Are Amalgam Fillings Safe - Coursework Example

Are Amalgam Fillings Safe and Meaning of Dental Amalgam Dental amalgam is a filling substance used to fill cavities on teeth caused by tooth decay. Dental amalgam is usually a mixture of metal components consisting of mostly liquid mercury and powdered alloys composed of copper, tin and silver (Von, 2010). Emerging issues in the use of Dental Amalgams The controversy over the mercury component of dental amalgam is as old as its origin. Although the United States dental establishments opposed it firstly, it became a prominent debate in the twentieth century. Struggling to exist with consumer and regulatory pressure to eliminate it, it has evolved and emerged as one of the most preferred dental restoration material so far. There is widespread controversy about the safety and credibility of dental amalgams. Many people do not understand whether it is safe to use amalgams others saying that it poses danger in terms of health when engraved to occupy the teeth cavities (Hörsted, 1991). In some countries such as Denmark, Sweden, and Norway, dentists are not allowed to use mercury in filling service. These bans occurred as a result of both environmental and health issues, according to the Swedish authorities.Furthermore, the US food and drug administration (FDA) has also refused to sign the affirmations of its credibility and safety. Despite valid, undisputed consistent reports about the validity and safety of dental amalgams, there remains skepticism and unfounded controversy surrounding it (Karimian, 1989). Dental amalgams have real potential danger. It releases low levels of mercury vapors, which can be dangerous if inhaled. High levels of mercury vapor exposure are associated with auspicious effects in some parts of the body such as the Brain and the kidneys.Since mercury is odorless invisible and accumulated in the dental amalgam, it is therefore very difficult to avoid it since it is already in the body and poses a serious health risk. Once in the body, mercury starts working as neurotoxins poisonous to the brain and the entire nervous system.Despite clinical studies in adults and children ages six and above showing that there are no link between dental amalgams and health problems, it leaves a lot to be desired to many especially when it comes to pregnant women and their developing fetuses and on children under the age of six (Shannon, 2012). Although The Environmental Protection Agency (EPA) claims that the estimated amount of mercury in breast milk credited to dental amalgam is negligible and far below the level they consider as unsafe, other studies show that it is true that dental amalgam poses a danger and a health risk in some way. According to the U.S Department of Health and human services, there is no danger when it comes to using the dental amalgam. According to them, this substance does not reach the minimum threshold capable of posing any health problem. They therefore conclude that the currently existing data support that infants are not at risk for adverse health effects of breast milk from their mothers exposed to mercury vapor contained in the dental amalgam (Spigel, 2005). Children Amalgam Trials in New England According to New England Children’s Amalgam trials (C.A.T), “High dose exposures to elemental mercury cause mental disturbances.” According to a trial which was conducted involving a 6 – 10 year old children, it was established that “restoration of dental caries using dental amalgam resulted in worse psychosocial outcomes than restoration using free resin mercury composite ” (Phinney, 2008). They however clearly states that there was no evidence found to support that exposure to mercury from dental amalgams was associated with adverse psychosocial outcomes over the entire period they used while conducting their study (Goljan, 1984). Mercury, a poisonous and heavy metal usually occur in several chemical and physical forms. It is alleged that fish and dental amalgams are the two major sources of human exposure to organic and inorganic mercury respectively. In our case, exposure from dental amalgams usually occurs through inhalation of mercury evaporating from the filling. The central nervous system and the kidneys are the primary target organs for the poison emanating from mercury. It is diagnosed by testing the amount of mercury in hair, blood, and urine (Tyler, 2009). Amalgam Trials in Portugal According to a study “Neurobehavioral effects of dental amalgams in children: a randomized trial,” conducted in Lisbon, Portugal to a total of 507 children aged 8 – 10 years with at least one caries lesion in a permanent tooth, established that children who received dental restorative treatment with amalgam did not have differences in neurobehavioral assessment when compared to children who received resin composite materials without amalgam (Leinfelder, 1991). They therefore recommended that amalgam should remain as a viable dental restorative option for children. It is evident that despite the controversy and confusion surrounding dental amalgam and its credibility in terms safety and reliability as a dental restorative option, clinical evidence supports and justifies it (Al-Saleh, 2011, pp. 3003-3015). Basis for the use of Amalgam fillings Amalgam fillings are the oldest known form of dental