Dental Amalgam Research Articles

Mercury in dental amalgam: a risk analysis

Mercury is a highly potent cell toxin with effects on human and animal nervous systems. Mercury vapour released from dental amalgam is the predominant source of mercury in the human adult and foetal central nervous system in populations of developed countries. Only in small populations with high consumption of methyl mercury containing fish can the contribution from fish consumption reach or surpass that of amalgam fillings. The most severe health risk is that of interference with foetal and child brain development. This effect of mercury vapour exposure has been demonstrated in animal experiments on monkeys and rats and in nerve cell cultures at nanomolar concentrations. The effect is also supported by epidemiological studies on women occupationally exposed to mercury vapour during pregnancy. However, there is no data permitting an assessment of dose-response relations for this effect in humans. In epidemiological studies on populations with occupational exposure to mercury vapour, subclinical effects on kidneys, the immune system, thyroid function, and CNS function have been observed at an exposure level equal to the upper range of the exposure range seen in amalgam bearers and measured as urine excretion rate of inorganic mercury. The cell toxic effect of mercury is likely to be based on the ability of mercury to modify protein tertiary and quaternary structure. As protein structure is genetically determined, there is ample scope for genetic polymorphism to manifest itself in varying sensitivity and reaction to mercury exposure. It is also likely that mercury exposure from dental amalgam exerts side effects like most potent pharmaceuticals. The clinical support for this assumption is reviewed. An incidence of side effects exceeding 10% is unlikely considering available epidemiological evidence. However, an incidence of 1% or below is highly probable. It is recommended that use of amalgam for dental restorations is abandoned and substituted with available less toxic material and that amalgam restorations in children and women of childbearing age should be avoided due to the potential risk of interference by mercury with brain development.

Analysis of amalgam restorations done in class 1 cavities in a private dental college - A retrospective study

Amalgam is a very special type of alloy in which mercury is one of the components. It is a material of choice for dental restorations. There are various intriguing facts about dental amalgam that stand out from other materials—the dimensional changes of dental amalgam cause it to undergo initial contraction, expansion and delayed contraction. However, the usage is becoming lesser as the implementation of the dental composite material was introduced. Amalgam is usually indicated when aesthetics is of no concern and where occlusal contact is high. Mercury toxicity is the property which is considered negative as there have been debates and discussions of the hazards mercury can bring to health. There have been advancements in the dental amalgam to help improve its usage among restorative materials. Data collection was done in a university setting. One thousand cases were reviewed from the time period of June 2019 to March 2020. Excel tabulation and SPSS version 22 was used for data analysis. Chi-square test was used for the analysis of the data. There was no statistical significance between the variables that included types of base and the tooth number. (P-value>0.05). Zinc phosphate was the most commonly used base material in relation to lower molars, (p-value<0.05) which was statistically significant. The maximum number of amalgam capsules used were one capsule which showed high significance.

Mercury level in biological samples of dentists in Iran: a systematic review and meta-analysis.

Exposure to mercury is an important risk to dentists health. The aim of the present study was to assess the pooled mean mercury level (MML) in the urine, blood, nail, and hair of Iranian dentists (IDs) through the meta-analysis technique. Comprehensive and systematic searches were performed in main local databases including SID, Magiran, Iran medex, and ISC as well as internationally available databases including Embase, PubMed and Scopus for all the relevant studies up to 2018. In order to prevent bias in this study and identify eligible studies, various steps of the study was performed independently by two researchers. Out of 13 studies in the meta-analysis process which included 1499 IDs, the mean of the mercury level in the urine, nail, and blood was estimated to be 6.29 (95% CI: 2.61-9.97, I-square: 62.7%, P: 0.006), 3.54 (95% CI: 2.81-4.28, I-square: 0.0%, P: 0.968), 11.20 (95% CI: 2.28-20.13, I-square: 59.9%, P: 0.082), respectively. The mean mercury level (MML) in the biological samples of IDs was higher than the standard of World Health Organization (WHO). So, in accordance with Article 10 of the European Union Regulations (EUR), in the context of the Minamata Convention (MC) on Dental Amalgam (DA), in order to avoid the dangers of mercury exposure in dentists, it is necessary for Iran and other countries to approve laws and to implement a national plan to reduce mercury levels and replace the appropriate materials.

