Safety concerns regarding dental amalgam have been voiced ever since its introduction 150 years ago. As most people have amalgam fillings, the issue has received extensive coverage in the lay as well as the medical medical media. This has led to confusion about the terms amalgam allergy, mercury burden and intoxication, and amalgam disease, an understanding of which is crucial in consideration of this controversy. Allergy to amalgam is rare and should be investigated by a specialist, as diagnosis may result in a decision to remove dental amalgam. Dental amalgam is the most important source of mercury burden in the general population. Occupational exposure to mercury within established exposure limits reaches levels much higher without evidence of intoxication. However, mercury released from dental amalgam induces measurable organ effects. Amalgam disease has been introduced as a term to identify patients who typically ascribe a variety of symptoms to their amalgam fillings. Current literature lacks sound evidence of a role for amalgam in human disease other than allergy.