Safety Of Dental Amalgam Research Articles

Adverse reactions to dental biomaterials: Experiences from a specialty clinic

ObjectivesThe Dental Biomaterials Adverse Reaction Unit was initiated by the Norwegian health authorities in 1992 as a response to the public concern regarding the safety of dental amalgam and other dental materials. In this paper, experiences from the Unit are briefly summarized. MethodsThe Norwegian health authorities’ strategy included four main topics: (i) development of a manufacturer-independent system for monitoring adverse reactions related to dental materials, (ii) funding of a specialty unit for clinical examinations of referred patients, (iii) development of official guidelines for examination and treatment of patients with health complaints attributed to dental materials, and (iv) funding of an experimental treatment project for patients with health complaints attributed to dental amalgam. ResultsFrom the start, more than 2700 adverse reaction reports were received. In the initial years, amalgam was the most frequent material mentioned in the reports. Reports about polymer-based composite materials have not increased after the prohibition of amalgam in Norway. Clinical examination of referred patients is complex and time consuming, and it is important to consider differential diagnoses. There are methodological challenges associated with the design of experimental treatments used on patients with adverse reactions attributed to dental materials. However, the results from the treatment project indicate lower symptom load after replacement of amalgam with other dental restorative materials. SignificanceProducer independent adverse reaction reporting can provide valuable information about the safety of these materials and could serve as a complement to the mandatory reporting system described in the European medical device regulations (MDR).

Roadmap to mercury free dentistry: Toxic past to a healthier future

Ever since its introduction, mercury has been widely used in dental practice because of its durability, ease of handling and placement, low cost, lower technical sensitivity compared to other restorative materials, antibacterial effect, etc. When esthetics are not an issue, it can be used in people of all ages, in stressed areas and with poor oral hygiene. However, concerns have been raised that amalgam causes mercury toxicity. At present, there is much controversy about the safety of dental amalgam and it has been shown to pose an occupational risk to patients, dentists, and their assistants. This review has attempted to summarize the past controversies and the current status of this restorative material in routine dental practice. It also discusses various alternatives to its use in terms of safety and esthetics.

Human brain mercury levels related to exposure to amalgam fillings

The safety of dental amalgam as the primary material in dental restoration treatments has been debated since its introduction. It is widely accepted that amalgam restorations continuously release elemental mercury (Hg) vapor, which is inhaled and absorbed by the body and distributed to tissues, including the brain. The aim of the present study was to investigate whether the presence of amalgam fillings is correlated with brain Hg level. The Hg levels in the parietal lobes of the brains of 32 cadavers were analyzed with an atomic absorption spectrometer with the mercury hydride system. A total of 32 brain samples were tested; of these, 10 were from cadavers with amalgam fillings, while 22 of them were amalgam free. Hg was detected in 60.0% (6 of 10) of the samples in the amalgam group and in 36.3% (8 of 22) in the amalgam-free group. The average Hg level of the amalgam group was 0.97 ± 0.83 µg/g (minimum: 0.3 µg/g and maximum: 2.34 µg/g), and in the amalgam-free group, it was 1.06 ± 0.57 µg/g (minimum: 0.17 µg/g and maximum: 1.76 µg/g). The results of the present study showed no correlation between the presence of amalgam fillings and brain Hg level.

Dental amalgam and urinary mercury concentrations: a descriptive study

BackgroundDental amalgam is a source of elemental and inorganic mercury. The safety of dental amalgam in individuals remains a controversial issue. Urinary mercury concentrations are used to assess chronic exposure to elemental mercury. At present, there are no indications of mercury-associated adverse effects at levels below 5 μg Hg/g creatinine (Cr) or 7 μg Hg/L (urine). The purpose of the present study is to determine the overall urinary mercury level in the Canadian general population in relation to the number of dental amalgam surfaces.MethodsData come from the 2007/09 Canadian Health Measures Survey, which measured urinary mercury concentrations in a nationally representative sample of 5,418 Canadians aged 6–79 years. Urinary mercury concentrations were stratified by sex, age, and number of dental amalgam surfaces.ResultsThe overall mean urinary mercury concentration varied between 0.12 μg Hg/L and 0.31 μg Hg/L or 0.13 μg Hg/g Cr and 0.40 μg Hg/g Cr. In general, females showed slightly higher mean urinary mercury levels than men. The overall 95th percentile was 2.95 μg Hg/L, the 99th percentile was 7.34E μg Hg/L, and the 99.9th percentile was 17.45 μg Hg/L. Expressed as μg Hg/g Cr, the overall 95th percentile was 2.57 μg Hg/g Cr, the 99th percentile was 5.65 μg Hg/g Cr, and the 99.9th percentiles was 12.14 μg Hg/g Cr. Overall, 98.2% of participants had urinary mercury levels below 7 μg Hg/L and 97.7% had urinary mercury levels below 5 μg Hg/g Cr. All data are estimates for the Canadian population. The estimates followed by the letter “E” should be interpreted with caution due to high sampling variability (coefficient of variation 16.6%-33.3%).ConclusionsThe mean urinary mercury concentrations in the general Canadian population are significantly lower than the values considered to pose any risks for health.

