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Why Dental Amalgam Should Not be Phased Out in the Philippines
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Written by charlieddm   
Tuesday, 01 April 2014

Why Dental Amalgam Should Not be Phased Out in the Philippines

Dental amalgam or silver fillings have been used by the
> dental profession for more than a century now. The question
> whether it is a health risk has been regularly researched on
> and scrutinized by experts and reputable organizations. Here
> is a listing of all these reputable organizations and their
> conclusions
> 1. Dept of Health and Human Services (USPHS) and FDA, 1993
> "…current scientific evidence does not show that exposure
> to mercury from amalgam restorations poses a serious health
> risk in humans, except for an exceedingly small number of
> allergic reactions. "
> 2. Dept of Health and Human Services (USPHS) and FDA, 1997
> "In 1997, with input from a broad cross-section of
> scientists and dental professionals within USPHS, the FDA
> completed a review of nearly 60 studies that were published
> in peer reviewed scientific literature and were cited by
> citizen groups that petitioned the agency for stringent
> regulatory actions against dental amalgam. The analysis of
> the cited studies indicated that the current body of data
> does not support claims that individuals with dental amalgam
> restorations will experience adverse effects, including
> neurologic, renal or developmental effects, except for rare
> allergic or hypersensitivity reactions."

> 3. Life Science Research Office (LSRO,) 2004. This NGO
> conducted a review of the literature published from 1996 to
> 2003. This was funded by the National Institutes of Dental
> and Craniofacial Research, NIH and the Center for Devices
> and Radiological Health, US FDA. They concluded that, “The
> current data are insufficient to support an association
> between mercury release from dental amalgam and the various
> complaints that have been attributed to this restoration
> material….   Individuals with dental
> amalgam-attributed complaints had neither elevated urinary
> mercury nor increased prevalence of hypersensitivity to
> dental amalgam or mercury when compared with controls.” 

> 4. Agency for Toxic Substance and Disease Registry (ATSDR),
> 2005 
> "The practice of having all your dental amalgam fillings
> replaced with non-mercury filling materials just to remove
> the possibility of mercury exposure is not recommended by
> ATSDR. In fact, the removal of the mercury amalgam fillings
> would actually expose the patient to a greater amount of
> mercury for a while."

> 5. FDI (World Dental Federation) , October 2007 issued the
> following statements
>    a. dental amalgam releases very small
> amounts (nanograms) of mercury, some of which is absorbed by
> the body
>     b. the level of urinary mercury is positively
> correlated with the number of amalgam restorations, but can also be affected by sources other than amalgam.
>      c. there is no evidence to support an association between the presence of amalgam restorations and chronic degenerative diseases, kidney disease, autoimmune disease, cognitive function, adverse 
pregnancy outcomes or any non-specific symptoms
>      d. local hypersensitivity reactions
> can occur on the mucosa adjacent to amalgam
>      restorations, but are extremely
> rare and usually resolved on removal of the amalgam
>      e. further research into the
> possible adverse effects of dental amalgam is desirable
>      f. alternatives to amalgam may have adverse effects

> 6. WHO 2009 report on the ‘Future Use of Materials for
> Dental Restoration"
> "Existing alternative dental materials are not ideal due to
> limitation in durability, fracture resistance, and wear
> resistance... recognized the need for strengthening of
> research into the long-term performance, possible adverse
> effects, and viability of such materials". 

> 7. European Union Scientific Community on Emerging and Newly
> Identified Health Risks (SCENIHR), 2008. After looking at
> the researches done on the common filling materials,
> including dental amalgam, concluded that:
>    “All the materials are considered safe
> to use and they are all associated with very low rates of
> local adverse effects with no evidence of systemic
> disease.” The alternative materials such resin composites,
> glass ionomer cements, ceramics among others, are not
> without clinical limitations and toxicological hazards.”

> 8. National Center for Toxicological Research US Food and
> Drug Administration, July 2009
> "It is concluded that there is insufficient evidence to
> support an association between exposure to mercury from
> dental amalgams and adverse health effects in humans,
> including sensitive subpopulations" 

> 9. WHO Consensus on Dental Amalgam 2009
> Safety of Dental Amalgam
>     "While there has been a number of case
> studies and informal reports, no controlled studies have
> been published demonstrating systemic adverse effects from
> amalgam restorations. At present, there is NO scientific
> evidence showing that general symptoms are relieved by the
> removal of amalgam restorations"

> 10. American Dental Association,  Council on Scientific
> Affairs, July 2009
>    “The scientific evidence supports the
> position that amalgam is a valuable, viable and safe choice
> for dental patients.”

> 11. FDI (World Dental Federation), 2010
> "Amalgam is a safe and highly effective restorative
> material. To maintain and protect global public health, a
> phase down of amalgam will be only appropriate when an
> alternative and suitable restorative material is
> available."

> 12. United Nations Environment Programme (UNEP). Minamata
> Convention on Mercury, Geneva, 19 January 2013
> Delegates agreed to a phase-down of the use of dental
> fillings using mercury amalgam. 

> 13. International Association for Dental Research, 2013. As
> regards its participation in the UNEP Minamata Convention on
> Mercury, Geneva, 19 January 2013 "IADR participated and contributed to the negotiations,
> along with FDI World Dental Federation and the International
> Dental Manufacturers, and has advocated for a reduction in
> the use of dental amalgam (versus a ban) through increased
> attention to dental prevention and health promotion,
> increased research and development on alternatives, and best
> management techniques for amalgam waste."

> The University of the Philippines Manila, College of
> Dentistry is strongly opposed to the proposed ban on dental
> amalgam for the following reasons:

> a. All the reputable organizations listed above have
> concluded that there is no scientific evidence linking
> amalgam with any health condition 

> b. Banning dental amalgam in the Philippines will result in;

> ---an increase in the cost of dental treatment because the
> alternative, composite resin, is twice more expensive; 
> ---because of the high cost of the alternative, many people
> will instead have their teeth extracted. There will be more
> Filipinos that will become edentulous (toothless)

> c. There is no perfect filling material. All will have their
> indications, contraindications, advantages and
> disadvantages. Dental amalgam is economical, not
> technique-sensitive and is indicated for the restoration of
> moderate to large cavities which is commonly seen among
> majority of Filipinos. In contrast, posterior composites are
> two times more expensive, technique-sensitive and indicated
> for restoring small to medium- sized cavities in patients
> with good oral hygiene. We have to accept the sad reality
> that many of our kababayans have poor oral hygiene and do
> not even have a toothbrush. 
College of Dentistry
University of the Philippines Manila
Tel. No. 3033603

Read more at: UP College of Dentistry

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