Oral Health Topics
Amalgam (Dental Filling Options)
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Overview
Dental amalgam has an established record of safety and effectiveness. Amalgam has been used to restore the teeth of more than 100 million Americans. However, the fact that its formulation includes mercury content has raised safety concerns in the minds of some. Small amounts of mercury vapor can be released from amalgam during placement, mastication and brushing. The safety of dental amalgam has been studied and reviewed extensively and no correlation has been found between the small amounts of mercury released from amalgam restorations and any adverse health effect.
Resources
Life Sciences Research Office Literature Review
In 2004, an expert panel reviewed the peer-reviewed, scientific literature published from 1996 to December 2003 on potential adverse human health effects caused by dental amalgam and published a report. The review was conducted by the Life Sciences Research Office (LSRO) and funded by the National Institutes of Dental and Craniofacial Research, National Institutes of Health and the Centers for Devices and Radiological Health, U.S. Food and Drug Administration (FDA). The resulting report states that, “The current data are insufficient to support an association between mercury release from dental amalgam and the various complaints that have been attributed to this restoration material. These complaints are broad and nonspecific compared to the well-defined set of effects that have been documented for occupational and accidental elemental mercury exposures. Individuals with dental amalgam-attributed complaints had neither elevated urinary mercury nor increased prevalence of hypersensitivity to dental amalgam or mercury when compared with controls.”
- Executive Summary (PDF)
ADA Literature Review
Based on the results of a comprehensive literature review on amalgam safety, the ADA Council on Scientific Affairs (CSA) reaffirmed that the scientific evidence supports the ADA’s position that amalgam is a valuable, viable and safe choice for dental patients.
FDA Literature Review (White Paper)
In 1997, the U.S. Food and Drug Administration (FDA) and U.S. Public Health Service concluded from a review of nearly 60 peer-reviewed studies that the “data does not support claims that individuals with dental amalgam restorations will experience adverse effects, including neurologic, renal or developmental effects, except for rare allergic or hypersensitivity reactions.” Recently the FDA set out again to update its position on dental amalgam based upon the literature that has been published since the 1997 review. In 2009 they concluded “that there is insufficient evidence to support an association between exposure to mercury from dental amalgams and adverse health effects in humans, including sensitive subpopulations.”
The Journal of the American Dental Association
- Prenatal exposure to dental amalgam: Evidence from the Seychelles child development study, main cohort (2011)
- Neurological outcomes in children with and without amalgam-related mercury exposure (2008)
- Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial (2007)
- A Dose-Effect Analysis of Children’s Exposure to Dental Amalgam and Neuropsychological Function (2007)
Additional Resources
- Public Health Reports: Economic Impact of Regulating the Use of Amalgam Restorations (PDF)
- ADA Principles of Ethics and Code of Professional Conduct
- ADA Statement on Dental Amalgam
- ADA News Release: American Dental Association Statement: Food and Drug Administration Action on Dental Amalgam (Posted 07/28/09)
- Oral Health Topic: Amalgam Separators
- Oral Health Topic: Best Management Practices (BMPs) for Amalgam Waste
- Centers for Disease Control and Prevention (CDC): Dental Amalgam Use and Benefits
- FDA: Dental Amalgam
