Dental Amalgam

Table of Contents

Chapter 1: Amalgam Fillings: Do Dental Patients Have a Right to Informed Consent?

Introduction
History of Amalgam Fillings
Mercury Toxicity
Patient Exposure to Mercury from Amalgam Restorations
Mercury Toxicity from Amalgams
Current Research
Amalgam and the Environment
Pima County, Arizona Dentists Suspended
EPA Takes Action in Connecticut
Do Patients Have the Right to Know?
Class Action Suit Against ADA179
Legislative Efforts to a Solution
Conclusion
Notes

Dentists Sue State Licensing Boards Over First Amendment Rights

Dental Amalgam
Use and Benefits
Highlights of the Report on Dental Amalgam
Composition of Amalgam Alloy

Consumer Update: Dental Amalgams

Predictions for the Future of Dental Amalgam

Dentists Are The Biggest Mercury Polluters, A New Study Finds

Dental Materials Fact Sheet
Dental Materials Fact Sheet (DMFS)_Frequently Asked Questions
 
bulletWhat is the Dental Materials Fact Sheet?
bulletWhat if I disagree with the DMFS, do I still have to provide it to my patients?
bulletI don't place amalgams, or I do only orthodontics – am I exempt? The majority of my patients are Hispanic. Is the DMFS going to be provided in Spanish or any other language?

Dental Materials Fact Sheet

Position of the Academy of General Dentistry

bulletWhat is dental amalgam?
bulletIs mercury in dental amalgam safe?
bulletWhy do dentists use dental amalgams?
bulletWhy don't dentists use alternatives to amalgam?
bulletWhat about patients allergic to mercury?
bulletAre staff occupationally exposed?
bulletWhat are other sources of mercury?

Study Finds No Link Between Amalgam and Decrease in Mental Abilities

American Dental Association Recommendations

Position of the British Dental Association

bulletWhat is amalgam?
bulletCan mercury from amalgam fillings reach the rest of the body?
bulletDo dentists say that amalgam is safe?
bulletBut mercury is toxic, isn't it?
bulletWho regulates dental filling materials?
bulletHow much of our day-to-day mercury intake comes from dental fillings and how much comes from other sources?
bulletHow can patients find out about mercury exposure?
bulletIs it possible to remove mercury absorbed into the body?
bulletChelation has side effects of its own. How should amalgam fillings be removed?
bulletShould amalgam be used during pregnancy?
bulletShould amalgam be used for children?
bulletIs there any group for whom amalgam should not be used?
bulletShould amalgam fillings be kept below a safe maximum related to body weight?
bulletWhat do other governments and health bodies say?
bulletShould dentists explain current concerns about amalgam safety when suggesting its use?
 
References

Position of Health Canada

Health Canada Position Statement on Dental Amalgam

Can a Dentist Ethically Remove Serviceable Amalgam (Silver) Fillings?

Dental Amalgam–Patient Teaching

Post-Test

 

Learning Objectives

After completing the course, you'll be able to:

Amalgam Fillings: Do Dental Patients Have a Right to Informed Consent?

  1. Recount the history of amalgam fillings and controversy swirling around their use over the past 150 years.

  2. Describe the current research being done regarding the safety of amalgam fillings.

  3. Discuss informed consent as it may apply to amalgam fillings in dental practice.

Dental Amalgam Use and Benefits

  1. List 7 circumstances where the use of dental amalgam is indicated.

  2. List 3 instances where dental amalgam is contraindicated.

  3. Provide at least 4 reasons as to why it is inappropriate at this time to recommend any restrictions on the use of dental amalgam.

Consumer Update: Dental Amalgams

  1. Discuss the investigative efforts of the U.S. Public Health Service to determine the safety of amalgams used in dental restorations.

Dental Materials Fact Sheet

  1. Discuss with the patient the risks and benefits of various dental materials taking into account patient's susceptibility to sensitivity and allergic reactions to certain materials.
  2. Compare 4 direct restorative dental materials (amalgam, composite resin, glass ionomer cement and resin ionomer cement) with respect to various factors for use in dental restorations.

Dental Amalgam

  1. Compare 4 indirect restorative dental materials (ceramic porcelain, fused-to-metal porcelain, gold alloys, nickel or cobalt-chrome alloys) with respect to various factors for use in dental restorations.

  2. Implement in your dental practice 4 specific recommendations made by the ADA regarding the use of amalgam fillings.

Can a Dentist Ethically Remove Serviceable Amalgam (Silver) Fillings?

  1. Make an appropriate response in the event a patient asks the dentist to remove patient's serviceable amalgams.

  2. List 5 things a dentist should do before removing serviceable amalgam restorations from the non-allergic patient at the patient's request.

Dental Amalgam–Patient Teaching

  1. Inform the patient with scientific data of the safety and durability features of amalgam fillings.

 

Learning Objectives

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.