Some topics come up repeatedly in biological dentistry – biocompatibility, for instance. And fluoride. And root canals. And “cavitations.”
Then, of course, there’s amalgam.
You know the stuff: the material used for what are often still called “silver” fillings, despite the fact that mercury is their main component – about 50% by weight. Already banned in a number of countries, it’s set to be phased out in the EU by 2034 under the Minamata Convention on Mercury.
But here in the US, change has come more slowly. Although we, too, signed onto the treaty back in 2013, it wasn’t until 2020 that the FDA updated its guidance to advise against using amalgam – and then, only in certain high risk groups.
Lately, though, there’s been more movement toward a mercury-free future in the US. Recently, the Indian Health Service announced that it will phase out mercury amalgam in its dental clinics by 2027. The International Academy of Oral Medicine & Toxicology (IAOMT), in coordination with DAMS, inc., formally petitioned the FDA to finally ban the use of amalgam.
And now Consumers for Dental Choice has followed suit, calling on federal regulators to end mercury amalgam use. They’re joined on the petition by the Alliance of Nurses for Healthy Environments and the Mercury Policy Project.
Their filing argues that amalgam meets two existing criteria that would allow the FDA to ban the material. The first is that the marketing of amalgam fillings as “silver” fillings amounts to a form of consumer deception, given that mercury is their main component. The second is that mercury amalgam poses an “unreasonable and substantial risk of illness or injury,” which they note is increasingly recognized across numerous government agencies, health authorities, industry shifts, and international policy.
Of course, filling teeth with mercury amalgam isn’t the only procedure of concern to biological dentists. Root canal treated teeth, for one, carry their own potential risks.
This is something that has long been studied and followed by the IAOMT. As with amalgam, the organization regularly publishes and updates position papers on the matter to reflect the latest relevant science. Just recently, they released their latest “State of the Science on Root Canal Treated Teeth.”
The paper looks closely at what can remain after root canal treatment. While the procedure is designed to remove infection from inside of a tooth, there’s evidence that lingering infection around the tip of the root – a condition called chronic apical periodontitis – remains fairly common, affecting an estimated 40 to 60% of root canal teeth.
This can surprise some people, mainly because older, two-dimensional x-rays don’t always catch what’s happening in the surrounding bone. Newer 3D imaging (CBCT) has been giving us a clearer, more detailed picture – literally. In many cases, it’s showing that persistent infection is more common than once thought. The paper notes that factors like the shape of the canals, the limits of disinfection, and individual biology all play a role in this phenomenon.
The paper also brings together research on how these lingering infections might connect with broader health concerns. Areas of interest include cardiovascular disease, diabetes, and other inflammatory or immune-related conditions. These links are still being sussed out, and causality isn’t always clear. Proposed mechanisms include the spread of bacteria and inflammatory byproducts into the bloodstream and the body’s ongoing immune response to that presence.
If you’re interested in digging into the research itself, it’s worth a look. You’ll find the paper here, including as a downloadable PDF.
