Dentists: BPA is Back Making Front Page Dental News Again

BPA in Children is Making Front Page Dental NewsBisphenol A (also known as BPA), a chemical used in lightweight plastics, dental sealants and dental fillings is back making news headlines once again.

First, the federal government announced this month that baby bottles and sippy cups can no longer contain BPA.

This was followed by reports from a new study stating that children getting dental fillings made with BPA are more likely to have behavior and emotional problems later in life.

The study, as reported in Pediatrics Online, “makes a strong case that in the short-term, use of BPA-containing dental materials should be minimized,” asserts Philip Landrigan, director of the Children’s Environmental Health Center at Mount Sinai School of Medicine in New York City.

The researchers in the study tracked 534 children with cavities from when each child received their first dental fillings. Over the following 5 years, the researchers noted that those children who had cavities filled with a composite material containing traces of BPA consistently scored 2 – 6 points less on 100-point behavior assessments than those who didn’t have fillings.

As reported in Science News, the researchers never administered clinical diagnostic behavioral tests to the children.

Instead, they periodically administered some widely used checklists to the children or their parents, allowing each to self-assess features such as a child’s attitudes toward teachers or others, depression, self-esteem, attention problems, delinquent behaviors, acting-out or problems with attentiveness.

Since the children were 6-12 years old at the time, these type of behaviors are not uncommon for children living with a variety of circumstances like divorce, bullying, and problems at home.

However researchers argue that the behavior problems being reported seemed to happen more with the children who had BPA fillings, causing them to believe that some dental fillings may start to break down over time, thus exposing these children to the chemical.

The U.S. government is currently spending $30 million on its own BPA research to determine the chemical’s health effects on humans.

As a dentist, what are your thoughts on the use of BPA?

For more on this story see: Putting BPA-based Dental Fillings in Perspective 

Dentist Amalgam Separators To Be Required by EPA

EPA to require dental amalgam separators for every dentistDentists, take note! The Environmental Protection Agency (EPA) has announced plans to require every US dentist have an amalgam separator.

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

Dental Amalgam Provokes Passionate Response Among Dentists

Silver Fillings Are the Best Thing Ever… Unless Mercury Is Killing Us All

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

Dental Amalgam: The Language of Controversy

Just What Do You Call Those Metal-Colored Dental Fillings?

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.

Dental Survey Results

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?

Post your own comments

Should Anti-Amalgam Dentist Larry Hanus Get His Dental License Back?

 

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.

Dental Survey ResultsHere 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…

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