Dental amalgam: effective, but disputed
The advantages of dental amalgam (grey filling) are many: it is a durable, economical and easy to use material. The effectiveness of amalgam is no longer to be proven; however, its biological safety is increasingly being questioned.
Our company has already banned the use of various products because of their harmful effects on the environment as well as on our health. Leaded gasoline and asbestos tiles are among these products that have been banned over the years. In 1998, the Environmental Protection Agency (EPA) in the United States classified amalgam waste as “hazardous waste” because of the mercury contained in it. Therefore, amalgam waste must be placed by dentists in unbreakable and airtight containers, specially designed for this purpose, and kept away from any source of heat. Mercury separators are now mandatory in all dental clinics, following the protocol adopted by the Canadian Dental Association and Environment Canada in 2002.
Knowing that mercury amalgam is harmful to the environment, why should we continue to use it to treat dental caries?
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The traditional position
Faced with the debate on the use of dental amalgams, the major associations took a stand. In the United States, the American Dental Association, which represents a major leader in dentistry, states that the amount of mercury in dental amalgam is not sufficient to affect health.
For its part, the Canadian Dental Association argues that dental amalgams are safe, including for people with increased sensitivity to mercury (between 2 and 3% of the population).
Finally, the Ordre des dentistes du Québec, without denying the dangers of mercury exposure, indicates that the quantity absorbed by a person in the presence of a restoration made from dental amalgam is well below the minimum dose with an adverse health effect.
Mercury in the environment and the solutions considered
The most important source of mercury to which the population not working in the industrial sector is exposed comes from dental amalgam. This was reported by the World Health Organization (WHO) in 1991. According to various studies, the mercury contained in a dental amalgam restoration would exceed the limit recommended by the Environmental Protection Agency (EPA) for an adult for 100 years. In addition, toxicologists have reportedly stated that the minimum quantity of mercury that does not cause any health damage is unknown to date.
In 2009, a WHO expert committee suggested the phasing out of dental amalgam through various strategies, including research and development of beneficial alternatives, the introduction of biocompatible materials, training of oral health professionals and public education.