Association of age and sex of patients undergoing class 2 amalgam restoration in mandibular premolars

The most versatile restorative materials in the field of dentistry are dental amalgam which constitutes 75% of all restorative materials used by dental practitioners. Due to its excellent load-bearing capacity and low costs, it is still the top priority for many dentists. In this retrospective study, the details of the 86,000 patient records were reviewed and analyzed, out of which 160 patients who had undergone class 2 amalgam restoration in mandibular premolars between June 2019 to March 2020 were included in this study. The details like age, gender, tooth number and the surface of restorations were evaluated and entered in SPSS, version 23. The data were analyzed through a chi-square test. It was observed that there is no significant association between age, and surface distribution in mandibular premolars (p>0.05), however, on analyzing the association between gender and tooth surface, the statistical significance between gender and tooth surface was found ( p <0.05). Within the limitations, the mandibular second premolars had undergone more class 2 amalgam restoration than the first premolar. Disto occlusal restoration was performed in higher numbers, followed by mesio occlusal restoration in both genders.

CLINICAL DIAGNOSTIC DECISION ON ORAL WHITE LESIONS: A CASE REPORT

Oral lichenoid lesions (OLLs) are clinical and histologic contemporaries of oral lichen planus (OLP). The differentiation between the 2 groups is the association of the former with known inciting factors, and dental amalgam has been the most implicated restorative material in the induction of OLLs. We report a 32-year-old feoderm woman who sought the stomatology service complaining of lesion on her lower lip. On examination painless white plate on the lower lip was observed. The intraoral examination evidenced white plate in the buccal mucosa on the right side, smooth surface, and painless. The clinical diagnoses were common wart on the lower lip and lichen planus in the buccal mucosa. The incisional biopsies were conducted for both, and the histopathologic results showed hyperkeratosis on the lower lip and OLP/OLLs on the buccal mucosa. This case reinforces the importance of the stomatologist in the decision to biopsy more than 1 area to elucidate the diagnosis. Oral lichenoid lesions (OLLs) are clinical and histologic contemporaries of oral lichen planus (OLP). The differentiation between the 2 groups is the association of the former with known inciting factors, and dental amalgam has been the most implicated restorative material in the induction of OLLs. We report a 32-year-old feoderm woman who sought the stomatology service complaining of lesion on her lower lip. On examination painless white plate on the lower lip was observed. The intraoral examination evidenced white plate in the buccal mucosa on the right side, smooth surface, and painless. The clinical diagnoses were common wart on the lower lip and lichen planus in the buccal mucosa. The incisional biopsies were conducted for both, and the histopathologic results showed hyperkeratosis on the lower lip and OLP/OLLs on the buccal mucosa. This case reinforces the importance of the stomatologist in the decision to biopsy more than 1 area to elucidate the diagnosis.

Removal of dental amalgam restorations in patients with health complaints attributed to amalgam: A prospective cohort study.

The Norwegian Ministry of Health and Care Services initiated a project including experimental treatment for patients with health complaints attributed to amalgam restorations. The aim was to evaluate changes of general health complaints in patients who participated in the project and had all amalgam restorations removed. The project was designed as a prospective cohort study and organised by the Dental Biomaterials Adverse Reaction Unit in Bergen, Norway. The dental treatment was provided by the patient's local dentist. The main target group consisted of patients with medically unexplained physical symptoms, attributed to dental amalgam restorations (Amalgam cohort). The primary comparison group consisted of patients with medically unexplained physical symptoms without attribution to dental amalgam restorations (MUPS cohort). Primary outcome was self-reported general health complaints (GHC index) at follow-up 12-months after completed amalgam removal. In the Amalgam cohort, a significant reduction of GHC index from 43.3 (SD 17.8) at baseline to 30.5 (SD 14.4) at follow-up (mean reduction 12.8, SD 15.9; n=32; P<.001) was observed. The change scores for GHC index indicated that the reduction of complaints was significantly higher (P=.004) in the Amalgam cohort compared with the MUPS cohort (mean reduction 1.2, SD 12.3, n=28). After adjustment for age, gender, education and baseline GHC index, the mean adjusted difference was -8.0 (95% confidence interval from -15.4 to -0.5; P=.036). In a group of patients with medically unexplained physical symptoms, which they attributed to dental amalgam restorations, removal of amalgam restorations was followed by a significant reduction of health complaints.

