The Hidden Dangers of Mercury Fillings—and Why Safe Removal Matters
How mercury amalgam fillings contribute to chronic toxic burden—and why SMART-certified removal and functional detox support are essential
For decades, silver-colored dental fillings—commonly referred to as amalgam fillings—have been considered routine and durable solutions for cavities. What is far less commonly discussed is that these fillings are composed of approximately 50% elemental mercury by weight, a heavy metal with well-documented neurotoxic and immunotoxic effects (1).
Unlike acute toxic exposures, mercury from amalgam fillings represents a chronic, low-dose exposure. Mercury vapor is released continuously, particularly during chewing, brushing, teeth grinding, or dental procedures (2). Because mercury vapor is readily absorbed through the lungs and can cross the blood–brain barrier, this exposure pattern raises important concerns—especially for individuals already experiencing fatigue, cognitive changes, inflammatory conditions, hormonal imbalance, or impaired detoxification capacity (3).
As awareness grows, many people begin asking an important question: Should mercury fillings be removed?
The more critical—and often overlooked—question is how they are removed.
Improper removal can significantly increase mercury vapor exposure over a short period of time, temporarily overwhelming detoxification pathways and nervous system regulation (4). For this reason, mercury amalgam removal should be approached as a risk-managed medical decision, not a routine dental procedure.
In this article, we will examine what mercury amalgam fillings are, how chronic mercury exposure affects the body, why removal must be performed using strict safety protocols, and how systems-based medical support can help stabilize and support the body before and after removal.
What Are Mercury Amalgam Fillings?
Mercury amalgam fillings have been used in dentistry for more than 150 years due to their durability, low cost, and ease of placement. Dental amalgam is a mixture of metals that typically includes elemental mercury, silver, tin, and copper, with mercury comprising approximately half of the material by weight (1).
Mercury is used in amalgam because it binds the other metals into a pliable substance that can be shaped easily and then hardens quickly inside the tooth. Once set, amalgam fillings may appear stable, but they are not chemically inert.
A key concern with amalgam fillings is their continuous release of mercury vapor, the most toxic form of mercury exposure for humans (2). This vapor release increases during common activities such as chewing, teeth grinding, brushing, and exposure to heat (3). Dental procedures involving amalgam—particularly drilling or removal—can dramatically increase vapor release if proper safeguards are not in place (4).
Unlike ingested mercury, inhaled mercury vapor is rapidly absorbed through the lungs and distributed throughout the body. It readily crosses the blood–brain barrier and placental barrier, allowing it to accumulate in the brain, nervous system, kidneys, and other tissues over time (5).
Because this exposure occurs chronically and invisibly, many individuals are unaware that their fillings may represent a persistent source of toxic burden. For people with compromised detoxification capacity, chronic inflammation, mitochondrial dysfunction, or genetic variations affecting metal metabolism, the biological impact of this ongoing exposure may be more pronounced (6).
Understanding how mercury amalgam fillings behave in the body is essential before making decisions about removal—because reducing exposure safely requires far more than simply replacing a filling.
Mercury as a Neurotoxin: How Chronic Exposure Affects the Body
Mercury is recognized as one of the most potent neurotoxins encountered in environmental and medical exposure. Once inhaled as vapor, mercury readily enters the bloodstream and accumulates in tissues with high lipid content, particularly the brain and nervous system (7). Unlike nutrients or transient toxins, mercury has a strong affinity for sulfur-containing proteins, allowing it to bind tightly within cells and persist for long periods of time.
At a cellular level, mercury disrupts mitochondrial function, impairing the body’s ability to generate energy efficiently. It interferes with key enzymes involved in oxidative phosphorylation, increases the production of reactive oxygen species, and depletes intracellular antioxidants such as glutathione (8). Over time, this contributes to oxidative stress, cellular damage, and impaired tissue repair.
Mercury exposure also affects the nervous system by altering neurotransmitter signaling and promoting neuroinflammation. Chronic low-dose exposure has been associated with symptoms such as brain fog, memory impairment, mood changes, anxiety, tremors, and reduced cognitive resilience (9). Because mercury crosses the blood–brain barrier, these effects may persist even after external exposure is reduced.
Beyond the brain, mercury exerts broad immunotoxic effects. It can dysregulate immune signaling, promote autoimmune activity, and reduce the body’s ability to clear infections effectively (10). Mercury has been shown to shift immune balance toward chronic inflammation while simultaneously impairing immune surveillance.
