We have been amalgam free for over twenty years now. Ever since I attended a lecture given by John Kanca on bonding and avoidance of amalgam fractures back in 1992, I put my stock of mercury and silver on the shelf and used the composite resin: tooth colored, bonding materials. With one exception, most of the different brands have held up very well. I dropped amalgam from use, not from any fear about toxicity or safety, but for biomechanical reasons. I do believe amalgam is safe when properly placed by a clinician. However, there is no question amalgams weaken teeth and can set them up for fractures. Bonding composite can be more conservative, and can help hold a tooth together better. However, even bonding (resins/composites) have their limitations, and there is concern about bis-phenol A in the oral environment. Gold still remains the most biocompatible material, and has the longest longevity. Of course, not many people want to show off the “bling” in their mouths, and would rather show it off on their wrist, ears, lapels, etc.
The future of dental restorative materials may fall by the wayside, With stem cell harvesting, the future may bring the genetic manipulation to the forefront and relegate tooth repair to the rear.