Question

My new NHS dentist said he could only provide Amalgam fillings not white fillings unless I paid privately. Is this correct and are amalgam fillings safe?

Answer

“The patient’s previous dentist was probably doing white fillings for them as a goodwill gesture as white fillings take longer and are more technique sensitive. This can make them more expensive. A lot of dentists will do what the new dentist is looking to do, that is taking someone on as an NHS patient and effectively up-selling in order to do some private dentistry for them.

“Amalgam is a very old established material, having been used for around 200 years, and it is very effective and durable. Surprisingly, despite the fact it contains mercury, few people seem to come to any harm, although it is currently being phased out and shouldn’t be used on pregnant women or children. In some countries, it is already illegal, but mostly for environmental reasons rather than health. A small number of people are sensitive to it and can develop symptoms that are resolved once it is removed from their bodies/mouths, but for them, fillings have to be removed carefully as their removal increases the risk of exposure.

“I personally hardly ever use it, even on the NHS, whatever the medical history of the patient. There are still situations where I feel it can be the only way to save a tooth. So I would generally do white fillings whether the patient has ME/CFS or not. I would advise an ME/CFS patient to have white fillings, but I’m not sure there is a good evidence base to justify the decision.”

Dr Richard Cantillon, Hon. Dental Adviser, ME Association.

See also: Dental: Pain, Dental: Anaesthetics.

More information

• Dental Care – Your Questions Answered
  We help address common questions about maintaining dental hygiene while ill with ME/CFS. We also consider how to best manage mouth ulcers, anaesthetic sensitivity, and the role of antibiotics in dental practice. This leaflet is available to download from the website shop.