Dental fillings - Amalgam or Porcelain?

The FDA agreed to update its website to inform consumers that the mercury in metal dental fillings can pose a risk to the health of pregnant women, fetuses, and children.

The agreement is part of a settlement on a lawsuit filed by consumer advocacy groups. In addition, the FDA has also promised to come out with a more specific ruling by July 2009 on the silver-colored dental fillings that contain mercury.

The FDA Web site now contains the notice that the mercury in dental amalgams can “have neurotoxic effects on the nervous systems of developing children and fetuses.”

The agency further advises pregnant women and persons having health conditions that increase their sensitivity to mercury exposure to discuss fully their dental care options with the health professionals.

The advocacy groups in their lawsuit wanted the FDA to ban mercury fillings from the U.S. market. In a number of countries, including Austria, Canada, Denmark, Germany and Sweden, mercury fillings have been banned or discouraged from use particularly in pregnant women and growing children.

The amalgam used for dental fillings contains liquid mercury (50 percent by weight) and an alloy powder of other metals like copper, silver, zinc, and tin. The mercury binds the powder together. Amalgam has been in use for over 150 years.

The position of the American Dental Association (ADA), along with the U.S. Public Health Service, the European Commission and the World Health Organization and many scientific studies, is that the minuscule amounts of inorganic mercury in dental fillings are not easily absorbed into the human body.

There have been warnings about eating fish containing mercury (see Safety Issues article: Eating Fish during Pregnancy Safe?). There is a difference, however. The mercury in fish comes in the form of methyl mercury, which is absorbed quite easily by the gastrointestinal tract. Amalgam contains inorganic, elemental mercury, which is not easily absorbed.

Many clinical studies indicate that there is no harm coming from dental fillings.

Still, there are people who may carry mercury in their body systems from exposure to other sources — and even trace amounts of mercury can be toxic. There is concern that very little amounts of mercury from dental amalgam could prove to be the straw that breaks the camel’s back for such people.

The FDA is not yet telling people to have existing dental fillings removed. Its final ruling in July 2009 will define exactly how dental amalgam will be regulated.

Safety Tip:

* Porcelain fillings are available. They have the advantage of looking exactly like real teeth. The downside is that they are more expensive and do not last as long as amalgam.