Consumer advocacy groups are pushing the U.S. Food and Drug Administration to ban mercury used in dental amalgam fillings. Although a ban doesn’t look likely, the government may issue restrictions on amalgam fillings by next year.
Dental amalgam, in widespread use for over 150 years, is one of the oldest materials used in oral health care. Its use extends beyond that of most drugs, and is predated in dentistry only by the use of gold. Dental amalgam is the end result of mixing approximately equal parts of elemental liquid mercury (43 to 54 percent) and an alloy powder (57 to 46 percent) composed of silver, tin, copper, and sometimes smaller amounts of zinc, palladium, or indium.
The dental amalgam controversy is a debate over the use of mercury amalgam as a dental filling. The concern centers around the long-term health effects of toxicity or allergy which may be associated with constant mercury exposure, particularly as a potential cause of chronic illnesses, autoimmune disorders, neurodegenerative diseases, birth defects, and mental disorders. Scientists agree that mercury amalgam fillings expose the bearers to a daily dose of mercury, but different studies have concluded that this exposure may be as low as 1-3 µg/day (FDA), or as high as 27 µg/day (Patterson).
A recent lawsuit forced the Food and Drug Administration (FDA) to warn people about the possible dangers of mercury in dental fillings for some people, especially pregnant women and young children. The FDA is also expected to release stricter guidelines next year regarding amalgam use.
FDA Changes Position on Mercury Dental Fillings
For years, the FDA said amalgam fillings were safe. However, after a recent settlement with consumer advocacy groups such as Moms Against Mercury, the FDA now recognizes mercury’s possible harmful effects on the following:
- pregnant women
- nursing women
- young children
- people with compromised immune systems
- people sensitive to mercury exposure
- unborn children
The FDA posted new information on its Web site about mercury amalgam’s possible risks:
- “Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses.”
- “Pregnant women and persons who may have a health condition that makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden, should not avoid seeking dental care, but should discuss options with their health practitioner.” (Reuters, 6/4/08)
According to FDA spokeswoman Mary Peper Long, more than likely the FDA will not ban amalgam fillings. Instead, its new guidelines as of July 2009 may restrict the use of amalgam in some patients.
Charles Brown, a lawyer for Consumers for Dental Choice, one of the plaintiffs, said, “Gone, gone, gone are all of FDA’s claims that no science exists that amalgam is unsafe.” (Reuters, 6/4/08)
Worries over Mercury Dental Fillings
Groups such as Moms Against Mercury and Consumers for Dental Choice say mercury fillings may trigger health problems, including…
- Alzheimer’s disease
- brain damage
- irritability (erethism)
- kidney damage
- multiple sclerosis
The Environmental Protection Agency lists mercury as a neurotoxin. It can interfere with brain development and cognitive and motor skills.
The American Dental Association (ADA) considers amalgam safe, as does the National Institutes of Health (NIH).
More Mercury Research Needed, FDA Says
More than 100 million Americans have mercury dental amalgams, according to the American Dental Association (ADA).
Their use, though, declined as consumer concern over mercury rose. In 2003, dentists used amalgam in only 30% of 150 million fillings they placed in patients. Alternatives to amalgam include the following:
- composite resins
- metals like gold
However, dentists say amalgam fillings are stronger, cheaper, and more durable than the above alternatives.
The FDA started reviewing the use of mercury fillings in 2002. In 2006, a panel of independent advisers reviewed 34 studies and found no evidence that fillings cause problems in patients.
They did say, however, that the risks can’t be quantified until they see short-term exposure studies in specific groups of patients.
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