Knowledge, Attitude and Practice on Dental Amalgam Restoration among Dental Students

Amalgam has been used in Dentistry for about 150 to 200 years and is still under use due to its low cost, ease of application, strength and durability. It is an alloy of mercury, is an excellent and versatile restorative material. The development of various tooth coloured cements and resins serves as an alternative and have reduced the use of amalgam. Yet, amalgam stands as one of the excellent restorative materials. The aim of the study was to assess the knowledge, awareness and practice of dental amalgam among dental students in a private dental school. Study was conducted as a cross sectional questionnaire based study among the dental students. The study was conducted as an online survey as it is timesaving and a majority of the population can be covered. There were one hundred participants involved in this online survey from second year, third years, final years and internship. The questionnaire consisting of ten questions were posted for an online survey using google forms. The validity of the questionnaire was cross verified by experts. The data were extracted and tabulated in MS Excel sheets with respect to each question and their response. The data obtained were subjected to statistical analysis using SPSS software v20. Chi square test was done to assess the association between the variables. The descriptive data obtained were plotted in bar graphs. It was evident that interns had adequate knowledge about amalgam restorations than other participants.

Clinical Effects of Mercury in Conservative Dentistry: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials.

Methods A systematic literature search was conducted in four electronic databases (Ovid via PubMed, Web of Science, Scopus, and CENTRAL) including all available randomised controlled trials published in the last 15 years comparing the use of dental amalgam with composite resins in humans with a follow-up period of at least one year. The primary outcome was the Hg concentration in biological fluids (urine, hair, blood, and saliva) with the aim of assessing their reliability as biomarkers of Hg exposure. The risk of bias was assessed through the Cochrane Collaboration tool and the overall quality of evidence through the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. The results of the meta-analysis were expressed using a random-effects model, and their power was assessed through the trial sequential analysis (TSA). Results From the initial 2555 results, only 6 publications were included in the review: five were considered as having high risk of bias, whereas one as having moderate risk. Only two articles were eligible for quantitative analysis. The meta-analysis gathered data from 859 patients but was nevertheless not significant (p = 0.12). The TSA confirmed this evidence revealing that it was due to a lack of statistical power since the required information size (RIS) threshold is not reached. Conclusions The existing evidence revealed that there are not enough data to support the hypothesis that restorations with dental amalgam can cause nephrotoxicity when compared with composite resins restorations.

Dental Amalgam Influence on the Amount of Absorbed Energy from Mobile Phone

The topic of the research presented in this paper is numerical calculation and analysis of the electric field and Specific Absorption Rate (SAR) distributions in the vicinity of dental amalgam exposed to the radiation of mobile phone at the frequencies corresponding to 3G and 4G mobile networks. This is carried out by numerical solving of the electromagnetic propagation equation. The results related to different tissues and organs placed in the vicinity of dental amalgam and exposed to radiation are presented and analysed. In order to obtain the most accurate results, the realistic 3D model of human jaw has been created. A comparative analysis of models with and without dental amalgam has been carried out, with aim to determine the impact of amalgam on biological tissues in its vicinity. According to the obtained results, the maximum values of electric field strength and SAR are higher in the presence of dental amalgam. In both cases, maximum values are out of bounds of safety limits.

