ADA Facts & Messages on Amalgam and Personal Health

Ø      Dental amalgam, an alloy made by combining silver, copper, tin and zinc with mercury, is one of several safe, effective options available to treat cavities caused by dental decay.

Ø      It’s important to understand that amalgam isn’t mercury; rather amalgam is an alloy, the components of which include mercury.  The alloy has entirely different properties than mercury.  So whether you’re considering its effect on the body or on the environment, you cannot compare exposure to amalgam to exposure to an equivalent amount of mercury.

Ø      No properly designed, scientific study links dental amalgam to any disease.  However, we support continued research on all restorative materials. 

Ø      Amalgam fillings release an extremely small amount of mercury vapor  - so small it’s in the billionths of an ounce. A 2003 article in the New England Journal of Medicine states that there is no scientific evidence that such low levels cause health problems. To put the issue into perspective, experts say it would take almost 500 amalgam fillings to produce even the mildest symptoms in the most sensitive patient.

Ø      The only documented adverse health effect attributed to dental amalgams is a mild allergic reaction that is so uncommon that fewer than 100 cases have been reported in the dental literature—fewer than100 cases, out of hundreds of millions of amalgam fillings that have been placed.

Ø      The ADA believes that an informed patient in consultation with his or her dentist best determines decisions about any dental treatment.  If you need a filling, your dentist can advise you about the available options.  And remember:  ultimately, it’s your decision, in consultation with your dentist, as to what type of filling you get. 

Ø      The ADA supports research on all fillings, including dental amalgam, and encourages scientific inquiry and dialogue.  The ADA would promptly inform the profession and the public if the scientific community determined that any restorative material was unsafe for patients.

Ø      Other organizations concerned about public health, including the Alzheimer’s Association, the National Multiple Sclerosis Society and the American Academy of Pediatrics, have publicly stated that there is no scientific evidence linking dental amalgam with any disease or syndrome.

Ø      The Autism Society of America states that there is no known cause for autism, but that it is generally accepted that it is caused by abnormalities in brain structure or function, and that children with autism are born with the disorder or with the potential to develop it.

Ø      No foreign country has banned dental amalgam.  A few countries have adopted cautionary statements against placing amalgam fillings in certain patient groups, but these same countries admit that the scientific evidence does not support these limitations.

Ø      For example, Health Canada’s amalgam advisory clearly states that current scientific evidence does not indicate that dental amalgam is causing illness in the general population.  It also states that neither a ban on amalgam or removal of existing sound amalgam fillings are justified.

Amalgam and the Environment

The scientific assessment commissioned by the ADA on amalgam waste combed through numerous EPA and other environmental studies and provided three major findings:

Ø      First, the vast majority of mercury in surface water is from coal-fired utility plant exhaust that travels through the air then falls back to the earth.

Ø      Second, very little amalgam enters surface water, because standard dental equipment and wastewater treatment facilities capture approximately 95 percent of waste amalgam;

Ø      Third, more research needs to be done to determine whether mercury is even released from the remaining few percent of amalgam waste that might enter surface water. 

Ø      Research is ongoing, but certainly at this point, all indications are that the tiny amount of amalgam that enters surface water is not causing any harm to fish. Methyl mercury is what you hear about in connection with certain types of seafood, and amalgam does not contain methyl mercury.

Ø      Amalgam, tooth-colored and gold fillings are all valuable to patients. Different cavities need different types of fillings. Out of concern for the environment, the ADA recommends dentists recycle amalgam, but it’s too important a material to just stop using it.

The ADA has a four-point plan to address amalgam waste disposal:

Ø      First, we commissioned a scientific assessment to determine the impact of amalgam in wastewater.

Ø      Second, we looked at the results and developed Best Management Practices, which include step-by-step guidelines urging dentists to recycle amalgam.

Ø      Third, we are currently promoting these recycling guidelines to our 149,000 member dentists through ADA conferences, educational materials and training workshops.

Ø      And finally, we’re encouraging our state and local dental societies to discuss amalgam waste disposal with regulators in their communities so they can decide upon an appropriate course of action. Our ultimate goal is for every dentist to recycle amalgam, just as every dentist uses a surgical mask and gloves when caring for patients.