Amalgamation: From heavy metal to health

Posted by Dr Henry Clover on 13/12/2017
Alchemical symbol for Amalgamation

For those of you who are unfamiliar with ancient alchemical symbolism, or haven't as yet delved into the latest offering from an Brown of 'The Da Vinci Code' fame (and fortune), the opposite symbol meals amalgamation. Music aficionados might also recognise this as the logo from the band Rush's Time Machine Tour which, given the heavy metal nature of their music, is really quite apt. Perhaps even more significantly, the band was signed to Mercury records for a google part of their career - what a clever bunch they are.

Now, I very much doubt Mr Brown had our profession in mind when penning his latest best seller. However, it did make me think that in one sense amalgam has been the mainstay of restorative, interventive dentistry for nearly two centuries, although there is mention of the substance by the Chinese in 659AD in the Material Medica1.

Declining Amalgam Usage

So, in terms of longevity, of usage and individual restorations, there are very few materials anywhere in industry that have such a track record. However, with the implications of the Minamata Convention and the continuing development of alternative restorative materials, amalgam usage will continue to wane. Even prior to this treaty being ratified, amalgam usage in the US decline by some 45% in the nine year period to 20102.

While the symbol represents amalgamation, and our thoughts turn naturally to the aforesaid material, the word is also synonymous with integration. And rather than looking to the past, ancient or more recent, this could well be indicative of the future direction of travel. There is much talk of integration of health and social care services. Earlier in the year, the National Audit Office was critical of The Better Care Fund, stating that it had not achieved the expected value for money in terms of savings, outcomes for patients or hospital activity3

Huge Opportunities

I do believe this is where primary dental care can, in the longer term, make a significant difference. Whereas some practices are beginning to have the foresight to introduce additional services to screen patients from a broader non-communicable disease perspective, there are still huge opportunities to engage further in a true preventative approach to overall healthcare within the dental environment. Ultimately, this can only be of benefit to patients and indeed severely financially challenged and constrained healthcare systems. And the independent sector could take the lead. 

The signs are here. From heavy metal to health. 


1 Dental Amalgam: An update Ramesh Bharti, Kulvinder Kaur Wadhwani, Aseem Prakash Tikku, and Anil Chandra J Conserv Dent. 2010 Oct-Dec; 13(4): 204-208.

2. IMERC Fact Sheet - January 2014


Henry writes a regular column in our Insight  magazine, available to all member dentists. To find out more about how to become a member, click here.