Amalgam (dentistry) and the American Society of Dental Surgeons (ASDS), the only US dental association at the time, forced all of its members to sign a pledge to abstain from using the mercury fillings. This was the beginning of what is known as the first dental amalgam war. The dispute ended in 1856 with the disbanding of the old association. The American Dental Association (ADA) was founded in its place in 1859, which has since then strongly defended dental amalgam from allegations of being too risky from the health standpoint. Amalgam has been used for many years for restorations, commonly known as
Amalgam tattoo from pencil leads), and is sometimes termed a "graphite tattoo", although this is less common than tattooing with amalgam. The diagnosis is clinical. Amalgam tattoo can be distinguished from other causes of localized oral pigmentation because it does not change significantly in size or color, although it may appear to slowly enlarge for several months after the initial implantation of the metal particles. Some amalgam tattoos appear radio-opaque on radiographs (i.e. they show up on x-rays), although in many cases amalgam tattoos have no radiographic features since the responsible particle(s) of amalgam are very small even though clinically the area