Evaluation of mercury release from dental amalgam after cone beam computed tomography and magnetic resonance imaging with 3.0-T and 1.5-T magnetic field strengths

This in vitro study aimed to investigate leakage of mercury from amalgam restorations after cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) examinations. In total, 238 amalgam disks were prepared and placed in saline solution. The samples were allocated randomly to 7 groups, with 34 samples in each group. CBCT imaging was performed for 4 groups with different imaging parameters (narrow/wide field of view [FOV]; standard/high-resolution). MRI procedures were performed with 3.0-T and 1.5-T magnetic field strengths. No imaging was performed for the samples in the control group. The amalgam samples were removed from the tubes 24 hours after imaging and submitted for plasma mass spectrometry analysis. Kruskal-Wallis and Dunn's tests were performed to compare data. A P value less than .05 was accepted as statistically significant. The highest mean mercury value was found in the 3.0-T MRI group, whereas the lowest mean value was found in the narrow FOV, standard-resolution CBCT group. There were no significant differences between the control group and the experimental groups (P ≥ .338) or between the experimental groups (P > .05). CBCT and MRI procedures similar to those used in patient care caused no significantly different mercury release compared with nonexposed samples.

Development of a stereoscopic CT metal artifact management algorithm using gantry angle tilts for head and neck patients.

Dental amalgams are a common source of artifacts in head and neck (HN) images. Commercial artifact reduction techniques have been offered, but are substantially ineffectual at reducing artifacts from dental amalgams, can produce additional artifacts, provide inaccurate HU information, or require extensive computation time, and thus offer limited clinically utility. The goal of this work was to define and validate a novel algorithm and provide a phantom‐based testing as proof of principle. An initial clinical comparison to a vendor's current solution was also performed. The algorithm uses two‐angled CT scans in order to generate a single image set with minimal artifacts posterior to the metal implants. The algorithm was evaluated using a phantom simulating a HN patient with dental fillings. Baseline (no artifacts) geometrical measurements of the phantom were taken in the anterior–posterior, left–right, and superior–inferior directions and compared to the metal‐corrected images using our algorithm to evaluate possible distortion from application of the algorithm. Mean HU numbers were also compared between the baseline scan and corrected image sets. A similar analysis was performed on the vendor's algorithm for comparison. The algorithm developed in this work successfully preserved the image geometry and HU and corrected the CT metal artifacts in the region posterior to the metal. The average total distortion for all gantry angles in the AP, LR, and SI directions was 0.17, 0.12, and 0.14 mm, respectively. The HU measurements showed significant consistency throughout the different reconstructed images when compared to the baseline image sets. The vendor's algorithm also showed no geometrical distortion but performed inferiorly in the HU number analysis compared to our technique. Our novel metal artifact management algorithm, using CT gantry angle tilts, provides a promising technique for clinical management of metal artifacts from dental amalgam.

FTIR, structural and radiation attenuation properties of amalgam dental composites for medical applications

Dental amalgam is one of the most adapted ceramic material which is used in dentistry. On the other hand, they are candidate materials for ionizing radiation exposure during the diagnostic imaging and therapeutic applications. This study is focused on determination of some vital material and physical parameters of dental amalgam composites. The elementary test of the dental amalgam composites have performed using SEM and EDS. On the other hand some significant photon interaction parameters such as mass attenuation coefficients (μ/ρ), half-value layer (HVL), tenth-value layer (TVL), mean free path (MFP), effective atomic number (Zeff) and effective electron density (Nel), energy build up factor (EBF), exposure the factor (EABF) of investigated materials have been determined. The last composition encoded DA5 has obtained with a smooth surface with some small agglomeration. The results showed that DA5 sample has the smallest EABF and EBF values, while DA1 and DA2 own the largest ones. This means that the DA5 sample is more effective than other samples in terms of absorbing gamma radiation.

Mercury Exposure Assessment in Mother-Infant Pairs from Continental and Coastal Croatia.

