Mercury in Dental Amalgams, Dental Fillings
Dental amalgams contain about 50% mercury and there are concerns that unborn children can be exposed to mercury vapors given off by the amalgams in mothers. Some special interest groups have tried to ban or limit the use of mercury based amalgams. In order to investigate this issue, the U.S. Public Health Service (PHS) assembled a group of scientists from various governmental agencies. The following excerpts, taken directly from the report generated in 1993, summarize some of the primary conclusions reached by the scientists (U.S. Department of Health and Human Services Public Health Service, January 1993):

Dental amalgam, an inter-metallic compound, contains elemental mercury that is emitted in minute amounts as vapor. Because vapor emitting from amalgam restorations can be absorbed by the patient through inhalation, ingestion, or other means, concerns have been raised about possible toxicity. At present, there is scant evidence that the health of the vast majority of people with amalgam is compromised, nor that removing amalgam fillings has a beneficial effect on health. It also is recognized that a total conversion from dental amalgam to alternative materials would cause a significant increase in U.S. health care costs. Nonetheless, the possibility that this material, as well as currently available alternatives, could pose health risks cannot be totally ruled out because of the paucity of definitive human studies.

Given the limitations of existing scientific data, a research program should be designed and implemented to fill as many gaps as possible in current knowledge about the potential long-term biological effects of dental amalgam and alternative restorative materials. The PHS should be a leader in this effort.

The PHS should also educate dental personnel and consumers about the risks and benefits of dental amalgam. An educational program should include information on all restorative materials to help dentists and their patients make informed dental treatment decisions, and encourage dental care providers to report adverse reactions. Such a program should promote the use of preventive measures such as fluoride and dental sealants to prevent caries and thus further reduce the need for dental restorations.

The U.S. Public Health Service believes it is inappropriate at this time to recommend any restrictions on the use of dental amalgam, for several reasons. First, current scientific evidence does not show that exposure to mercury from amalgam restorations poses a serious health risk in humans, except for an exceedingly small number of allergic reactions. Second, there is insufficient evidence to assure the public that components of alternative restorative materials have fewer potential health effects than dental amalgam, including allergic-type reactions. Third, there are significant efforts underway in the U.S. to reduce the amount of mercury in the environment. And finally, as stated previously, amalgam use is declining due to a lessening of the incidence of dental caries and the increasing use of alternative materials.

The U.S. Public Health Service reassembled the group in 1997 to discuss new information published since the original report in 1993. According to the 1997 report (U.S. Department of Health and Human Services Public Health Service, October 1997), "In 1997, with input from a broad cross-section of scientists and dental professionals within USPHS, the FDA completed a review of nearly 60 studies that were published in peer reviewed scientific literature and were cited by citizen groups that petitioned the agency for stringent regulatory actions against dental amalgam. The analysis of the cited studies indicated that the current body of data does not support claims that individuals with dental amalgam restorations will experience adverse effects, including neurologic, renal or developmental effects, except for rare allergic or hypersensitivity reactions." The FDA concluded that "the agency does not believe there is scientific justification for discontinuing or curtailing amalgam use."

The 1997 U.S. Public Health Service Report also discussed opinions of foreign governments regarding the use of mercury amalgams. According to the report U.S. Department of Health and Human Services Public Health Service, October 1997, "The governments of Sweden and Denmark have recommended against the use of mercury-containing materials as part of national environmental protection initiatives provided that suitable non-amalgam materials are available. The German government has recommended against the placement of dental amalgam and dental restorative materials in general in patients with demonstrated allergy to such materials, as well as patients with severe renal dysfunction. Germany has also advised against the placement of dental amalgam and the removal of amalgam fillings in pregnant women as a precautionary measure while at the same time acknowledging the lack of evidence that exposure of the unborn to mercury released from the mother's amalgam fillings causes any health damage to the child. The European Commission, the governments of Canada, Quebec and New Zealand, and the World Health Organization have independently evaluated the current body of science relating to dental amalgam safety and universally concluded that the vast majority of people treated with dental amalgam are not at risk. Notwithstanding this conclusion, Canada and its province of Quebec have recommended prudence in dental intervention therapies for certain patient sub-populations such as pregnant women."

Research to address health concerns of dental amalgams continues.
Content Courtesy : cerhr.niehs.nih.gov
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