restorative material dating back up to 600 AD. Apart from its long history, it also has longevity and some advantages that might not be there in other composite filling materials. Early amalgam was made by mixing mercury with the filings of silver coins . (Bailer et al., 2001, pp. 255-263). Amalgam is tolerant to a variety of conditions and controllably tolerant to moisture during placement. This one positive attribute associated with it and which makes it to be more preferably selected by prospective patients in all walks of life. Amalgam consists of approximately fifty percent of the mercury. Mercury has properties of bacteriostatic agent, which discourages the growth of microorganisms. It is therefore advantageous because it surpasses other restorative materials such as methacrylite polymers that encourage the growth of microorganisms causing tooth decay (Derouen et al., 2006, pp. 1784-1792). Amalgam has remained as superior restorative material despite sentiments across the society hurled into it because of this reason. A randomized trial conducted by The New England children amalgam trial NECAT, yielded some results. It postulated that amalgam has a more longetivity as compared to other resin based compomer in primary teeth and composites in permanent teeth. It stated that whereas amalgam needed to be restored only once, the compomer needed to be replaced seven times to match with amalgam. The said compomers were seven times likely to require replacements and composites were as well seven times as likely to require repair (University, 2014). Ensuring Dental Safety Composite resin fillings Better alternatives to dental amalgam exist. This includes the composite resin filling which is the most common replacement. Composite resin fillings are made of a type of plastic reinforced with powdered glass. It is more preferred as the color of this composite can be made according to specification or requirement to fit the required teeth colour or closely match the surrounding teeth (Epa.gov, 2014). Composite resin fillings blend very well with the tooth surrounding it and require minimum supervision or even removal of healthy tooth structure for what we call a placement. However, composite resin filling may be less durable and cost more than the other dental filling materials (Cda-adc.ca, 2014). Glass Ionomer Cement Fillings Just like composite resins, the glass ionomer cements are put up by acrylic resin and some components of glass. This glass releases some fluoride over time. Although even these ionomer cements blend with teeth colour, they are not as splendid as composite resins. The ionomer cements are preferred because of their appearance. On the contrary, ionomer cements are limited to filling only small teeth cavities. They are specifically suited for small restorations (Levine, 2014). Gold Foil Fillings Gold foil fillings can also be a suitable alternative to dental amalgams. They are used to restore cavities on biting surfaces. They are very strong and durable. But their cost is too expensive not to mention the color which doesn’t match with the surrounding teeth (Guyot, 2014) List of References Von Fraunhofer, J. A. 2010. Dental materials at a glance. Chichester, U.K.: Wiley-Blackwell. Hörsted. 1991. Dental amalgam. Copenhagen: Munksgaard. Karimian. 1989. Mercury in dental care: Amalgam toxicity and its implications for public health education. Shannon, J. B. 2012. Dental care and oral health book. Detroit, MI: Omnigraphics. Spigel, S. 2005. Dental amalgam prevalence and alternatives. [Hartford, CT: Connecticut Assembly, Office of Legislative Research. Phinney & Halstead. 2008. Dental assisting. Clifton Park, NY: Thomson Delmar Learning. Goljan, K. R. 1984. Mercury and dental amalgam. Orlando FL (4401 Real Ct., Orlando 32808): Bio-Probe. Tyler, L. 2009. Pearsons comprehensive dental assisting. Upper Saddle River, N.J.: Pearson. Leinfelder, K. F. 1991. Alternatives to amalgam. Atlanta, GA (P.O. Box 740056, Atlanta 30374): American Health Consultants. Al-Saleh. 2011. Mercury (Hg) burden in children: The impact of dental amalgam. Science of the Total Environment, 409 (16), pp. 3003--3015. Bailer et al. 2001. Adverse health effects related to mercury exposure from dental amalgam fillings: toxicological? Psychological medicine, 30 (3), pp. 256-263 Derouen et al. 2006. Neurobehavioral effects of dental amalgam in children: a randomized clinical trial. Jama, 295 (15), pp. 1784-1792. University, C. 2014. Is Dental Amalgam Safe? Exploring the Risks of Mercury in Amalgam Fillings. [online] Available at: http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-and-Dental-Procedures/Fillings/article/Dental-Amalgam-A-Health-Risk.cvsp [Accessed: 26 Mar 2014]. Epa.gov. 2014. Dental Amalgam | Mercury | US EPA. [online] Available at: http://www.epa.gov/hg/dentalamalgam.html [Accessed: 26 Mar 2014]. Levine, D. J. 2014. Toxic Teeth: Are Amalgam Fillings Safe?. [online] Available at: http://www.doctoroz.com/videos/toxic-teeth-are-our-amalgam-fillings-safe [Accessed: 26 Mar 2014]. Guyot, D. 2014. [online] Available at: http://www.davidmguyotdds.com/gold/ [Accessed: 26 Mar 2014]. Cda-adc.ca. 2014. Canadian Dental Association: Your Oral Health. [online] Available at: http://www.cda-adc.ca/en/oral_health/talk/procedures/fillings/tooth-coloured.asp [Accessed: 26 Mar 2014]. Read More