The main source of mercury (Hg) exposure in the general population is fish. Another possible source is dental amalgam. Here, we compare the levels of Hg and selenium (Se) in samples of maternal and fetal origin collected shortly after childbirth of healthy postpartum women in the coastal (n = 96) and continental (n = 185) areas of Croatia related to maternal seafood/fish consumption. We also evaluated Hg concentrations and maternal serum metallothionein (MT2) concentrations in relation to the number of dental amalgam fillings, and MT2A-5A/G (rs28366003) polymorphism. The levels of Hg and Se in maternal hair and blood/serum, placenta and cord blood/serum increased in relation to increasing fish consumption with the highest values in subjects from the coast. The concentrations of each element and between elements correlated across the matrices. Increasing amalgam number correlated linearly with increased Hg levels in maternal and cord serum and was not associated with serum MT2. No association of MT2A-5A/G polymorphism and Hg or Se levels were found. The results confirmed higher fish consumption in coastal vs. continental Croatia and increases of both Hg and Se related to fish consumption in all analyzed samples. Increased blood Hg reflected the predominant MeHg share from seafood, while increased serum Hg matched exposure from dental amalgams.

Synthesis and mechanical properties of dental amalgam

The purpose of the study was to fabricate the dental amalgam to improve its mechanical properties for dental field. Silver amalgam (γ1-phase) and silver-tin amalgam (γ-phase) was synthesized by using chemical reduction method. The structural analysis of the prepared dental amalgam was characterized by XRD, SEM and EDX. Tensile and hardness test were performed using UTM. XRD confirmed the cubic (bcc) structure of Ag- Hg and orthorhombic structure of Ag-Sn-Hg. SEM analysis demonstrated the morphology of pure silver amalgam (γ1-phase) and silver tin amalgam (γ-phase). The EDX analysis revealed the chemical composition of prepared amalgam Ag, Sn and Hg. Tensile and hardness test were performed to assess the mechanical characteristics of prepared dental amalgam. Tensile and hardness tests showed that mechanical properties were enhanced by adding the polyethylene glycol in the γ-phase and γ1-phase amalgam for current application of dental industry.

Knowledge and Attitude of Dentists and Patients Toward Use and Health Safety of Dental Amalgam in Saudi Arabia.

Objective The aim of this study was to assess: (1) the perceptions of dentists in Saudi Arabia concerning the amalgam controversy, (2) their attitude toward the ethical responsibility of patient information, and (3) patients’ knowledge and attitude toward the use of dental amalgam. Materials and Methods A total of 1,139 dentists were sampled on convenience by electronic survey. The questionnaire contained questions about the safety of dental amalgam, use of amalgam, case selection, alternate materials, and informing their patients about risks of amalgam. Also, 425 patients were sampled on convenience and information collected on their knowledge about amalgam and its acceptance in their oral cavities. Results A total of 201 dentists and 425 patients participated in the study. A total of 60% of dentists and specialists declared it safe. A total of 32.4% (31) of general dental practitioners and 41% (43) specialists considered it a moral obligation to inform patients about the potential health risks associated with amalgam. Mercury toxicity was identified as the most common health hazard. About 57.3% dentists and 36.2% specialists opted for superior longevity as the principle advantage. Majority of patients (52.2%) in Saudi Arabia had no knowledge about dental amalgam. While 23.1% (98) had concern about poor color, 8.7% (30) knew it contained silver while only 7.8% (27) patients were aware of its mercury content. Conclusion Majority of dentists in Saudi Arabia found it safe to use amalgam while the patients had little knowledge about the possible issues with amalgam. It is recommended to improve public awareness about impact of mercury containing products on the environment.

(Invited) Highly Selective and Efficient Conversion of CO2 to Fomate at 100 mA/cm2

We succeeded in fabricating a dental amalgam composition on a copper foam electrode and could convert CO2 selectively to formate. The formate was produced at a current efficiency of 80~100% in the wide range of the potential shown below. The remaining electricity was used only for producing H2. The concentration of the produced formate is over 1.2 M in the batch electrolysis of 30 hours operation. The CO2-to-formate conversion system built based on the electrode in 9 cm x 9 dimension is shown to be stable in continuous operation at 100 mA/cm2 for more than a month. Figure 1

Dental amalgams and risk of gestational hypertension in the MIREC study.

