Holistic Dentistry · Patient Guide
Mercury-Free Dentistry in London: What Holistic Patients Should Know
More patients in London are asking about mercury-free dentistry — and for good reason. Dental amalgam has been used for over 150 years, but it contains approximately 50% mercury by weight, and concerns about mercury vapour, environmental impact and the availability of better-looking alternatives have led to a global shift away from its use. Understanding what mercury-free dentistry actually means, what the evidence says and what the options are helps patients make informed decisions about their dental care.
This guide explains what mercury-free dentistry involves, the current evidence on amalgam safety, the alternatives available, how safe amalgam removal works and what holistic dental care means in practice at DentAkademi London.
Mercury-free dentistry means no amalgam fillings are placed or used in treatment — with tooth-coloured, biocompatible materials chosen instead. It also typically includes the option to safely remove existing amalgam fillings using protective protocols designed to minimise mercury vapour exposure during the process.
What Is Amalgam and Why Are Patients Concerned?
Dental amalgam is a mixture of metals including silver, tin, copper and approximately 50% mercury. It has been used as a filling material since the 19th century because it is durable, easy to place and relatively inexpensive. For decades it was considered the standard of care for back tooth restorations. Concerns about amalgam centre on the mercury it contains. Mercury is a known neurotoxin, and amalgam fillings release small amounts of mercury vapour — particularly during chewing, grinding and especially during placement and removal. The question is not whether any mercury is released, but whether the amounts involved pose a meaningful health risk. On this, the evidence is more nuanced than either dismissive reassurance or alarmist warnings would suggest.What Does the Evidence Say About Amalgam Safety?
The official position of bodies including the NHS, the World Health Organisation and the European Commission is that dental amalgam is safe for most patients in the general population. Large-scale studies have not found a clear link between amalgam fillings and systemic illness in healthy adults. Patients with intact amalgam fillings are exposed to mercury vapour levels that remain below thresholds associated with harm in occupational settings. However, the regulatory picture is changing. The European Union has phased out amalgam use in children under 15, pregnant women and breastfeeding mothers, and has been working towards a broader phase-out. The environmental impact of mercury — from dental waste entering water systems — is a well-established concern that has driven policy change independently of toxicity debates. Many patients choose mercury-free dentistry not because they believe their current fillings are harming them, but because they prefer not to have mercury in their body when biocompatible alternatives exist.Amalgam Alternatives: Composite Fillings
The most widely used alternative to amalgam is composite resin — a tooth-coloured material bonded directly to the tooth surface. Composite is mercury-free, aesthetically natural and does not require the same degree of tooth preparation as amalgam, which often necessitates removing more healthy tooth structure to create the right shape for the filling. At DentAkademi London, composite fillings are available from £250 per tooth. The cost depends on the size of the filling and the number of surfaces involved. Composite has a shorter track record than amalgam — typically lasting seven to ten years before it may need repair or replacement — but advances in bonding agents and composite materials have significantly improved longevity in recent years.Other Biocompatible Restoration Options
- Ceramic inlays and onlays — laboratory-made restorations for larger cavities, highly durable and biocompatible
- Zirconia crowns — metal-free, high-strength crowns for teeth requiring full coverage
- E-max (lithium disilicate) — premium ceramic for crowns and veneers, strong and natural-looking
- Composite bonding — tooth-coloured resin for cosmetic and restorative work, metal-free
Safe Amalgam Removal: What It Involves
For patients who already have amalgam fillings and want them replaced with composite or ceramic, safe removal is an important consideration. Removing amalgam generates mercury vapour — more than is released by an intact filling in normal use. Simply drilling out an old amalgam filling without protective measures increases the patient’s short-term mercury exposure. At DentAkademi London, amalgam removal is carried out with appropriate protective protocols to minimise exposure during the procedure. These typically include isolating the tooth with a rubber dam, using high-volume suction close to the tooth, sectioning the amalgam into larger chunks rather than grinding it continuously, and providing adequate ventilation. These measures do not eliminate all mercury vapour but substantially reduce the amount released into the oral cavity during removal.The SMART Protocol
SMART — Safe Mercury Amalgam Removal Technique — is a specific set of protocols developed to minimise patient and practitioner exposure during amalgam removal. Key elements include: rubber dam isolation, high-volume evacuation, cutting the amalgam into large sections rather than grinding, providing the patient with alternative air or oxygen to avoid inhaling any released vapour, and appropriate protective equipment for the clinical team. Patients who are particularly concerned about amalgam removal should ask specifically whether SMART or equivalent protocols are followed.Should You Have Your Amalgam Fillings Removed?
