thumb|right|160px|Premolar tooth with amalgam filling

The dental amalgam controversy is the debate over whether dental amalgam (the mercury alloy in dental fillings) should be used. Supporters claim that it is safe, effective and long-lasting, while critics argue that amalgam is unsafe because it may cause mercury poisoning and other toxicity.

It is the position of the FDI World Dental Federation Consumer Reports

The U.S. Food and Drug Administration (FDA) formerly stated that amalgam is "safe for adults and children ages 6 and above"

History

Dental amalgam has had a long history and global impact. Any existence of galvanic pain or association of either currents or mercury to presence of symptoms has been disproven.

Very weak currents have been measured in the mouth of those with multiple dental fillings consisting of different alloys, but there was no association between presence of current and symptoms, Claims of causing a variety of symptoms such as oral discomfort, skin irritation, headaches and a metallic taste in the mouth have been discredited. and became well known in Sweden during the 1970s and 80s, because of a campaign to educate about and replace oral amalgam fillings with mercury with other compounds such as ceramic or polymer restorations.

According to one dental textbook, eating seafood once a week raises urine mercury levels to 5 to 20 μg/L, which is equivalent to two to eight times the level of exposure that comes from numerous amalgam fillings. Neither exposure has any known health effect.

Alternative materials

Alternative materials which may be suitable in some situations include composite resins, glass ionomer cements, porcelain, and gold alloys.

Chelation therapy

Anti-amalgam sources typically promote the removal of amalgam fillings and the substitution with other materials. Detoxification may also be advised, including fasting, restricted dieting to avoid mercury-containing foods, and quasi-chelation therapies, allegedly to remove accumulated mercury from the body. In the United States, several states, including New Jersey,

The WHO reported in 2005 that in the United Kingdom, mercury from amalgam accounted for 5% of total mercury emissions.

Organizational statements

American Dental Association (ADA)

The American Dental Association (ADA) has asserted that dental amalgam is safe and has held, "the removal of amalgam restorations from the non-allergic patient for the alleged purpose of removing toxic substances from the body, when such treatment is performed solely at the recommendation or suggestion of the dentist, is improper and unethical". of the Medical Devices Advisory Committee, the ADA supports the 2009 FDA ruling on dental amalgam. The ADA asserts the best scientific evidence supports the safety of dental amalgam. The FDA concluded that individuals age six and older are not at risk of mercury-associated health effects from mercury vapor exposure that come from dental amalgam.

Regulation

Mercury in dental fillings is considered safe and effective in all countries practicing modern dentistry (see below). There are currently two countries, Norway and Sweden, that have introduced legislation to prohibit or restrict use of amalgam fillings; however, in both cases amalgam is part of a larger program of reducing mercury in the environment and includes the banning of mercury-based batteries, thermometers, light bulbs, sphygmomanometers, consumer electronics, vehicle components, etc. In many countries, unused dental amalgam after a treatment is subject to disposal protocols for environmental reasons. Over 100 countries are signatories to the United Nations "Minamata Convention on Mercury". The British Dental Association has worked with the Council of European Dentists to prevent an immediate ban of amalgam until further research into practicalities has been undertaken, which is currently ongoing. The European Commission will report to European Parliament by June 2020, and to the European Council by 2030 regarding the viability of ending dental amalgam use by 2030.

Japan

In Japan, the use of amalgam began to decline around the 1990s; since 2016, fillings with amalgam alloys have been excluded from insurance coverage. Amalgam is still allowed as of 2023, but is rarely used because it is very expensive. Dental composite and palladium alloys are used instead.

See also

  • Erethism

References

  • Mercury Policy Project
  • Position Statement against Dental Mercury Amalgam Fillings for Medical and Dental Practitioners, Dental Students, and Patients, International Academy of Oral Medicine and Toxicology (IAOMT), 16 April 2013
  • The "Mercury Toxicity" Scam: How Anti-Amalgamists Swindle People

fr:Amalgame dentaire#Toxicité