Endocrine and metabolic systems may also be affected. Mercury can disrupt thyroid hormone conversion, impair adrenal signaling, and interfere with reproductive hormone regulation (11). These effects may contribute to fatigue, temperature dysregulation, menstrual irregularities, fertility challenges, and stress intolerance.
Importantly, mercury does not affect everyone equally. Individuals with reduced detoxification capacity, existing inflammatory conditions, mitochondrial dysfunction, or genetic variations affecting metal metabolism may retain mercury more readily and experience symptoms at lower exposure levels (12).
These systemic effects underscore why mercury amalgam fillings are not simply a dental issue. They represent a whole-body exposure, with potential implications for neurological, immune, metabolic, and mitochondrial health—especially when exposure is ongoing over many years.
Health Risks Associated With Mercury Amalgam Fillings
Because mercury exposure from amalgam fillings occurs gradually over time, its health effects often develop subtly and may not be immediately linked to dental materials. Rather than producing a single defining symptom, mercury tends to disrupt multiple physiological systems simultaneously, contributing to a broad pattern of dysfunction (13).
Neurological and Cognitive Effects
Chronic mercury exposure has been associated with a range of neurological symptoms, including brain fog, impaired concentration, memory difficulties, mood changes, anxiety, depression, tremors, and reduced stress tolerance (14). Long-term accumulation in neural tissue has also been linked to an increased risk of neurodegenerative conditions, including Alzheimer’s disease and other forms of cognitive decline (15).
Immune and Inflammatory Dysregulation
Mercury can alter immune signaling and promote persistent inflammatory activity. Studies have shown associations between mercury exposure and autoimmune activation, chronic infections, allergic hypersensitivities, and impaired immune surveillance (16). This immune dysregulation may worsen existing inflammatory or autoimmune conditions over time.
Endocrine and Hormonal Disruption
Mercury interferes with hormone signaling at multiple levels. It may impair thyroid hormone conversion, disrupt adrenal stress responses, and interfere with reproductive hormone balance (17). These effects can manifest as fatigue, cold intolerance, menstrual irregularities, fertility challenges, libido changes, and difficulty adapting to physical or emotional stress.
Mitochondrial Dysfunction and Chronic Fatigue
By damaging mitochondrial enzymes and increasing oxidative stress, mercury reduces cellular energy production. This contributes to fatigue that is resistant to rest, exercise intolerance, muscle weakness, and slower recovery from illness or exertion (18). Mitochondrial impairment also amplifies vulnerability to other environmental stressors.
Gastrointestinal and Microbiome Effects
Mercury exposure may alter gut microbial balance and increase intestinal permeability. Associations have been observed between mercury burden and dysbiosis, candida overgrowth, digestive discomfort, and nutrient malabsorption (19). Because the gut plays a central role in detoxification and immune regulation, these effects can further compound systemic symptoms.
Cardiovascular and Oxidative Stress
Mercury contributes to oxidative damage within blood vessels and may impair endothelial function. Elevated mercury levels have been associated with increased cardiovascular risk, partly through inflammation, oxidative stress, and disruption of normal vascular signaling (20).
Research has demonstrated a correlation between the number of amalgam fillings and mercury concentrations in the brain and kidneys, reinforcing the concept that dental amalgams represent a meaningful source of systemic exposure (21). Individuals with genetic variations affecting detoxification pathways—such as MTHFR or glutathione-related enzymes—may be particularly susceptible to mercury retention and toxicity (22).
Taken together, these findings illustrate why mercury amalgam fillings cannot be viewed in isolation. They represent a chronic exposure capable of influencing neurological, immune, endocrine, metabolic, and cardiovascular health over time.
Why Safe Removal Is Essential
When individuals decide to address mercury amalgam fillings, the method of removal becomes just as important—if not more important—than the decision to remove them. Improper removal can result in a significant spike in mercury vapor exposure, temporarily exceeding the chronic exposure that occurred while the fillings were intact (23).
Drilling into amalgam fillings without adequate safeguards releases large amounts of mercury vapor and particulate matter. This acute exposure can overwhelm detoxification pathways, increase oxidative stress, and place additional strain on the nervous system—particularly in individuals with existing inflammatory conditions, mitochondrial dysfunction, or impaired detoxification capacity (24).
For this reason, mercury amalgam removal should not be approached as a routine dental procedure. It is best understood as a controlled exposure event that requires careful risk mitigation.
Biological dentists trained in the Safe Mercury Amalgam Removal Technique (SMART) follow protocols designed to minimize mercury exposure for both patients and dental staff. These protocols are outlined by the International Academy of Oral Medicine and Toxicology (IAOMT) and are based on current understanding of mercury vapor dynamics and exposure pathways (25).