This is one of the most frequently asked questions in holistic dentistry, and the honest answer is: it depends. Amalgam fillings that are intact, well-sealed and not causing clinical problems do not need to be routinely removed. The process of removing them — even with protective protocols — involves a short-term mercury exposure greater than simply leaving them in place. If your amalgam fillings are old, cracked, leaking or failing and need replacing for clinical reasons, choosing a mercury-free replacement at that point makes sense and avoids any additional exposure from unnecessary removal. If your fillings are clinically sound, the decision to remove them proactively is a personal one — and should be based on a clinical assessment and an honest conversation about the balance of risk and benefit, not on anxiety or pressure from a clinic that profits from doing the work.Holistic Dentistry at DentAkademi London
Mercury-free dentistry is one part of the broader holistic approach to dental care at DentAkademi London. Holistic dentistry considers the relationship between oral health and overall wellbeing — including the materials used in treatment, the minimally invasive approach to preserving natural tooth structure, and the connection between dental health and systemic health. DentAkademi London uses tooth-coloured, biocompatible restorative materials as the default — composite, ceramic and zirconia rather than amalgam and metal alloys. This approach reflects both patient preference and current best practice in restorative and cosmetic dentistry.Patients should be cautious of clinics that promote aggressive, unnecessary amalgam removal without a clinical reason — particularly those that create anxiety about existing fillings to generate revenue from replacement work. Intact amalgam fillings in otherwise healthy mouths do not need to be urgently removed. Any clinic recommending removal of all your amalgam fillings without individual clinical assessment of each one should be approached with scepticism.
Frequently Asked Questions
What is mercury-free dentistry?
Mercury-free dentistry uses no amalgam fillings — choosing composite resin, ceramic or zirconia instead. It also includes the option to remove existing amalgam safely using protective protocols that minimise mercury vapour exposure during removal.Are amalgam fillings dangerous?
The scientific consensus is that amalgam is safe for most patients in the general population. However, concerns about mercury vapour and environmental impact have led to regulatory restrictions and a global shift toward mercury-free alternatives. Many patients prefer to avoid amalgam as a precautionary measure.What are the alternatives to amalgam fillings?
Composite resin is the most widely used alternative — tooth-coloured, mercury-free and available from £250 per tooth at DentAkademi London. Larger restorations may use ceramic inlays, zirconia crowns or E-max porcelain.Is it safe to have amalgam fillings removed?
Removing amalgam releases mercury vapour. Using protective protocols — rubber dam, high-volume suction, sectioning rather than grinding — substantially reduces exposure. At DentAkademi London, amalgam removal is carried out with appropriate precautions.What is the SMART protocol?
SMART (Safe Mercury Amalgam Removal Technique) involves rubber dam isolation, high-volume suction, sectioning the filling into chunks, providing alternative air for the patient and appropriate protective equipment — to minimise mercury vapour during removal.How much do composite fillings cost in London?
At DentAkademi London, composite fillings start from £250 per tooth. The cost depends on the size and complexity of the restoration.Should I have my amalgam fillings removed?
Intact amalgam fillings that are clinically sound do not need to be routinely removed. If fillings are failing or need replacing for clinical reasons, a mercury-free alternative is a sensible choice at that point. Any decision to remove intact fillings should be based on clinical assessment, not anxiety.What are biocompatible dental materials?
Biocompatible materials are designed to be compatible with body tissues — composite resin, ceramic, zirconia and titanium are all examples. Mercury-free dentistry uses these materials in place of amalgam and metal alloys.Is holistic dentistry the same as mercury-free dentistry?
Mercury-free is one aspect of holistic dentistry. Holistic dentistry more broadly considers the connection between oral and overall health, minimally invasive treatment, biocompatible materials and preventive care — not just the absence of amalgam.What is the first step for mercury-free treatment at DentAkademi London?
Book a consultation at £50 with Phung Mai Hien. This includes a clinical assessment of existing restorations, a discussion about your priorities and a written treatment plan — with no obligation to proceed.