients with a lot of large amalgams or those that grind their teeth will have more leakage than someone with only one or two small fillings it is most important to keep a perspective on things. 

To give an example if you eat fish more than once a week you will ingest far more mercury from this source than from your fillings and I don't know of any health warnings on fish.!!

Additionally, white fillings have plenty of toxic chemicals in as well (surprisingly the manufacturers and alternative health specialists fail to point this out to anyone!) but again the levels are insignificant and all the research shows that it is not worth worrying about.

All my composite fillings are placed under rubber dam which acts as a physical barrier to the amalgam, which is removed from the tooth,  from being ingested. Although a fine aerosol is created, high volume suction systems will cope with this, leaving the patient exposed to little or no mercury during the removal process.

This is a question that occurs constantly and indeed is one that will continue to occur until metal amalgam fillings that contain mercury are considered inappropriate for whatever reason. As ever, there is no concrete evidence that mercury amalgam fillings are unsafe from a medical health perspective, although there is good evidence that mercury amalgam fillings can create a reaction on the gum (in certain individuals) which is usually inflammatory in nature. Common sense would dictate that the dental profession would have a high rate of the symptoms that are put down to amalgam fillings if there is a genuine link with ill health and this has never been demonstrated.

Therefore replacement of old metal fillings on health grounds 'alone' are not indicated and one must consider the replacement material and the potential problems associated with these prior to considering the means of filling removal.

1. Tooth coloured composite materials of resin with a glass filler are good aesthetically and have reasonable strength and wear characteristics, however they leak monomer initially which is a proven carcinogen in laboratory conditions and they tend to flex and fail relatively quickly in large cavities.

2. Gold is inert and has excellent properties in the mouth but is unaesthetic and costly.

3. Porcelain is inert, aesthetic and has good strength when compressed, however it is brittle and can fracture and also requires the tooth to be cut down alot to create space for the new filling, it is also as expensive or more so than gold alone.

Removal of old fillings should ideally be carried out with a barrier technique called rubber dam to ensure the waste  material is sucked away rather than being swallowed to make the process as pleasant as possible for the patient. Swallowing  or inhaling the aerosol from the dental drill water supply has been shown to transitorily raise the levels of mercury in the urine when several fillings are removed but no longlasting effect has been demonstrated.

As you can tell from my answer, this is a subject that has been exhaustively investigated with no real negative outcome given for metal amalgam fillings, however they are very unaesthetic and if this bothers you, have them replaced with the most appropriate material. As an experienced and reasonably well qualified dentist, I would be personally sorry to see the demise of amalgam fillings as they have excellent strength and longevity and are an excellent base for crowns and bridges.
So I would be a little wary of the dental health professional or 'alternative' or 'complementary therapist' who suggests it is a good idea for your general well being and health to remove a mouthful of servicible metal fillings.