Face 
Dentistry 
The short answer: No – amalgam fillings do not routinely need to be removed simply because they are amalgam. The right decision depends on the condition of the filling, the surrounding tooth and your individual reasons for considering treatment.
This is one of the most important questions we answer for patients considering amalgam removal.
It is also one where online information can make the decision unnecessarily difficult.
Some websites begin with the assumption that amalgam should be removed.
At Evolve Dentistry, we begin somewhere different:
Does this particular tooth actually need treatment?
Only once we understand that can we have a sensible conversation about removal.
Amalgam restorations, like all dental restorations, can eventually require further treatment.
There are several possible reasons.
A restoration may become damaged, fractured or otherwise require replacement.
This is not unique to amalgam. All restorative materials can eventually need maintenance or replacement.
Sometimes the issue is the tooth rather than the filling itself.
For example, further decay, damage or structural concerns may mean treatment is required.
Some heavily restored teeth eventually require more support than a direct filling can provide.
Depending on the amount of healthy tooth remaining, an inlay, onlay, crown or another restorative approach may be considered.
Some adults are perfectly happy with silver fillings.
Others become increasingly conscious of them, particularly if they are visible when laughing or opening their mouth.
If appearance is important to you, it is reasonable to ask whether replacement is possible.
That does not necessarily mean treatment is clinically required.
It means we can discuss the potential aesthetic benefit alongside the implications of removing a functioning restoration.
Age alone does not tell us whether a restoration needs replacing.
Some amalgam fillings have been present for many years and remain serviceable.
Rather than using a fixed age at which fillings should be replaced, we assess the individual restoration and surrounding tooth.
This may include looking at:
An older filling deserves monitoring.
It does not automatically deserve drilling.
Pain is not the only reason a tooth might need treatment, but the absence of pain is still useful information.
Some dental problems can be identified before they become painful.
Conversely, the fact that a filling has been present for a long time without symptoms does not by itself tell us whether it should stay or go.
This is why examination matters.
We combine what you tell us with what we can see clinically and, where appropriate, what appears on dental X-rays.
This is where we need to be particularly careful.
Amalgam contains mercury as part of a mixture of metals, and this understandably leads some patients to research the subject.
However, we do not recommend removing a sound amalgam filling on the basis that doing so will improve your general health.
We also do not make claims that removing amalgam treats fatigue, headaches, immune conditions, neurological symptoms or other general health concerns.
If online information has made you worried, you are welcome to discuss those concerns with us.
Our role is to assess your teeth, explain your dental options and help you separate clinical decisions from unsupported claims.
That is a different conversation.
Dental appearance matters differently to different people.
If you have a visible silver-coloured restoration that bothers you, you can ask whether a tooth-coloured replacement is possible.
The key consideration is that replacing a functioning restoration still requires treatment of the tooth.
Before you decide, Carol or Maggie can explain:
You can then decide whether the cosmetic benefit is worthwhile for you.
Because dentistry should not involve treating healthy or serviceable teeth without good reason.
If you have six amalgam restorations and two require treatment, that does not automatically mean all six should be removed.
Each tooth should be considered individually.
You may end up with a plan that says:
That is often more useful than a blanket “remove them all” approach.
SMART stands for Safe Mercury Amalgam Removal Technique.
It describes additional precautions used when an amalgam restoration is being removed.
It does not provide the reason for removal.
The sequence should therefore be:
Does the tooth or restoration need treatment, or do I have another informed reason for considering replacement?
If removal goes ahead, how will the amalgam be removed?
At Evolve, SMART can be used as part of that second stage.
If you are unsure what to do, work through these questions.
Has your dentist identified an issue with the restoration or tooth?
If yes: understand what the problem is and why treatment is recommended.
If no: move to question two.
Would changing the silver-coloured restoration make a meaningful cosmetic difference to you?
If yes: discuss whether elective replacement is sensible for that particular tooth.
If no: monitoring may remain an option.
Before agreeing to removal, understand how the tooth will be restored afterwards.
This is an important question.
If monitoring is a reasonable alternative, you should know that.
If you decide to proceed, ask about the SMART protocol, appointment length, comfort, aftercare and cost.
Reality: All restorations require monitoring, but there is no blanket rule that every amalgam restoration should be removed simply because it exists.
Reality: Restoration age is only one consideration. The condition of the tooth and filling is more important.
Reality: Evolve does not recommend removal on the basis that it will improve general health and does not make claims that amalgam removal treats medical symptoms.
Reality: Dental examinations can identify problems before complete restoration failure. If treatment is required, it can be planned appropriately.
Reality: Patients are allowed to care about how their teeth look. Cosmetic replacement can be discussed, but you should understand the implications of treating a functioning tooth before deciding.
