The next round of “mercury talks” is scheduled for Monday in Kenya and State Department officials reportedly said they hope to garner support for a legally-binding treaty to reduce worldwide mercury emissions.

Dr. David Simone, a dental surgeon from Northbrook, Ill., who attended the State Department meeting, told FoxNews.com that State Department officials reiterated that amalgam fillings will likely remain on the U.N.’s designated list of products to eventually be phased down with passage of the so-called global mercury treaty.

There is a controversial ongoing argument among dental health professionals about the possible health risks associated with mercury exposure from amalgam fillings, and competing sides disagree on whether the amount of mercury in fillings causes risks.

The ADA supports the position that dental amalgam is safe and posts the following statement on its website -

Dental amalgam is considered a safe, affordable and durable material that has been used to restore the teeth of more than 100 million Americans. It contains a mixture of metals such as silver, copper and tin, in addition to mercury, which binds these components into a hard, stable and safe substance. Dental amalgam has been studied and reviewed extensively, and has established a record of safety and effectiveness.

The FDI World Dental Federation and the World Health Organization concluded in a 1997 consensus statement: “No controlled studies have been published demonstrating systemic adverse effects from amalgam restorations.” Another conclusion of the report stated that, aside from rare instances of local side effects of allergic reactions, “the small amount of mercury released from amalgam restorations, especially during placement and removal, has not been shown to cause any … adverse health effects.”

In 1998 the ADA’s Council on Scientific Affairs published its first major review of the scientific literature on dental amalgam which concluded that “based on available scientific information, amalgam continues to be a safe and effective restorative material.” The Council’s report also stated, “There currently appears to be no justification for discontinuing the use of dental amalgam.”

In an article published in the February 1999 issue of the Journal of the American Dental Association, researchers report finding “no significant association of Alzheimer’s Disease with the number, surface area or history of having dental amalgam restorations” and “no statistically significant differences in brain mercury levels between subjects with Alzheimer’s Disease and control subjects.”

A 2003 paper published in the New England Journal of Medicine states, “Patients who have questions about the potential relation between mercury and degenerative diseases can be assured that the available evidence shows no connection.” [Read more ...]

Robert Ferguson, founder and president of the Science and Public Policy Institute (SPPI), told Foxnews.com that he sees the controversy surrounding dental amalgam as little more than the latest scare to drive more regulation.

What are your thoughts on the use of silver amalgam in dental treatments?

For more on this story see U.S. Weighs Support for U.N. Treaty That Could Force Dentists to Change Materials Used in Fillings.

Watch for more on this subject in the November issue of Academy of General Dentistry in a feature article by Eric K. Curtis, DDS, MA, MAGD titled, Black and White with Shades of Gray Ruminations on Amalgams in a World of Composites.

The proposed rule would likely take effect by 2014. Twelve US states already require separators.

In their announcement, the EPA stated that 3.7 tons of mercury are discharged each year by US dental practices. A 2003 study funded by the ADA found that dental mercury is the source of about 50% of the mercury encountered by water treatment plants.

Expect this to be a topic of discussion at the ADA annual meeting later this month.

Read more: US EPA to regulate dental mercury waste

Past surveys have consistently shown dentists split on the topic of amalgam, as about half of dentists place amalgam fillings. But in this survey, 74% of dentists said that dentists should be able to make their own choices about restorative materials.

“I’ve personally not used it for 30 years,” said one dentist, “but I would guard the right of others to use it when indicated by their ethics and philosophy.”

Here are some further dentist comments:

