The amalgam saga continues… – Mark Allen
Featured Products Promotional FeaturesPosted by: Dental Design 17th November 2018
The use of amalgam as a primary filling material has been debated for some time now with more than one concern raised about its safety. Now, there is evidence to suggest that amalgam restorations could leak mercury if they are exposed to a newer and more powerful MRI scanner that uses stronger magnetic fields to take a more detailed image.[i]
The recent study was carried out in Turkey where 40 extracted teeth with amalgam fillings were placed into separate pots of artificial saliva and scanned for 20 minutes using either the conventional MRI, which has an exposure of 1.5-T, or new 7.0-T machine. Alongside this, 20 teeth were placed in artificial saliva and kept away from any type of MRI to act as a control group. The study found that the mercury content released from the 7.0-T test subjects was significantly greater than that in the two other groups.
As it stands, it is not clear whether the amount of mercury released when exposed to this new MRI machine will pose a risk to patients, and it is yet to be established how much would be absorbed by the body. Further research will therefore be needed to determine the full extent of these findings. What we do know, however, is that mercury can be poisonous to humans when inhaled and absorbed by the lungs in high enough doses, and can cause serious health problems. The nervous, digestive and immune systems, lungs and kidneys in particular can be affected by inhalation, with potentially fatal consequences. It has also been observed that mercury exposure can lead to neurological and behavioural disorders, with symptoms including tremors, insomnia, memory loss, neuromuscular effects, headaches and cognitive and motor dysfunction.[ii]
Luckily, mercury poisoning as a result of metal dental fillings is a far from common occurrence and overall, amalgam fillings are considered to be a safe option for patients with restorative needs. Still, there are plans to completely phase out amalgam, possibly by as early as 2030, and there are restrictions that are now in place following regulations imposed by the European Parliament. The first change was introduced on 1 July 2018, which means that dental amalgam can no longer be used for; the treatment of deciduous teeth; children under the age of 15 years old; and pregnant or breastfeeding women, unless it is absolutely necessary. Other aspects of the regulation are expected to come into force in 2019 and beyond.
Of course, it must be noted that these changes to EU regulations on amalgam are not as a result of concerns regarding health, but because of the impact of mercury on the environment, which further supports professionals’ beliefs that amalgam is safe for dental restorative use. Nevertheless, this does not change the fact that amalgam is being phased out. Nor can it be denied in light of recent research that amalgamcouldpose a risk in certain medical circumstances; even if it is not yet clear what the damage would be.
As such, it is time that dentists look for a suitable replacement to amalgam. There are a number of alternatives available, but one type of material that has risen to the fore in particular is bulk fill resin-based composites, as they can help to reduce treatment time, facilitate handling and can be applied in one easy step.
Like with any restorative material though, some products from certain manufacturers are naturally better designed than others and provide far more superior outcomes. Fill-Up! by COLTENE is at the top end of the scale when it comes to quality results for Class I and Class II cavities, and is the only dual cured bulk fill available in the UK that provides thorough and gentle curing right down to the deepest layers. At the time of writing, no other bulk fill composite is yet able to offer an unlimited curing depth. The material is also completely safe and offers first class results with minimal shrinkage, excellent marginal adaptation and amazing aesthetics at a reasonable, affordable price.
Whichever material you go for, be sure to weigh up your options before making a decision to ensure you find a product that is both safe and effective. Moreover, it might be worth considering switching to an alternative for the future. That way if amalgam does eventually peter out or amalgam leakage becomes more of an issue, you will already be prepared.
To find out more visit www.coltene.com, email info.uk@coltene.comor call 01444 235486
[i]Yilmaz S, Adisen MZ. Ex Vivo Mercury Release from Dental Amalgam after 7.0-T and 1.5-T MRI. Radiology. 2018; 00: 1-5. Accessed online July 2018 at https://pubs.rsna.org/doi/pdf/10.1148/radiol.2018172597
[ii]World Health Organisation: Mercury and Health. Published31 March 2017. Accessed online July 2018 at http://www.who.int/news-room/fact-sheets/detail/mercury-and-health
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