Carol or Maggie will first listen to why you are considering amalgam removal.
They can then examine your restorations and surrounding teeth.
Where clinically appropriate, assessment may include dental X-rays.
The aim is to establish:
An assessment does not commit you to removal.
Not automatically. Each tooth and restoration should be assessed individually.
You can discuss elective replacement with your dentist, including cosmetic reasons. Whether treatment is appropriate depends on the tooth and your individual circumstances.
No restorative material is automatically best for every tooth. The appropriate option depends on the amount of remaining tooth, the position of the tooth and other clinical factors.
No. SMART relates to how an amalgam restoration is removed if treatment is going ahead. It does not mean Evolve recommends routine removal of sound fillings.
If the restoration is serviceable, monitoring it during your normal dental care may be entirely appropriate.
What is SMART amalgam removal?
Understand the protocol itself.
Is it safe to remove amalgam fillings?
Explore the considerations involved in the removal procedure.
What can replace an amalgam filling?
Understand the restorative options available afterwards.
Or return to:
Amalgam removal using the SMART protocol – our complete patient resource
Your guide to SMART amalgam removal brings the entire decision-making process together in one place.
Download it to read in your own time or bring your questions to your consultation.
Carol or Maggie can examine your existing restorations and explain whether treatment or monitoring may be appropriate.
You do not need to arrive having decided to remove anything.
For general information about fillings and restorative dental treatment, visit the NHS:
Why is my dentist taking photographs of my teeth?
“Why are you taking photographs of my teeth?”
A perfectly reasonable question.
Dental photographs aren`t just for before-and-afters.
They can help us record what we`re seeing, monitor changes, explain things more clearly and involve you in conversations about your own teeth.
Richard explains why you might see a camera appear during an appointment at Evolve.
Because when we`re talking about your mouth, we think it`s rather useful if you can see what we`re talking about too.
There`s more to a smile transformation than two photographs
A before-and-after shows you two moments.
What it doesn`t show is everything that happened between them.
The conversations. The planning. What the patient wanted to change. The different options considered. And the decisions about what not to change.
That`s why we think the story behind a smile is every bit as interesting as the finished result.
Every patient is different - and every treatment plan should be too.
Here`s one of the lovely transformations we`ve had the privilege of being part of at Evolve. 💚
What actually happens during a dental examination?
If it’s been a while since your last dental examination, not knowing what to expect can sometimes make booking that appointment feel like a much bigger deal.
So what actually happens when you come in?
Richard explains what your dentist is looking for during a dental examination - and why it involves much more than simply checking whether you need a filling.
Regular examinations give us an opportunity to keep an eye on your teeth, gums and mouth, talk about anything that has changed and identify anything that may need our attention.
And if you haven’t been for a while? Please don’t feel embarrassed.
We’re simply pleased you’ve decided to come and see us.
🦷 We’re hiring - Dental Nurse | Portishead
We’re looking for a lovely new person to join our award-winning team at Evolve Dentistry.
You could be an experienced or newly qualified Dental Nurse, already in training, or looking for a completely new career - we’re genuinely open to all three. Finding the right person matters most.
If you’re new to dental nursing, we’ll fund and support you through your qualification.
💚 Permanent | Approx. 36 hours per week
💷 Trainee: £13.50-£14.50 per hour
💷 Qualified: £14.50-£16.55 per hour
📍 Portishead
📅 Monday, Thursday, Friday + alternate Saturdays
You’ll join a friendly, supportive team with great benefits, funded training and plenty of opportunities to develop.
Interested? Send your CV and a short covering note to hello@evolve-dentistry.co.uk.
Know someone who might be perfect for Evolve? Please tag them or share this with them. 💚
https://evolve-dentistry.co.uk/recruitment/
A little Evolve refresh 💚
You may have noticed something new if you’ve passed us recently…
Our new external signage is up!
We’ve given the outside of Evolve a refresh, making it even easier to spot us when you’re visiting the practice.
It’s been lovely seeing everything come together, and we think it looks rather smart. 😊
Have you spotted it yet?
#EvolveDentistry #Portishead #PortisheadDentist #LovePortishead #Evolve
Starting orthodontic treatment can feel like a big step.
But once you know what to expect, the whole journey often feels much less daunting.
From your first appointment to the day your braces come off, every stage is carefully planned to help you achieve a healthy, confident smile.
Swipe through our step-by-step guide to see what happens during orthodontic treatment - and how we’ll support you every step of the way.
https://bit.ly/3RTNc22
#AdultBraces #Orthodontics #SmileJourney #SmileConfidence #EvolveDentistry #portishead #nailsea #clevedon #Portisheadmarina
