While the FDA holds fast to its position on mercury amalgam, the same can’t be said for the European Commission’s Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). In their just released final report, they now state
that alternative materials to dental amalgam should be the first choice for certain restorations, such as those in pregnant patients and primary teeth.
Suffice it to say, this is another important step toward a mercury-free future. (Previously)
And while SCENIHR still holds that mercury amalgam poses no health risk to the general population and remains an appropriate choice, they also acknowledge the increasing benefits of alternative materials.
“Alternative materials have now been in clinical use for well over thirty years, initially in anterior teeth and more recently also for restorations in posterior teeth,” the committee wrote. “Existing clinical experience has revealed little evidence of clinically significant adverse events.” It noted that the composition of available materials has changed substantially in recent years because of “improved polymerization processes and particular improvement in the adhesive systems and the filler parts.” Among the benefits, the committee wrote, is that there is “no evidence that infants or children are at risk of adverse effects arising from the use of alternatives to dental amalgam.”
There is a trend toward minimal interventional, adhesive techniques in dentistry, which are “based on adhesion to tooth structure by chemical interaction, and/or micromechanical retention,” according to the opinion. At the same time, the committee noted, the quality and durability of alternative materials have improved.
The committee also addressed the need for patients to be informed of both the risks and benefits of any dental treatment – which is as it should be. Without that knowledge – as well as an understanding of all appropriate options that are available to them – there can be no truly informed consent. (This is one of the reasons why patient education is such a critical part of our practice.)
In the video below, Dr. Rehme goes over some of the basics of what everyone should know about mercury amalgam “silver” fillings:
