Dental amalgam controversy demonstrated that mercury released from amalgam restorations does not give rise to toxic effects on the nervous system of children. More recently, a Cochrane Systematic review in 2014 found, "insufficient evidence to support or refute any adverse effects associated with amalgam or composite restorations." Those opposed to dental amalgam suggest that mercury from dental amalgam may lead to nephrotoxicity, neurobehavioural changes, autoimmunity, oxidative stress, autism, skin and mucosa alterations, non-specific symptoms and complaints, Alzheimer's disease, and multiple sclerosis. Both those opposed and those not opposed to dental amalgam recognize that amalgam has been found to be a rare contributor to
Amalgam (dentistry) conservative preparation would be beneficial, composite is the recommended restorative material. These situations would include small occlusal restorations, in which amalgam would require the removal of more sound tooth structure, as well as in "enamel sites beyond the height of contour". For cosmetic purposes, composite is preferred when a restoration is required on an immediately visible portion of a tooth. Dental amalgam does not by itself bond to tooth structure. This was recognized as a shortcoming by early practitioners such as Baldwin. He recommended that the prepared cavity be coated with zinc phosphate cement just prior to filling with amalgam,