In 1994, Sweden announced the ban of amalgam as dental filling material. It was totally implemented on 1995 (for children) and on 1997 (for adults). Even if the ban didn’t take into effect in a single beat, it is said that only few believed that it doesn’t do any harm in their health. Some of the states in the US and countries followed the banning in Sweden.
The events that happened in Sweden is no less dramatic than what was experienced in Germany. In 1987, only a warning was sent in prevention or avoding of amalgam usage as dental fillings.While on 1993, Degussa AG (largest dental amalgam producer in Germany) announced their stoppage in production of amalgam.
Dental amalgam can aid the prevention of stress and pain of a patient. However, it is not all the time that amalgam should be used in case of oral cavities. So here are some incidents on which dental amalgam should not be used.
First, esthetics are essential (such as the anterior teeth and the root canak restorations of the anterior teeth. It should also not be used if the patient has a history of being allergic to mercury or those elements and components from which amalgam is formed. Lastly, it should be used when a large restoration is needed and the cost of the other retorative materials are indeterminate in the treatment results.
There is a myth going around which states that there are other materials that can be used to treat caveties, but the American Dental Association promotes the use of dental amalgam instead because it earns a profit from amalgam manufacturers. This myth is false. The ADA does not profit when patients use dental amalgam and it does not necessarily promote it. The ADA does promote education and awareness so that patients can make informed decisions about their oral health care together with their dentist. The choice of which filling material to use is determined by the dentist and patient together and is based upon a variety of factors like the location and size of the cavity, cost, cosmetic concerns, and patient history.
In Asia, Japan is the only country that regulates the use of dental amalgam. Most European countries like the UK, Italy, and France have unrestricted use of dental amalgam. Other countries like Sweden have regulated or banned the use of mercury as a component in dental amalgam due to environmental and health issues. The Swedish Chemicals Inspectorate has a website that contains a report on the investigation regarding the general ban of dental amalgam. Countries like Germany and Austria place restrictions on the use of dental amalgam. Except for pregnant women, children, and people with kidney problems, the general public can use dental amalgam. In Norway, the use of dental amalgam was made illegal on January 2008.
There are other types of dental fillings that you can use instead of dental amalgam if you think you may be allergic to its mercury component.
Resin composite is a tooth-colored material made out of resin compounds and powdered glass. When they were first introduced in dentistry, they were not strong enough and was limited to the front teeth. Today, resin composites are stronger and can be used for molars, although they need earlier replacement since they don’t last as long as metal-based fillings.
Glass iomer cement is made out of glass and is a tooth-colored material like resin composite. However, it is not used for long-term fillings because glass iomer breaks easily.
Other metals like porcelain and gold are also used as fillings, especially for bridges, inlays, crowns, and veneers.
Dental amalgam or silver filling is a safe, durable, and affordable material that is used to restore teeth. It is made up of a mixture of metals like tin, silver, copper, and mercury, and is chemically bound into a safe and stable substance.
Dental amalgam has a fairly consistent safety record and cases have been reviewed extensively. Except for rare cases where patients are sensitive to mercury, the US Public Health Service says that there are no health reasons not to use dental amalgam. This supports the conclusions of the Food and Drug Administration and the National Institute of Dental Research, which says that amalgam fillings are safe and effective. Besides this, people are more exposed to mercury from water, air and food than the mercury vapor in amalgam fillings.
Mercury as a single element is highly poisonous metal but in dental amalgam, it is made in an alloy composed of copper, tin, and silver. Very little mercury vapor is released from the dental amalgam. For most patients, there are no known harmful effects caused by the mercury in amalgam fillings. For those who have high exposure to mercury, such as people who work in industrial settings, the severity of mercury poisoning depends on the amount of exposure and the duration. However, in low level mercury exposure associated with dental amalgam, the relationship between the possible effects and the duration and level of exposure is still unknown. Dental amalgam is still the most affordable and most durable of all dental fillings, and further research is still being done to arrive at definite scientific answers.
The controversy over dental amalgam is due to the use of mercury as a component in the dental filling. A federal health survey called NHANES III discovered that the number of patients with amalgam fillings has a significant correlation with cases of thyroid problems, cancer, mental conditions, disorders in the circulatory, eye, and respiratory systems, as well as diseases of the nervous system. However, correlation does not necessarily mean causation and the US Food and Drug Administration say that the data presented does not show that dental amalgam poses a direct hazard to humans. Although dentists do acknowledge that a small number of patients can suffer from problems due to mercury allergy or sensitivity, there is still no substantial evidence that shows mercury poisoning is caused by dental amalgam.
Dental amalgams have been in use for over 150 years, making this one of the oldest methods used in oral health care, predated only by the use of gold fillings. Dental amalgam is the combination of 43-54% liquid mercury and 46-57% of alloy powder made out of copper, silver, tin, and sometimes small amounts of palladium, zinc, and indium.
The use of dental amalgams decreased during the 1970s due to a general decline in dental caries among children and adults. Improved oral hygiene products and practices as well as modification in diets also contributed to the decrease in use of dental amalgam. In the 1990’s, there were over 200 million restorative treatments done in the United States. Only 96 million of these procedures were of dental amalgams, a 38% decrease since the 1970’s.
Dental amalgams can be used for patients of all ages, in small or moderately-sized cavities in teeth, as a foundation for metal-ceramic or cast-metal restorations, when the tooth structure is severely destroyed, when the patient has poor commitment to oral hygiene, when the patient has a problem with moisture control, and when cost overrides patient concern.
Dental amalgams should not be used for restorations of anterior teeth, in root canals, when the patient has a history of allergy to amalgam components like mercury, and when a major restoration is needed and other restorative options is cannot be taken.