Mercury Amalgams-What is the Issue

[jpn123]

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I am trying to get prepared for my interviews and could someone help me by reffering me to any good articles that summarize the controversial issues of this topic.

 

[PERFECT3434]

i have the same question as you and i too am preparing for my interviews.

i talked to the dentist that i work for about amalgums being safe or not and he told me that he doesn't think it is unsafe.
amalgum has been used for many years and there are not many cases where it has had any negative effects. in fact, he completely dislikes the white filling as he thinks white fillings aren't even close to being as good an alternative as amalgum is.

he said that he has had many people who showed tooth sesitivity after using the white filling. this is very rarely the case with amalgum.

so i take it as it is safe and there is nothing comprable to it in the market yet.

am i right?

 

[Jone]

the only issues i know of are:

1) is it harmful to dentists and patients? (tons of medline studies are availeble - do a search)

2) all the mercury waste that is drained down the sink from dental offices to the environment.

 

[3rdMolarRoller]

There is absolutely nothing harmful about them. I did my senior thesis on it.

Exact topic: Effects of low level mercury exposures from dental amalgams

Result from doing a world lit review (of course I was limited to those in english):

There is a significant effect on animals, but they expose these animals to very high levels of mercury vapor...kinda like having 100 fillings in your mouth...but wait we have 32 teeth

No study yet (well as of 2001 when I wrote it) to show any effects on humans. There are some that show some sort of correlation and human disease state, but they are very biased and an undergrad could clearly see the flaws in the methodology.

They saw my topic at UF and brought it up at the interview and just so happened that one of the biomaterial guys was interviewing me. He said that shortly silver amalgams will be a thing of the past, not for health reasons but bec of technology and new materials.

I'll call my mom up and see if she could find my paper on the computer back home and will foward it to you. Its pretty good with around 75 reference articles.

Best of luck on your interviews!!!

 

[aphistis]

Another consideration most people leave out is the difference between organic and elemental mercury. The mercury poisonings you hear about tend to involve aklylated mercury compounds, which are absorbed into the blood at an efficiency approaching 100% Elemental mercury (the kind in amalgams), on the other hand, is absorbed at <1%. Plus, it's not even possible unless mercury leaches out of the restoration, penetrates the dentin tubules, and enters the pulp cavity.

That's in addition, of course, to the crop of primary literature indicating no significant difference between amalgam'ed patients and controls.

Come to think of it, where's nyscof when we need him? 😉

 

[ShawnOne]

Originally posted by PERFECT3434
in fact, he completely dislikes the white filling as he thinks white fillings aren't even close to being as good an alternative as amalgum is. he said that he has had many people who showed tooth sesitivity after using the white filling. this is very rarely the case with amalgum.

Talking to my boss, he beleives that amalgam vs. white composite is really a matter of which better for a specific patient.

The fact is that amalgam is harder and longer lasting makes it the #1 choice. However if a patient insists on white fillings AND they come in regularly then composites are OK. They are not expected to last as long as amalgams and need to be checked out more often. (after all its plastic)

Unfortunately, those in lower socioeconomic classes do not see a dentist nearly as often as those in the higher classes. As a result, amalgam is much more dependable and long-lasting (could last 15-20 years in some cases) for those cases.

There is also another issue with shrinkage in composites vs. slightly expansive in amalgam, i'll leave that to someone who knows more than I.

 

[UBTom]

Yep... Amalgam has gotten a bad rap and sometimes it's the dentist's fault.

Some dentists try to do things quick and take shortcuts and not properly condense an amalgam, the result is a weak amalgam with excessively high mercury content, sometimes as high as 50%.

When a dentist uses a modern high-copper amalgam formulation like Valiant PhD correctly, the result is a very strong restoration with less than 20% mercury. One has to squish the amalgam VERY hard with a condenser until most of the Gamma-2 fluid phase containing most of the mercury (which weakens the amalgam if left in there) rises to the top so that it can be scraped away in the process of carving it into shape.

As far as amalgam expansion is concerned, sadly it is also the dentist's fault-- Hardly any dentist in private practice uses rubber dams, which is crucial in field isolation because it is precisely moisture contamination from saliva that causes an amalgam to set improperly and expand (and weaken).

But if properly placed, an amalgam can last 30, 40 or 50 years if the patient takes proper care of his teeth!

 

[ItsGavinC]

Here's an update as far as Arizona is concerned: we won't even be learning amalgam.

Put that in your pipe and smoke it 😉

 

[rsweeney]

I was speaking with a dentist and he agreed that there should be nothing to worry about with mercury amalgams. Basically, as long as the mercury composition is maintainted at a relatively stable level, and you have enough tin and silver (or copper, etc.) such that the expansion and contraction coefficients result in no net expansion and contraction, hence the amalgam restoration maintains its integrity, everything should be fine. True, composites bond well to your teeth, but as mentioned it is just so expensive. As long as the composition is right and proper condensing takes place in amalgam preparations, then I see no harm in using the more cost-efficient amalgam. Nevertheless, I would prefer composite if it was the same price😉 I wonder if mercury-free amalgams will ever exist. Is there not another element that is less deletarious than mercury?

My two cents!

 

[ShawnOne]

Originally posted by ItsGavinC
Here's an update as far as Arizona is concerned: we won't even be learning amalgam.

Put that in your pipe and smoke it 😉

GAvin,
What material will you guys be using for posterior restorations? Banishing amalgams sounds a little outrageous. Amalgam is VERY widely used, and as far as I know, it was the preferred material at UCLA dental school last year. Also, don?t you think you?ll need to perform amalgam restorations during your 4th year externships?

I think your school officials may be releasing some very forward-looking statements.

 

[Jone]

Originally posted by ItsGavinC
Here's an update as far as Arizona is concerned: we won't even be learning amalgam.

Put that in your pipe and smoke it 😉

that's too bad, because i believe you need to know amalgams for your boards/regional licensing..... am i wrong?

 

[anamod]

Gavin you lucky bastard.