The potential association between the presence or replacement of dental amalgams and gestational hypertension (GH) is unclear. To assess the association between the presence or replacement of dental amalgams and the risk of GH in a prospective cohort study. We assessed dental amalgam status (presence or replacement), blood mercury concentrations, and measured blood pressure (BP) in 1817 pregnant women recruited in 10 Canadian cities. BP was assessed in each trimester of pregnancy and mercury concentrations in 1st and 3rd trimesters. Logistic regression analysis was performed to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations between dental amalgam status and GH. Concurrent measures with systolic BP (SBP) and diastolic BP (DBP) were assessing through linear generalized estimating equations. Dental amalgam status was weakly statistically correlated with mercury concentrations but there was no evidence of an association with GH in women having 1-4 (aOR=1.31 (0.92, 1.85)) or≥5 dental amalgams (aOR=1.32 (0.86, 2.04)), compared to women without amalgam reported at first trimester. Dental amalgam replacement reported in the first or third trimester was similarly not associated with GH (aOR=0.75 (0.40, 1.42) and 0.73 (0.39, 1.34), respectively) but with SBP (beta=-1.58 (-2.95, -0.02)). We found weak correlations between dental amalgams and blood mercury among pregnant women. However, the presence of dental amalgams or their replacement was not associated with GH but with decreased SBP for the replacement. Further studies are required.

Choices for fixing cavities

Many adults grew up with “silver” fillings when they had a cavity. Although these fillings are still an option, there are now other choices, such as tooth-colored fillings and materials that release fluoride to help protect your teeth from developing new cavities. Each of these choices has its pros and cons, but most importantly, you and your dentist have choices available when repairing a cavity. You may have seen silver, or amalgam, fillings. These fillings are a mixture of mercury, silver, tin, copper, and very small amounts of other metals. Usually amalgam fillings are used on the chewing surfaces of the back teeth because these fillings are very strong and can typically hold up without forming cracks when you chew. They also last longer than fillings made of other materials.1Moraschini V. Fai C.K. Alto R.M. Dos Santos G.O. Amalgam and resin composite longevity of posterior restorations: a systematic review and meta-analysis.J Dent. 2015; 43: 1043-1050Crossref PubMed Scopus (113) Google Scholar Some people wonder about amalgam fillings because they contain mercury. Many government agencies, professional groups, and national health associations agree that dental amalgam fillings are safe.2American Dental AssociationOral health topics: amalgam.https://www.ada.org/en/member-center/oral-health-topics/amalgamDate accessed: February 19, 2020Google Scholar Resin composites are a tooth-colored material. They can be used to repair a cavity in any tooth but are often used in front teeth because the color can be matched to the tooth being repaired. Although they seem to be able to handle chewing forces as well as amalgam without cracking, they do not usually last as long as silver fillings.1Moraschini V. Fai C.K. Alto R.M. Dos Santos G.O. Amalgam and resin composite longevity of posterior restorations: a systematic review and meta-analysis.J Dent. 2015; 43: 1043-1050Crossref PubMed Scopus (113) Google Scholar Small cavities can sometimes develop around the edges of a resin composite filing, which then may need to be replaced.3Nedeljkovic I. De Munck J. Vanloy A. et al.Secondary caries: prevalence, characteristics, and approach.Clin Oral Invest. 2020; 24: 683-691Crossref PubMed Scopus (69) Google Scholar Also, resin composites need to be placed on a clean, dry surface, free from blood or saliva. For this reason, they might not be best for people who have trouble sitting still, like small children. However, resin composites have become more popular with older children and adults,4Eltahlah D. Lynch C.D. Chadwick B.L. Blum I.R. Wilson N.H.F. An update on the reasons for placement and replacement of direct restorations.J Dent. 2018; 72: 1-7Crossref PubMed Scopus (91) Google Scholar probably because they usually look like real teeth. Glass ionomers are another kind of tooth-colored filling material. These release small amounts of fluoride, a cavity fighter. Fluoride helps harden the outside of the tooth and, together with brushing and flossing, helps protect it from developing cavities.5Dhar V. Hsu K.L. Coll J.A. et al.Evidence-based update of pediatric dental restorative procedures: dental materials.J Clin Pediatr Dent. 2015; 39: 303-310Crossref PubMed Scopus (29) Google Scholar Unlike resin composites, blood and saliva are not as much of a problem when placing a glass ionomer filling.5Dhar V. Hsu K.L. Coll J.A. et al.Evidence-based update of pediatric dental restorative procedures: dental materials.J Clin Pediatr Dent. 2015; 39: 303-310Crossref PubMed Scopus (29) Google Scholar Glass ionomers can be used on areas of teeth that you do not bite down on and the chewing surfaces of primary teeth. But because adults chew with much greater force than children and need their fillings to last much longer, glass ionomers may not be the right choice for chewing surfaces in adults.5Dhar V. Hsu K.L. Coll J.A. et al.Evidence-based update of pediatric dental restorative procedures: dental materials.J Clin Pediatr Dent. 2015; 39: 303-310Crossref PubMed Scopus (29) Google Scholar Some cavities may be managed with silver diamide fluoride (SDF), which can be painted directly onto the cavity. SDF stops the cavity from getting worse, but it does not repair the working surface of the tooth like the previously mentioned fillings. The tooth will be weak until it is repaired. However, SDF is easy to apply and inexpensive. Often, it is used to treat cavities in baby teeth or in situations in need of a quick fix. SDF is not tooth colored. The treated area of the tooth will turn black. You and your dentist can talk about the options that can best meet your needs. The best choice may depend on your individual situation, such as which tooth has the cavity and how long the treatment needs to last.