The evidence of genotoxic damage in the oral mucosa due to dental fillings is very questionable

The general public has a substantial interest in the safety of dental amalgam and alternative dental restoration materials as indicated by the recent request of the European Commission to the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) to update, if appropriate, the opinion on this subject adopted in 2008 (http://ec.europa. eu/health/scientific_committees/emerging/docs/scenihr_q_ 034.pdf). As members of the large population carrying restorative dental fillings we felt attracted by the subject of the study reported in this journal by Visalli et al. (2013), although none of us is actively involved in any work in this area. Yet, we cannot agree with the conclusions drawn by the authors that their data ‘‘provide unequivocal evidence’’ for genotoxic damage in the oral mucosa due to such fillings and that their findings are ‘‘of particular relevance.’’ This is based on the following considerations:

Academy of Operative Dentistry Hollenback Memorial Prize

Dr Mackert is professor in the Department of Oral Rehabilitation, School of Dentistry, Medical College of Georgia (MCG), Augusta, Georgia. He holds joint appointments in the Department of Oral Biology and the School of Graduate Studies. He has conducted research on dental amalgam and ceramic materials and has received $2.8 million in NIH funding as a principal investigator and more than $1 million as co-investigator. He has published 45 papers in refereed journals, 11 chapters and monographs in books and symposium proceedings and 66 abstracts. In addition, he has testified twice before Congressional committees and before legislative and policymaking bodies in multiple states on the safety of dental amalgam. He is first author of a monograph on mercury exposure from dental amalgam fillings that was published by the World Health Organization. Dr Mackert has been interviewed on the amalgam controversy by Time magazine, U.S. News & World Report, The Washington Post, the Wall Street Journal, National Public Radio, Consumer Reports, The Boston Globe, USA Today, Harper's Bazaar, Redbook, Men's Health magazine, Fitness magazine, McCall's magazine and other media outlets.He received his DMD degree in 1976 from the MCG School of Dentistry and his PhD in materials science in 1979 from the School of Engineering and Applied Science of the University of Virginia. After a one-year visiting lectureship at the Gifu College of Dentistry (now Asahi University School of Dentistry) in Japan, Dr Mackert joined the faculty of the MCG School of Dentistry in 1980. In 1992, Dr Mackert was a visiting scientist in the Ceramics Processing Research Laboratory at the Massachusetts Institute of Technology.Dr Mackert is a member of Omicron Kappa Upsilon, the American Dental Association and the International Association for Dental Research. He is a fellow in the Academy of Dental Materials and the International College of Dentists. He is a Distinguished Alumnus of the MCG School of Dentistry and recipient of a Presidential Citation from the American Dental Association. He has served on the Oral Biology and Medicine Study Section and the Special Grants Review Committee of the National Institute of Dental and Craniofacial Research, the Council on Scientific Affairs of the American Dental Association, the Scientific and TechnicalAdvisory Board of Quackwatch, Inc and other advisory panels. He has presented 51 invited lectures at local, national and international venues, including the 1990 NortonMRossMemorial Lecture at theAmerican Dental Association.The Academy of Operative Dentistry is pleased to present the 2010 Hollenback Prize to Dr J Rodway Mackert, Jr.

The safety of dental amalgam in children

The safety of mercury-containing dental amalgam has been hotly debated for well over a century. Dental exposures from mercury have been suggested as the cause of numerous diseases including multiple sclerosis, autism and many others. Known health effects of mercury exposure include CNS and renal damage. However, these effects have only been shown at occupational or higher levels of exposure, and have not been conclusively shown to be present at levels of mercury exposure consistent with that from dental amalgam fillings. The use of mercury amalgam fillings remains a state-of-the-art treatment for dental caries throughout the world. Although there have been a small number of peer-reviewed reports examining the health effects of dental mercury in children, only very recently have the only randomised, controlled clinical trials (two) of the safety of mercury amalgam been published. The purpose of this review is to discuss the scientific evidence on the safety of the use of mercury-containing dental amalgam as a treatment for dental caries.

SAFETY OF DENTAL AMALGAM

This Critical Appraisal is a departure from our usual format. Usually, contributors review several articles about a specific topic. Instead, we have asked Dr. Osborne to review several topics related to a specific issue, the safety of dental amalgam. Despite the increasing use of tooth‐colored restorative materials, amalgam remains a widely used and important part of the dentist's armamentarium. This article provides the practicing dentist with essential information regarding the safety of amalgam. We hope that you will find this helpful as you discuss safety issues with concerned patients.

DENTAL AMALGAM: UPDATE ON SAFETY CONCERNS

This report of the Council on Scientific Affairs reviews and discusses recent studies concerning the safety of dental amalgam, with an emphasis on studies that have been published since the 1993 review of dental amalgam by the U.S. Public Health Service Committee to Coordinate Environmental Health and Related Programs. The Council concludes that, based on currently available scientific information, amalgam continues to be a safe and effective restorative material.

Dental Amalgam Designs for Research In Human Populations

Questions have been raised about the safety of dental amalgam. The main point of contention is whether the mercury contained in dental restorations is released in sufficient quantities to pose a public health hazard. Most scientists agree that current evidence is not sufficient to show that amalgam restorations pose a general health threat. But researchers on both sides of this debate agree that much remains to be learned about any potential toxicity of dental amalgam--an issue serious enough to merit additional research.

Safety of Dental Amalgam

Safety of Dental Amalgam