Core Elements of SMART-Certified Removal May Include:
Use of a rubber dam to isolate the tooth and limit oral exposure
High-volume suction and external air filtration to capture mercury vapor
Oxygen delivery to the patient to prevent inhalation of contaminated air
Protective barriers and equipment for the patient and dental team
Controlled room ventilation and proper waste handling
These measures are not meant to eliminate all exposure—an unrealistic goal—but to significantly reduce the acute mercury burden that can occur during removal (26).
Equally important is recognizing that removal alone does not address mercury already stored in tissues. Without adequate physiological support, individuals may experience symptom flares or delayed reactions following removal due to mobilization of mercury from tissue stores (27).
This is why safe mercury amalgam removal is best approached as part of a coordinated, systems-based plan, rather than an isolated dental intervention.
Functional Support Before and After Mercury Filling Removal
Even when mercury amalgam fillings are removed using strict safety protocols, mercury already stored in tissues does not disappear immediately. In many cases, removal can mobilize mercury from long-term storage sites, temporarily increasing circulating levels and provoking symptoms if the body is not adequately supported (28).
For this reason, functional medicine support should begin before removal and continue after, with the goal of stabilizing detoxification pathways, reducing inflammatory reactivity, and supporting nervous system regulation.
Pre-Removal Preparation
Preparing the body in advance helps reduce the risk of symptom flares during and after removal. This phase focuses on:
Supporting liver and bile flow to improve toxin processing
Ensuring adequate mineral status, particularly zinc, selenium, and magnesium, which are required for metal displacement and antioxidant defense (29)
Strengthening antioxidant capacity, including glutathione availability, to buffer oxidative stress
Supporting gut integrity to prevent reabsorption of mobilized toxins
This preparatory phase is especially important for individuals with chronic illness, fatigue, autoimmune conditions, neurological symptoms, or known detoxification impairments.
Post-Removal Detoxification Support
After removal, the focus shifts to safe elimination, not aggressive detoxification. Mercury binds tightly to tissues, and overly aggressive strategies can worsen symptoms by redistributing metals rather than removing them.
Post-removal support may include:
Gentle binders to support gastrointestinal excretion of mercury and related toxins
Targeted liver and mitochondrial support to restore cellular energy production
Glutathione and related cofactors to support antioxidant and detoxification pathways
Mineral repletion to prevent ongoing metal retention
Adjunctive therapies such as infrared sauna or lymphatic support, used cautiously and progressively (30)
Functional lab testing—such as mercury challenge tests or porphyrin profiles—may be used selectively to assess toxic burden and guide the pace and intensity of detoxification, rather than relying on symptoms alone (31).
Most importantly, detoxification should be individualized. Factors such as genetic variations, nutritional status, inflammatory load, nervous system tone, and overall resilience determine how the body responds to mercury mobilization. A systems-based approach prioritizes regulation and recovery, not speed.
When mercury amalgam removal is coordinated with functional medical support, individuals are far more likely to experience a smoother transition, fewer setbacks, and sustained improvements in cognitive, immune, and metabolic health.
Is It Time to Address Mercury Exposure?
Mercury amalgam fillings were once considered standard care, but our understanding of chronic, low-dose mercury exposure has evolved significantly. What is now clear is that mercury is not biologically inert—and when exposure occurs daily over many years, it can contribute to cumulative toxic burden, particularly in individuals already navigating fatigue, cognitive symptoms, autoimmunity, hormonal imbalance, or chronic inflammatory conditions (32).
Addressing mercury exposure is not about reacting out of fear or urgency. It is about informed risk reduction. For some individuals, mercury fillings may represent a meaningful and modifiable source of physiological stress; for others, timing, preparation, and overall health status must be carefully considered before any intervention takes place.
What matters most is how the process is approached. Safe removal requires coordination, preparation, and post-removal support to avoid unnecessary exposure spikes or symptom flares. When mercury amalgam removal is treated as a systems-based health decision—rather than an isolated dental procedure—outcomes are more predictable and far better tolerated.
For those considering removal, working with both a SMART-certified biological dentist and a functional medicine provider allows for a coordinated plan that prioritizes nervous system regulation, detoxification capacity, and long-term resilience.
This integrated approach reduces risk, supports recovery, and helps ensure that reducing mercury exposure truly moves health in the right direction.
Coordinated Support for Mercury Detoxification
At Denver Sports and Holistic Medicine, mercury exposure is addressed within a broader systems-based framework. Rather than focusing on dental procedures alone, care is centered on preparing the body, supporting detoxification pathways, and stabilizing neurological and immune function before and after amalgam removal.