• “All studies demonstrate amalgam is safe and very effective.” (California dentist)
• “Composites are not without their own toxic byproducts.” (General dentist)
• “Once the ‘Old Guard’ passes, retires or fades away, there will be no more dental amalgam.” (General dentist)
• “I just travelled to Haiti to do volunteer work in a make shift mission. In the end, the amalgam was the best material of choice… Each dentist must be given the option of selecting the material of choice for the conditions in which they are required.” (General dentist)
• “It’s time to move on. Hopefully the options will get even better.” (New York dentist)
• “Most dentists cannot do a decent proximal contacted composite. I would much rather have a mediocre amalgam than an almost perfect composite.” (New Jersey dentist)
• “If amalgam was safe, OSHA would not require its disposal in hazardous waste.” (California dentist)
• “I could not, would not be able to serve the IDD (intellectually and developmentally disabled) population well if I was not given the choice of amalgam.” (Developmental Dentist)
• “I personally use amalgam probably less than 5% of the time, but at least I have that choice. Who would enforce this ban? The Government?? Let the dentist decide!!” (Florida dentist)
• “It works well, is very forgiving, seals its own margins. It is not the universal restorative material, but neither is anything else, including resin. Dentists should have the skill, knowledge and option to use a variety of materials.” (Indiana dentist)
• “If this were a new material applying for FDA approval, how long would the process take? How hard would the FDA laugh before saying ‘NEXT!’?” (Texas dentist)
• “Unless evidence exists – which it does not – a ban is totalitarian. What’s next – McDonalds? Pizza? Meat?” (Orthodontist)
• “You can’t do repairs under dental crowns with anything other than amalgam.” (General dentist)
• “I wouldn’t use it on myself or my family. So I haven’t used it on my patients in 17 years.” (Texas dentist)
• “Amalgam works fine. Never seen a negative effect of amalgam use.” (Prosthodontist)

Read more: Dentists Not in Favor of Banning Dental Amalgam

When we asked dentists about amalgam restorations, 66% said they tell patients that they have other cosmetic options. Another 22% tell patients about potentially safer options; many of these dentists no longer use any amalgams at all. However, 12% say they prefer placing amalgams.

Here are some dentist comments on the subject:

• “They were great 20th century restorations. Luckily, we are in the 21st century.” (Illinois dentist)
• “Amalgam fillings last much longer than composite. It is a travesty to not offer amalgams at all.” (Canada dentist)
• “I stopped doing amalgams 24 years ago. I would not place something in a patient’s mouth that the government does not allow in their sewer systems.” (Pediatric dentist)
• “It’s a safe, cost-effective restoration. If it’s banned, the cost of dentistry would increase and the poor would be the most to suffer.” (New York dentist)
• “They crack teeth and look ugly.” (Texas dentist)
• “Mercury poison causes mercury poison symptoms. To my knowledge, amalgam fillings never have. They try to blame amalgams on every disease under the sun. Why do people without fillings get the same diseases?” (Kentucky dentist)
• “It should be outlawed.” (Nevada dentist)
• “If you had a tooth-colored filling with the same characteristics as amalgam, few would use composite.” (Illinois dentist)
• “It is malpractice to tell the average patient who has no allergies to the components in amalgam that these restorations are a threat to their health. Patients have a right to a choice, but that choice needs to be based not on the dentists’ bias but on facts.” (Pennsylvania dentist)
• “Problem is: why should we have raw mercury in our offices? If there is a spill you need a Haz Mat team to clean it up and a risk to the staff with possible legal consequences.” (California dentist)

Read the complete dental amalgam survey results or post your own comments

The debate over mercury in dental fillings is a heated one – and the debate over the language used to describe those fillings is just as hot!

In our recent Wealthy Dentist survey on the subject, we referenced “mercury fillings” – and many dentists were not pleased. There are a lot of politics behind which words are used to describe dental amalgam. Different names highlight different ingredients (and different beliefs!).

Most dentists in a recent Wealthy Dentist poll preferred the term silver filling to refer to dental amalgam restorations. However, many dentists prefer alternate descriptors, with one respondent going so far as to call them mercury-releasing fillings.

The power of naming cannot be overstated. Remember what a major coup the Republican party scored when they successfully rebranded the inheritance tax as the death tax?

“It is as foolish to refer to amalgam fillings as ‘mercury fillings’ as it is to refer to composite as ‘bisPhenol A bisGMA’ fillings,” declared a Minnesota dentist. “Most dentists know too little about potential biological effect variants to justify ‘voting’ for or against any material with verifiable conviction.”

The Facts

• Today’s dental amalgams are generally composed of about 40% mercury and 40% silver, with the remainder consisting of tin, copper and zinc.
• Amalgam fillings are less expensive than composite fillings.
• Amalgam fillings are not aesthetically attractive.
• Amalgam fillings can last for 50 years or more.
• Dental amalgam was developed nearly 200 years ago.
• Amalgam use is now illegal in Norway and Sweden.

Is it poison?

• Health authorities do not agree on the safety of amalgam fillings. You can find respected voices on both sides of the debate.
• Mercury is a known toxin, but the elemental mercury in amalgams is significantly less toxic than in other chemical forms.
• Trace amounts of mercury do escape from dental amalgam. However, these levels are far lower than the metal’s known toxicity.
• People with amalgam fillings do have slightly higher levels of mercury in their blood. (It is not clear if the amount is biologically significant or not – that’s the million-dollar question!)
• When patients have amalgam fillings removed, their mercury exposure initially spikes (as a result of exposure during removal), then gradually decreases.

