ADA Weighs-in on Tooth-Filling Debate
Professor David J. Demko, PhD
AgeVenture News Service (08-06-02)
 A new survey indicates one in four people have heard that silver-colored fillings (amalgam) are "bad for you" or could cause health problems, despite assurances from major U.S. health agencies that this is not the case. Sounds like the simplist of tasks, deciding on a dental filling, is giving consumers a mental hernia. Well, help's on the way. Terry Donovan, DDS, professor and co-director of the advanced education in prosthodontics program at the University of Southern California says, "We need to help people sift through this alarmist talk." More to the point, patients must make "informed choices based on the best available science and their individual case history."
 The decision about what to use to fill cavities has patients caught in a debate that pits science against emotion, says the American Dental Association (ADA). Emotional reports claiming amalgam is responsible for a variety of diseases are confusing and perhaps even alarming people, say ADA officials.The dental filling materials available today include: gold, silver-colored amalgam, and tooth-colored fillings. However, one material, amalgam, has been attacked to the extent that some would ban it. The ADA is concerned that misguided fears about the safety of amalgam, coupled with the added costs of the more expensive filling options, may cause people to forego necessary dental care. Far fewer people have dental insurance than medical insurance, and not all insurance plans cover all filling options, the ADA says.
Despite amalgam's long and impressive track record, a small group, communicating primarily through the Internet, claims they know more than the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), U.S. Public Health Service (USPHS), National institutes of Health (NIH) and the World Health Organization (WHO), when they say that amalgam is somehow responsible for diseases such as autism, Alzheimer's and Multiple Sclerosis because it is an alloy with mercury. Currently, physicians and researchers have yet to determine the cause for each of these diseases, leaving the door open for speculation.
Concern about amalgam because it contains mercury is intuitive but not supported by scientific fact, the ADA says. It is true that amalgam contains mercury, but when it is mixed with metals such as silver, copper and tin, it forms a stable alloy that dentists have used for years to successfully treat dental disease in millions of people.
In some situations, like large cavities in the rear molars, or cavities below the gum line, amalgam is often used because of its durability, affordability and because it is one of the best filling materials that can be placed in areas of the mouth that are difficult to keep dry. In other situations, such as a tiny cavity where the patient wants a more natural-looking filling, amalgam clearly takes a back seat to tooth-colored fillings, says Frederick Eichmiller, DDS, director of the Paffenbarger Research Center (PRC), one of the nation's foremost dental research facilities.
To learn more about the different types of dental fillings available, the ADA offers a patient brochure, "Restoring Your Smile: Dental Filling Choices." Consumers will also benefit from reading ADA's "Dental Amalgam: Myths vs. Facts". Visit ADA online at: www.ada.org
For additional information on oral health care and amalgam, visit the following web sites:
- The American Dental Association
www.ada.org/public/topics/fillings.html
- The Food and Drug Administration
www.fda.gov/cdrh/consumer/amalgams.html
- World Health Organization
www.who.int/pcs/newsletter/ipcs-01.pdf
- National Institutes of Health
cerhr.niehs.nih.gov/genpub/topics/mercury2-ccae.html#Mercury
- Centers for Disease Control and Prevention
www.cdc.gov/OralHealth/factsheets/amalgam.htm
Image credit: American Dental Association, Chicago, Illinois.
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AgeVenture News Service, www.demko.com
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