On September 24, 2020, a new report from the U.S. Food and Drug Administration (FDA) provided recommendations about the use of dental amalgam in certain groups who may be at greater risk to the potential adverse health effects of mercury exposure. Children, especially those younger than six years of age, were included as one of the populations, based on the potential sensitivity of their developing neurological systems to mercury vapor exposure. The FDA recommended that non-mercury restorations such as composite resins and glass ionomer cements be used, when possible and appropriate, in people who may be at higher risk for adverse health effects from mercury exposure. Learn more here.
In response to the FDA report, the American Academy of Pediatric Dentistry (AAPD) confirms the safety and effectiveness of dental amalgam. According to the AAPD 2019 Best Practice on Pediatric Restorative Dentistry, “There is strong evidence that dental amalgam is efficacious in the restoration of Class I and Class II cavity restorations in primary and permanent teeth…. With regard to the safety of dental amalgam, a comprehensive literature review of dental studies found insufficient evidence of associations between mercury release from dental amalgam and the various medical complaints. Two independent randomized controlled trials in children have examined the effects of mercury release from amalgam restorations and found no effect on the central and peripheral nervous systems and kidney function.”
“Although the use of amalgam restorations has decreased in the last decade in favor of more esthetic alternatives, it remains an essential treatment option to protect access to care for our most vulnerable patient populations,” said AAPD Chief Policy Officer Paul S. Casamassimo. “In particular, this could pose a further barrier to needed care for patients with special health care needs for whom amalgam is the ideal restorative choice.”
The American Dental Association (ADA) reaffirmed its position that dental amalgam is a durable, safe and effective restorative material in response to the FDA’s report. Its statement emphasized that existing evidence shows that dental amalgam is not harmful to the general population, and treatment options should be thoroughly discussed by the patient and dentist. Read more here.