Dental Amalgam Fillings and Multiple Sclerosis: A Nationwide Population-Based Case-Control Study in Taiwan.

Multiple sclerosis (MS) is an inflammatory neurological disease characterized by autoimmune-mediated demyelination of the central nervous system. Genetic and environmental factors may contribute to the development of MS. This has not been confirmed yet. Dental amalgam has long been controversial in MS due to its mercury content but the toxicological implications of mercury-containing amalgam fillings (AMF) for MS remain to be elucidated. We conducted a case–control study to investigate the association between AMF and the risk of MS from the Taiwanese National Health Insurance Research Database (NHIRD). Case (n = 612) and control (n = 612) groups were matched by sex, age, urbanization level, monthly income, and Charlson comorbidity index by propensity score matched with a 1:1 ratio from 2000 to 2013. Differences between cases and controls was not statistically significant (OR: 0.82, 95% CI = 0.65–1.05). In subjects stratified by gender, MS was also not associated with AMF for women (OR: 0.743, 95% CI = 0.552–1.000) and men (OR: 1.006, 95% CI = 0.670–1.509), respectively. In summary, this Taiwanese nationwide population-based case–control study did not find an association between MS and AMF.

Dentists’ attitudes towards the phase-down of dental amalgam in Ireland

##Aim This study aimed to explore the attitudes of dentists in Ireland towards the phase-down of dental amalgam in relation to the Minamata Convention on Mercury. ##Methods A cross-sectional survey design was adopted using a quantitative 53-question survey piloted and distributed to dentists working in general dental practice. ##Results The study had a response rate of 11.8% (n=285). The study found a high level of awareness regarding recommended guidelines concerning the Minamata Convention on Mercury, with 96% of participants reporting that they were aware of the recommendations. Over half of the participants (61%) reported that they felt the phase-down was a good idea. ##Conclusions Training and remuneration were identified as the main barriers to a total phase-out of dental amalgam in Ireland in the future.