Dental amalgam controversy

This discussion of the dental amalgam controversy outlines the debate over whether dental amalgam (the "silver" in dental fillings) should be used. Supporters claim that it is safe, effective and long-lasting while critics argue that claims have been made since the 1840s that amalgam is unsafe because it may cause mercury poisoning and other toxicity.

Those who are not opposed to the use of amalgam point out that it is safe, durable, relatively inexpensive, and easy to use. On average, amalgam lasts twice as long as resin composites, takes less time to place, is tolerant of saliva or blood contamination during placement (unlike composites), and is often about 20-30% less expensive. Consumer Reports has suggested that many who claim dental amalgam is not safe are "prospecting for disease" and using pseudoscience to scare patients into more lucrative treatment options.

Those opposed to amalgam use suggest that modern composites are improving in strength. In addition to their claims of possible health and ethical issues, opponents of dental amalgam fillings claim amalgam fillings contribute to mercury contamination of the environment. The World Health Organization (WHO) reports that health care facilities, including dental offices, account for as much as 5% of total waste water mercury emissions. The WHO also points out that amalgam separators, installed in the waste water lines of many dental offices, dramatically decrease the release of mercury into the public sewer system. However, critics say that the separators are not mandatory in some states of the United States. The critics also point to cremation of dental fillings as an additional source of air pollution, contributing about 1% of total global emissions.

It is the position of the FDI World Dental Federation as well as numerous dental associations and dental public health agencies worldwide that amalgam restorations are safe and effective. In addition, numerous other organizations have publicly declared the safety and effectiveness of amalgam and warned the public against those who suggest otherwise. These include the Mayo clinic, the U.S. Food and Drug Administration (FDA),Health Canada,Alzheimer's Association, American Academy of Pediatrics,Autism Society of America,U.S. Environmental Protection Agency, National Multiple Sclerosis Society, New England Journal of Medicine, International Journal of Dentistry,National Council Against Health Fraud, The National Institute of Dental and Craniofacial Research NIDCR,American Cancer Society,Lupus Foundation of America, the American College of Medical Toxicology, the American Academy of Clinical Toxicology,Consumer ReportsPrevention Magazine, and WebMD.

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