Dental Amalgam Table of Contents
Introduction
History of Amalgam Fillings
Mercury Toxicity
Patient Exposure to Mercury from Amalgam Restorations
Mercury Toxicity from Amalgams
Current Research
Amalgam and the Environment
Pima County, Arizona Dentists Suspended
EPA Takes Action in Connecticut
Do Patients Have the Right to Know?
Class Action Suit Against ADA179
Legislative Efforts to a Solution
Conclusion
Notes
Dental Amalgam
Use and Benefits
Highlights of the Report on Dental Amalgam
Composition of Amalgam Alloy
Predictions for the Future of Dental Amalgam
Dental Materials Fact Sheet
Dental Materials Fact Sheet (DMFS)_Frequently Asked Questions
- What is the Dental Materials Fact Sheet?
- What if I disagree with the DMFS, do I still have to provide it to my patients?
- I don't place amalgams, or I do only orthodontics – am I exempt? The majority of my patients are Hispanic. Is the DMFS going to be provided in Spanish or any other language?
Dental Materials Fact Sheet
- What is dental amalgam?
- Is mercury in dental amalgam safe?
- Why do dentists use dental amalgams?
- Why don't dentists use alternatives to amalgam?
- What about patients allergic to mercury?
- Are staff occupationally exposed?
- What are other sources of mercury?
American Dental Association Recommendations
Position of Health Canada
Health Canada Position Statement on Dental Amalgam
Post-Test
- What is amalgam?
- Can mercury from amalgam fillings reach the rest of the body?
- Do dentists say that amalgam is safe?
- But mercury is toxic, isn't it?
- Who regulates dental filling materials?
- How much of our day-to-day mercury intake comes from dental fillings and how much comes from other sources?
- How can patients find out about mercury exposure?
- Is it possible to remove mercury absorbed into the body?
- Chelation has side effects of its own. How should amalgam fillings be removed?
- Should amalgam be used during pregnancy?
- Should amalgam be used for children?
- Is there any group for whom amalgam should not be used?
- Should amalgam fillings be kept below a safe maximum related to body weight?
- What do other governments and health bodies say?
- Should dentists explain current concerns about amalgam safety when suggesting its use?
References
Learning Objectives
After completing the course, you'll be able to:
- Recount the history of amalgam fillings and controversy swirling around their use over the past 150 years.
- Describe the current research being done regarding the safety of amalgam fillings.
- Discuss informed consent as it may apply to amalgam fillings in dental practice.
- List 7 circumstances where the use of dental amalgam is indicated.
- List 3 instances where dental amalgam is contraindicated.
- Provide at least 4 reasons as to why it is inappropriate at this time to recommend any restrictions on the use of dental amalgam.
- Discuss the investigative efforts of the U.S. Public Health Service to determine the safety of amalgams used in dental restorations.
- Discuss with the patient the risks and benefits of various dental materials taking into account patient's susceptibility to sensitivity and allergic reactions to certain materials.
- Compare 4 direct restorative dental materials (amalgam, composite resin, glass ionomer cement and resin ionomer cement) with respect to various factors for use in dental restorations.
- Compare 4 indirect restorative dental materials (ceramic porcelain, fused-to-metal porcelain, gold alloys, nickel or cobalt-chrome alloys) with respect to various factors for use in dental restorations.
- Implement in your dental practice 4 specific recommendations made by the ADA regarding the use of amalgam fillings.
- Make an appropriate response in the event a patient asks the dentist to remove patient's serviceable amalgams.
- List 5 things a dentist should do before removing serviceable amalgam restorations from the non-allergic patient at the patient's request.
- Inform the patient with scientific data of the safety and durability features of amalgam fillings.
To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.