venerdì 14 ottobre 2011

A New Era in WHO policy about amalgam

In a clear sign that dentistry’s amalgam era is ending, the World Health Organization released its report on dental amalgam, “Future Use of Materials for Dental Restoration” this week; http://www.who.int/oral_health/publications/dental_material_2011.pdf. WHO urges “a switch in use of dental materials” away from amalgam, explaining that “for many reasons restorative materials alternative to dental amalgam are desirable.”

The report described three of these reasons in detail:

1. WHO says amalgam releases a “significant amount of mercury”: WHO concludes that amalgam is a serious environmental health problem because amalgam releases a “significant amount of mercury” into the environment, including the atmosphere, surface water, groundwater, and soil. “When released from dental amalgam use into the environment through these pathways, mercury is transported globally and deposited. Mercury releases may then enter the human food chain especially via fish consumption” (page 13).

2. WHO says amalgam raises “general health concerns”: The WHO report concludes that “Amalgam has been associated with general health concerns.” The report explains, “According to the Norwegian Dental Biomaterials Adverse Reaction Unit, the majority of cases of side-effects of dental filling materials are linked with dental amalgam” (page 12).

3. WHO says “materials alternative to dental amalgam are available”: WHO concludes that “Materials alternative to dental amalgam are available” – and cites many studies indicating that they are superior to amalgam (p.35). For example, WHO says “recent data suggest that RBCs [resin-based composites] perform equally well” as amalgam (page 11). And compomers have a higher survival rate, says WHO, citing a study which finds that 95% of compomer restorations survive after 4 years, while only 92% of amalgam fillings survive that long” (page 12). WHO touts the benefits of mercury-free filling materials: “Adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself.”

In light of the many problems with amalgam, WHO commits itself to “work for reduction of mercury and the development of a healthy environment.” To accomplish this goal, “WHO will facilitate the work for a switch in use of dental materials” (pages 33, 37).

 Charlie Brown
President, World Alliance for Mercury-Free Dentistry

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