The following article is from The Harvard Medical School Adviser paper, researched and written by the faculty and staff of Harvard Medical School www.health.harvard.edu/adviser

If you disagree with Harvard's position on amalgam fillings, share your story/comments/opinion about mercury dental fillings with them by emailing: barbara@postandcourier.com

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Are amalgam fillings safe?

Q I have some old silver fillings that my dentist says need to be replaced. I've heard that removing these types of fillings can release mercury. Is this dangerous?

A: Dental amalgam is the silver-colored material used to fill (restore) teeth that have cavities. Also called silver or mercury amalgam, this material consists of two materials in nearly equal parts: a powder containing silver, tin, copper, zinc and other metals; and liquid mercury. Even though amalgam has been used for more than 150 years and is the most common material used for fillings, it remains controversial.

The source of the concern is fear that mercury may promote conditions such as Alzheimer's disease, multiple sclerosis and autism. Amalgam fillings release a tiny amount of mercury vapor when they are put in or removed from teeth. Even chewing can release mercury vapor. But there is no evidence that removing amalgam fillings will benefit — or harm — your health.

To date, no scientific studies have demonstrated any harm from dental amalgam. As a result, organizations such as the Food and Drug Administration, American Dental Association, National Institutes of Health and the Centers for Disease Control and Prevention have, at one time or another, stated that amalgam is safe for everyone except the few individuals who are allergic to the material. In addition, banning it would eliminate an important dental option for many people. Amalgam fillings are strong and durable, so they last longer than most filling materials. They are also relatively inexpensive.

However, the debate isn't over yet. After reviewing studies on amalgam from 1997 to 2006, the FDA drafted a report that reiterated that amalgam is safe for nearly all people. But in September 2006, the advisory panel that reviewed this report said there were too many uncertainties to make that claim. They say more information is needed on how it might affect certain groups, particularly pregnant women, children and people who are sensitive to mercury.

Nearly all the data on amalgam safety come from studies of adults. In many cases, these people worked in places where mercury is present in sizable quantities, such as dental offices. In fact, the first randomized trials in children appeared only in April 2006. These two studies found that children whose cavities were filled with amalgam had no health problems as a result. Each study involved more than 500 children, who randomly received either amalgam or composite fillings. One study tested the children over several years for memory, attention, physical coordination and speed of nerve conduction. The other study tested IQ. Researchers found no difference in test scores between the children in the two groups. They did find, however, that the children with the amalgam fillings had slightly higher levels of mercury in their urine.

While these studies are reassuring, we still need more research. The FDA advisory panel said there wasn't enough information to determine whether pregnant women and children should avoid amalgam fillings.

The debate about amalgam has prompted some dental professionals to substitute more expensive restorations for still serviceable silver fillings for all patients. Composites, which are tooth-colored materials made from powdered glass and other compounds, are a common option. When composites were introduced, they were not very strong and were used primarily in the front teeth. Newer composites are stronger, although they still tend to wear out faster than metal-based materials and generally need to be replaced earlier than amalgam fillings. Porcelain, gold and other metals also are used as filling materials.

If you got your fillings more than a decade ago, your dentist is correct. Most amalgam fillings wear out in 10 years or less and need to be replaced. Ask him or her which restoration material would be best for your particular situation and needs. Make your decision calmly, without undue worry about the mercury in amalgam.

http://www.charleston.net/news/2007/aug/20/are_amalgam_fillings_safe13345/