Toxicity of Dental Materials Dental Amalgams



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Toxicity of Dental Materials
Dental Amalgams
Mercury in its elemental form is on the State of California's proposition 65 list of chemicals known to the state to cause reproductive toxicity. Mercury may harm the developing brain of a child or fetus.
Dental amalgam is created by missing elemental mercury (43-54%) and an alloy powder (46-57%) composed mainly of silver, tin and copper. This has caused discussion about the risks of mercury in dental amalgam. Such mercury is emitted in minute amounts as vapor. Some concerns have been raised regarding possible toxicity. Scientific research continues on the safety of dental amalgam. According to the Centers for Disease Control and Prevention, there is scant evidence that the health of the vast majority of people with amalgam is compromised.
The Food and Drug Administration (FDA) and other public health organizations have investigated the safety of amalgam used in dental fillings. The conclusion: no valid scientific evidence has shown that amalgams cause harm to patients with dental restoration, except in rare cases of allergy. The World Health Organization reached a similar conclusion stating, “Amalgam restorations are safe and cost effective.”
A diversity of opinions exists regarding the safety of dental amalgams. Questions have been raised about its safety in pregnant women, children, and diabetics. However, scientific evidence and research literature in peer-reviewed scientific journals suggest that otherwise healthy women, children, and diabetics are not at an increased risk from dental amalgams in their mouths. The FDA places no restriction on the use of dental amalgam.
Composite Resin
Some Composite Resins include Crystalline Silica, which is on the State of California’s Proposition 65 list of chemicals known to the state to cause cancer.
It is always a good idea to discuss and dental treatment thoroughly with your dentist.
Dental Materials – Advantages & Disadvantages
Dental Amalgam Fillings
Dental amalgam is a self-hardening mixture of silver-tin-copper alloy powder and liquid mercury and is sometimes referred to as silver fillings because of its color. It is often used as a filling material and replacement for broken teeth.

Advantages




  • Durable; long lasting

  • Wears well; holds up well to the forces of biting

  • Relatively inexpensive

  • Generally completed in one visit

  • Self-sealing; minimal-to-no shrinkage and resists leakage

  • Resistance to further decal is high, but can be difficult to find in early stages

  • Frequency of repair and replacement is low

Disadvantages




  • Refer to “What About the Safety of Filling Materials”

  • Gray colored, not tooth colored

  • May darken as it corrodes; may stain teeth over time

  • Requires removal of some healthy tooth

  • In larger amalgam fillings, the remaining tooth may weaken and fracture

  • Because metal can conduct hot and cold temperatures, there may be a temporary sensitivity to hot and cold.

  • Contact with other metals may cause occasional, minute electrical flow

The durability of any dental restoration is influence not only by the material it is made from but also by the dentist’s technique when placing the restoration. Other factors include the supporting materials used in the procedure and the patient’s cooperation during the procedure. The length of time a restoration will last is dependent upon your dental hygiene, home care, and diet and chewing habits.


Composite Resin Fillings
Composite fillings are a mixture of powdered glass and plastic resin, sometimes referred to as white, plastic, or tooth-colored fillings. It is used for fillings, inlays, veneers, partial and complete crowns, or to repair portions of broken teeth.
Advantages


  • Strong and durable

  • Tooth colored

  • Single visit for fillings

  • Resists breaking

  • Maximum amount of tooth preserved

  • Small risk of leakage if bonded only to enamel

  • Does not corrode

  • Generally holds up well to the forces of biting depending on product used

  • Resistance to further decay is moderate and easy to find

  • Frequency of repair or replacement is low to moderate

Disadvantages




  • Refer to “What About the Safety of Filling Materials”

  • Moderate occurrence of tooth sensitivity; sensitive to dentist’s method of application

  • Costs more than dental amalgam

  • Material shrinks when hardened and could lead to further decay and/or temperature sensitivity

  • Requires more than one visit for inlays, veneers, and crowns

  • May wear faster than dental enamel

  • May leak over time when bonded beneath the layer of enamel

Dental Materials – Advantages & Disadvantages


Glass Ionomer Cement
Glass ionomer cement is a self hardening mixture of glass and organic acid. It is tooth-colored and varies in translucency. Glass ionomer is usually used for small fillings, cementing metal and porcelain/metal crowns, liners, and temporary restorations.
Advantages

Disadvantages




  • Cost is very similar to composite resin (which costs more than amalgam)

  • Limited use because it is not recommended for biting surfaces in permanent teeth

  • As it ages, this material may become rough and could increase the accumulation of plaque and chance of periodontal disease

  • Does not wear well; tends to crack over time and can be dislodged


Resin-Ionomer Cement
Resin ionomer cement is a mixture of glass and resin polymer and organic acid that hardens with exposure to a blue light used in the dental office. It is tooth colored but more translucent than glass ionomer cement. It is most often used for small fillings, cementing metal and porcelain metal crowns and liners.
Advantages


  • Very good esthetics

  • May provide some help against decay because it releases fluoride

  • Minimal amount of tooth needs to be removed and it bonds well to both the enamel and the dentin beneath the enamel

  • Good for non-biting surfaces

  • May be used for short-term primary teeth restorations

  • May hold up better than glass ionomer but not as well as composite

  • Good resistance to leakage

  • Material has low incidence of producing tooth sensitivity

  • Usually completed in one dental visit

Disadvantages




  • Cost is very similar to composite resin (which costs more than amalgam)

  • Limited use because it is not recommended to restore the biting surfaces of adults

  • Wears faster than composite and amalgam


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