One by one, let’s examine some of the terms used.

“Mercury amalgam fillings”

Though it seems a straightforward designation to non-dentists, I know from personal experience that many dentists object to this usage, as I myself have been repeatedly reprimanded for using this term. Though most people think of the word amalgam as meaning any mixture of metals, its original scientific meaning was of a mercury-based metal alloy. Therefore, mercury amalgam is a redundant term, like lettuce salad or bread sandwich.

“Silver amalgam filings”

This is the more technically accurate term. However, the average dental patient is unlikely to know that mercury is included in the definition of amalgam.

“Silver-mercury fillings”

Technically accurate, as amalgam is primarily an alloy of those two metals. Some feel including the word mercury in the descriptor is most informative, whereas others feel that including the term reeks of anti-amalgam bias.

“Silver fillings”

Preferred by some amalgam advocates, this term omits any reference to mercury. Though all dentists know that these metal fillings contain mercury, the truth is that a surprising number of consumers do not. “Why call them mercury fillings? They have been silver fillings for over 100 years,” said a Florida dentist.

“Mercury fillings”

This term is quite up-front about mercury content (perhaps too much so). “I don’t think calling them mercury fillings is something one does unless they are trying to direct the patient towards composite restorations,” said an Arkansas dentist.

“Mercury-releasing fillings”

This weighted term is preferred by some anti-mercury advocates. Evidence suggests that amalgam fillings release trace amounts of mercury vapor that are absorbed by the body. However, experts disagree on whether these levels are high enough to cause health problems.

“Dental amalgam restorations”

The terminology favored by the ADA omits the consumer-friendly filling for the umbrella term restoration.

Looking for more information?

• Results of the Wealthy Dentist’s dental amalgam filling survey
• ADA Press Kit
• FDA Consumer Guide
• Wikipedia: Dental Amalgam Controversy
• (Anti-Amalgam) Amalgam/Mercury Dental Filling Toxicity
• (Pro-Amalgam) The “Mercury Toxicity” Scam

Post your own comments

Dr. Larry Hanus lost his dental license years ago for his outspoken anti-amalgam views (read more). Now he’s asking for it back. When asked if Iowa’s board should reinstate him, 57% of dentists in our most recent survey said no: there are other issues with Dr. Hanus besides his recommendation that patients replace all their amalgam fillings. The remaining 43% supported him, saying that dentists must be free to voice their health concerns, even if the ADA doesn’t like it.

Here are a few of the comments our dentists had to share:

• “Dr. Hanus should have his license back ASAP.” (California dentist)
• “Half truths are never good.” (Louisiana oral surgeon)
• “These guys are quacks.” (Georgia orthodontist)
• “Return his license and apologize.” (Illinois dentist)
• “As a health care provider, I should be able to say whatever I think if it is evident in my practice.” (Michigan prosthodontist)
• “The ADA doesn’t gag anyone… All they ask is that we be truthful, present all the alternatives to our patients and, above all, do no harm.” (Nevada dentist)
• “I don’t know why you want to bash organized dentistry, and the ADA in particular, about the Hanus decision…. I thought this website was above such behavior.” (Ohio dentist)
• “I think that ADA executives who’ve buried their heads in the sand should have their licenses suspended once the truth comes out.” (New Jersey dentist)
• “Amalgam has NO proven side effects… Dentists should not make unscientific recommendations to patients.” (Oregon prosthodontist)
• “Can we revoke his DDS as well? The man is NOT a scientist: he’s a hysterical scaremonger! (California endodontist)
• “Dentists are free to avoid materials that they do not like. But there indications for amalgam as there are for most materials, and dentists should not be trying to have amalgam eliminated from our armamentarium.” (New York pediatric dentist)
• “It should be a non-issue. Amalgam is going away due to market forces related to cosmetics. In another 5 years it will fall all by itself.” (Alaska dentist)
• “More dentists should speak out. Can’t everyone see that there are two standards for mercury? It seems that the oral cavity is the only ‘safe’ place for mercury.” (Illinois dentist)
• “Is this who you would send your family to?” (Oklahoma pediatric dentist)
• Read more dentist comments or post your own below!

Check out the complete anti-amalgam dentist survey results…