→ Detoxification & Environmental Medicine
You may request a free 15-minute consultation with Dr. Martina Sturm to review your health concerns and outline appropriate next steps within a root-cause, systems-based framework.
Frequently Asked Questions About Mercury Fillings
Can mercury fillings cause health problems?
Yes. Mercury amalgam fillings continuously release mercury vapor, which can be inhaled and absorbed into the body. Over time, chronic exposure may contribute to neurological symptoms, immune dysregulation, hormonal disruption, mitochondrial dysfunction, and increased oxidative stress, particularly in susceptible individuals.
Are mercury fillings still considered safe?
While mercury amalgam fillings are still permitted in some countries, safety assessments are based largely on population-level averages. Many health organizations acknowledge that mercury exposure is cumulative and that certain groups—including pregnant individuals, children, and those with impaired detoxification—may be more vulnerable to its effects.
Is it safe to remove mercury fillings?
Yes, when removal is performed using strict safety protocols by a properly trained biological or SMART-certified dentist. Without these safeguards, removal can significantly increase short-term mercury exposure, which is why technique and preparation are critical.
What is the SMART protocol for mercury filling removal?
SMART stands for Safe Mercury Amalgam Removal Technique. It includes measures such as rubber dams, high-volume suction, external air filtration, oxygen delivery, protective equipment, and controlled ventilation to reduce mercury vapor exposure during removal.
Can removing mercury fillings make symptoms worse?
In some cases, symptoms may temporarily worsen if mercury is mobilized faster than the body can eliminate it. This risk is higher when removal occurs without proper preparation or post-removal support. A gradual, well-coordinated approach helps minimize this risk.
Do all dentists use the SMART protocol?
No. Only dentists who have completed SMART certification follow these specific safety standards. Conventional dental practices may not implement these protocols unless they are specifically trained to do so.
How long does mercury stay in the body?
Mercury can remain in tissues for years, particularly in the brain and kidneys. Elimination depends on individual detoxification capacity, nutritional status, genetic factors, and overall health. Reducing ongoing exposure is an important first step.
What support is recommended after mercury filling removal?
Post-removal support often focuses on gentle detoxification, antioxidant support, mineral repletion, and nervous system regulation. The goal is to support safe elimination rather than aggressive detoxification.
Resources
FDA – Dental Amalgam Fillings
World Health Organization (WHO) – Mercury and Health
StatPearls / NCBI Bookshelf – Mercury Toxicity
PubMed – Mercury concentrations in the human brain and kidneys in relation to exposure from dental amalgam fillings
ScienceDirect – The impact of genetic variation on metabolism of heavy metals: Genetic predisposition?
International Academy of Oral Medicine and Toxicology (IAOMT) – The Safe Mercury Amalgam Removal Technique (SMART)
PubMed Central (PMC) – Rethinking the Dental Amalgam Dilemma: An Integrated Toxicological Approach
PubMed – Mercury exposure and mitochondrial dysfunction
PubMed – Neurobehavioral effects of chronic low-level mercury exposure
PubMed – Immunotoxic effects of mercury
PubMed – Endocrine disruption associated with mercury exposure
PubMed – Genetic susceptibility and mercury toxicokinetics
NCBI – Chronic low-dose heavy metal exposure and multisystem effects
PubMed – Mercury exposure and cognitive dysfunction
PubMed – Mercury and neurodegenerative disease risk
PubMed – Mercury-induced immune dysregulation and autoimmunity
PubMed – Mercury interference with thyroid hormone metabolism
PubMed – Mitochondrial toxicity of heavy metals and chronic fatigue
PubMed – Mercury exposure, gut dysbiosis, and intestinal permeability
PubMed – Mercury, oxidative stress, and cardiovascular risk
PubMed – Correlation between dental amalgam burden and tissue mercury levels
PubMed – MTHFR and glutathione pathway polymorphisms in heavy metal detoxification
IAOMT – Mercury vapor release during amalgam removal
PubMed – Acute mercury exposure during dental procedures
IAOMT – Scientific basis for SMART mercury removal protocols
PubMed – Mercury exposure reduction using protective dental protocols
PubMed – Redistribution of mercury following dental amalgam removal
PubMed – Tissue mercury mobilization and detoxification challenges
PubMed – Role of minerals in heavy metal displacement and detoxification
PubMed – Sauna therapy and mercury excretion
PubMed – Laboratory assessment of mercury burden in clinical practice
PubMed – Chronic mercury exposure and cumulative toxic burdenoach - PMC