Dental amalgam has been a topic of conversation for many years because of one primary ingredient - mercury. Though studies are widely available that show amalgam is absolutely safe for patients and for dentists to use when filling cavities, many patients still have questions.
Dental offices should be prepared to not only address patients questions, but also to understand why recent EPA regulations focus on dental amalgam waste.
This post will take a closer look at what is found in dental amalgam, why it's considered safe and why dental offices must properly dispose of the material.
Dental amalgam is a common material used by dentists to fill cavities that have been created due to tooth decay. The U.S. Food and Drug Administration states dental amalgam has been in use for more than 150 years and has filled the cavities of hundreds of millions of patients throughout the entire world.
Composed of a mix of metals - liquid mercury and a powdered alloy of silver, tin and copper - dental amalgam is referred to as "silver fillings."
According to the FDA, about 50 percent of dental amalgam is elemental mercury by weight. It's the chemical properties of the elemental amalgam that allow for the binding together with the other metal particles and forming an amalgam.
Dental amalgam is known for being strong and long-lasting when used as a filling for cavities. Amalgam fillings give patients durable chewing surfaces. Because it's longer-lasting and can handle stress from chewing, dental amalgam requires fewer replacements.
In addition to those characteristics, dental amalgam is also able to better hold up in a moist environment, such as a patient's mouth. The temperature swings that occur in a mouth don't affect it as much, either.
However, when a replacement is required, dental amalgam is much more economical. It's less expensive when compared to other filling materials, so it's cheaper for the patient. In addition, filling a cavity with dental amalgam is less time-consuming for dentists.
The most significant reason a patient requests the use of a filling material other than dental amalgam is when cosmetic appearance is being strongly considered.
Composite fillings, for example, do hold this advantage over dental amalgam, but they aren't as durable, and must be used in areas that don't experience much pressure.
Dental amalgam used for fillings is considered safe by a wide array of organizations, including the FDA, FDI World Dental Federation, the World Health Organization and American Dental Association.
In its dental amalgam information page online, the FDA shares that, after reviewing "the best available scientific evidence," it considers dental amalgam fillings safe for adults and children 6 years old and older. According to the FDA, clinical studies of that segment of the population have never found a link between dental amalgam filling and health problems.
The American Dental Association's Council on Scientific Affairs also has conducted its own reviews of studies to confirm that dental amalgam is safe. The ADA cites this review and other studies extensively online.
Liquid mercury makes up about 50 percent of dental amalgam, according to the FDA. The other half is silver, tin and copper that makes up a powdered alloy.
Mercury has properties that make it bond well with those other materials, holding them together and creating a strong amalgam. When the dentist first mixes the mercury and other materials, the mixture is soft enough to adhere to the tooth. It also hardens quickly, giving the dental amalgam its durable quality.
That durability makes dental amalgam a preferred choice for larger fillings, such as those needed for molars.
Still, although unnecessary, the mercury used in dental amalgam does concern some patients.
While mercury is a natural substance that can be found in the ground, water or even air, it is a known toxin. As a whole, the public is knowledgeable of the health concerns mercury represents.
But in reality, mercury in dental amalgam does not cause adverse health effects in the general population.
For example, the over-consumption of fish is one known way a person could be exposed to high levels of mercury. However, as the FDA explains here, the mercury found in dental amalgam isn't even in the same chemical form as the mercury found in fish.
Dental amalgam shouldn't be a cause for concern among patients, but dental offices must take certain precautions with the material.
While amounts of mercury in dental amalgam in patients are not high enough to represent a health concern, large amounts of the material must be recycled and handled properly.
Heavier concentrations of dental amalgam from dental office waste could, in fact, contain enough mercury to create environmental concerns. That's why the Environmental Protection Agency now regulates the disposal of dental amalgam.
To prevent the substance - and the mercury found in it - from entering wastewater systems, the EPA requires dental offices to install, maintain and recycle amalgam separators.
All dental offices must become compliant by July 14, 2020.
DRNA is your dental office's 360-degree solution when it comes to remaining in compliance with local, state and federal regulations regarding amalgam separator installation and recycling.
The DRNA recycling program places your office on an schedule that ensures you'll receive a replacement amalgam separator unit once a year. All your office has to do is notify DRNA that your unit is ready to be recycled.
DRNA takes care of the rest, including ensuring your amalgam separator is recycled at an EPA-certified facility and providing your office with the required compliance documentation.
DRNA's services encompass much more than dental amalgam recycling. Our team can also help your office with pharmaceutical, sharps and x-ray waste disposal.
We're the complete regulatory solution for the dental community.
Contact DRNA today to learn how your dental office can more effectively and safely handle waste.