That was the title of the ITV Tonight programme I have just watched. This was about the "poison" that is dental amalgam (the stuff used for filling teeth) and is a story that crops up every few years. Like previous programmes (I think Panorama did one a few years ago) it is trying to shock and sensationalise, quoting a woman who had all her amalgam fillings replaced and is now miraculously cured of all her health problems.
I was disappointed by the representatives of the dental profession. Peter Ward from the BDA looked a total fool in response to not unreasonable questions. Chief Dental Officer Barry Crockroft seemed woefully underprepared. Surely someone could have found him some decent studies to support the argument for dental amalgam?
OK, how about some of the things that I know about dental amalgam...
1 Mercury is poisonous but in fillings is mixed with other metals. Most mercury is released during placement and removal of fillings, but it is unlikely that the amounts are harmful.
2 Dentists do have to follow regulations regarding the disposal of amalgam to safeguard the environment (otherwise mercury would build up and get into the food-chain, potentially much more damaging).
3 Scandinavian countries have banned amalgam, but in an attempt to reduce the amount in the environment and not due to direct impact on the health of individuals.
4 It is still the best filling material in terms of cost and longevity, although dental material science is advancing all the time and will eventually catch up.
5 There has been advice for a few years to limit placement of amalgam in pregnant women, but no advice on whether pregnant dentists should avoid using it!
Please don't panic about this and immediately rush off to your dentist to get your fillings taken out. By all means, discuss the options with your dentist. In fact, many patients are choosing alternatives to amalgam, but generally for aesthetic reasons. It is also worth looking carefully at the costs involved as the cheaper white filling materials tend not to perform as well as amalgam. Gold or porcelain inlays are an excellent alternative but are more costly, so many patients tend to choose them as old fillings wear out and need replacing anyway.
As for me, I will not be rushing to get my amalgam fillings replaced and would not hesitate to have another if my dentist recommended it.
Oh, and I might consider writing to the presenter of the programme to see if he would like some orthodontics to close the gaps in his teeth...!
4 comments:
Should I have toxic waste removed from my mouth? - it's a no-brainer!
Further Dental Surgeons and their nurses through placing amalgam restorations have a higher level of mercury with-in their bodies than the general population (still thousands of times beneath WHO safe limits). Therefore one would expect that there would be a higher rate of degenerative diseases with-in the dental profession.HOwever the current studies to date have found no increase in degenerative illnesses or any other illness with-in the dental profession compared to the general population. Guy’s hospital carried out a five year study into patients claiming that their amalgam restorations were causing them harm. The results found no evidence that the amalgam restorations were the cause of any of the alleged symptoms. Studies will continue as there may be yet some unknown link however unlikely and not to continue research would be unethical in light of public concern. I, as a restorative specialist, certainly would not be placing amalgam restorations if I felt my patients, my staff or my own health was being put at risk in the long or short term. At the present time I will happily place amalgam restorations and have my own amalgam restorations replaced in amalgam when they fail. But that is not to say I will not change my stance if research and evidence (not just hearsay or wild speculation) comes to light indicating that amalgam poses an unacceptable health risk.
It6 is good to hear Ian9559 is open to changing his stance, since in June last year 2008 Newsweek reported:
"In a legal settlement signed last week, the U.S. Food and Drug Administration has changed the information on its Web site about amalgam fillings to say that they “may have neurotoxic effects on the nervous systems of developing children and fetus,” and that pregnant women “should not avoid seeking dental care, but should discuss options with their health practitioner.” Previously, there was no such warning."
and further:
"The FDA also agreed to decide by next year whether mercury fillings need more regulation."
- so why take the risk now? It may be cheaper and easier for dentists to use amalgams but the true cost for a significant proportion of their patients is a genuine risk of severe health problems at some later date. There are effective alternatives - use them.
Its great that this has stimulated some debate. Unfortunately resare, it is not as simple as just not using amalgam. You are faced with the choice of removing (or not placing) something for which there is little evidence that it produces harm or using an alternative that is more expensive and potentially less effective as a dental filling. The implications for the patient are higher dental bills and a risk of increased dental problems which may lead to earlier tooth loss. As dentists we want to provide the best treatment possible and help patients keep their teeth for longer.
It is easy to get carried away by the anecdotal evidence such as shown on this programme, the reality is that scientific evidence does not back up the claims. But be reassured that this is still be researched and eventually we will know a lot more.
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