Known Negative Impacts of Dental Mercury Surpass Those of Alternatives

Reston, VA — Substituting alternative materials for mercury-based dental fillings has less negative impact on human health and the environment, according to a new report by the Health Care Research Collaborative. The Research Collaborative, of the University of Illinois at Chicago School of Public Health, the Healthier Hospitals Initiative and Health Care Without Harm released the study today, “Mercury in Dental Amalgam and Resin-Based Alternatives: A Comparative Health Risk Evaluation,” which compared the health and environmental impacts of mercury dental amalgam with those of the alternatives currently available in the United States.

The report found that the known impacts of mercury on human health and the global environment outweigh the known impacts of resin composites and glass ionomer fillings. The report also found that health systems in several countries have successfully substituted mercury with these alternatives with little or no negative impacts on oral health.

Based on this evidence, the report recommends “the ultimate goal of a phase-out of virtually all usage of dental mercury,” with allowance for exceptions due to clinical necessity, while at the same time suggesting caution with the alternatives. “Dental personnel handling these [composite] materials should take proper exposure control measures due the demonstrated genotoxicity and allergenicity of some of these compounds.”

“We looked at the evidence,” said Dr. Peter Orris, one of the report’s co-authors and Professor of Occupational and Environmental Health Sciences at the University of Illinois School of Public Health. “"We found no evidence of a negative effect on patients' health from either mercury amalgams or the alternatives used in restorations. Yet the alternatives were less hazardous to the general environment and the public’s health."

The report cautions that a “phase out must be planned and deliberate, assuring continued emphasis on adequate restorations to prevent continued tooth decay and the potential of malnutrition in economically impoverished areas.” Such a phase-out, therefore, must take into account:
• the practical availability of alternative materials in a region or country
• the equipment needed to utilize non-mercury alternatives,
• the training of dentists to utilize these alternatives, and
• the costs to the patient and society.

There has been considerable controversy concerning the health risks and benefits of utilizing mercury-containing amalgam. Neither epidemiologic studies nor consensus statements have identified evidence of harm to individuals due to their mercury amalgams. At the same time, the contribution of mercury dental amalgam use to the environmental mercury burden and its contribution to the neurotoxic damage of methyl mercury in children is well established. In 2005, The United Nations Environment Programme estimated that 362 tons of dental mercury is consumed annually worldwide.

The report, “Mercury in Dental Amalgam and Resin-Based Alternatives: A Comparative Health Risk Evaluation,” can be found here.

The Research Collaborative was initiated by Health Care Without Harm (HCWH), an international nonprofit coalition that promotes envi¬ronmental responsibility in health care, and is coordi¬nated by faculty of the University of Illinois at Chicago School of Public Health, with support from the Pioneer Portfolio of the Robert Wood Johnson Foundation. The Collaborative also interacts closely with the Healthier Hospitals Initiative (HHI), a group of health systems that are leading the way in implementing green practices in health care. This paper is the latest in a series of papers in which the Collaborative provides research and analysis of factors influencing patient, worker and environmental safety and sustainability in the healthcare sector. The editors of this series are Peter Orris, MD, MPH and Susan Kaplan, JD.

Heath Care without Harm, an international coalition of more than 500 organizations in 53 countries, is working to transform the health care sector, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment. To learn more about HCWH's work, visit our website at www.noharm.org, our YouTube channel at HCwithoutharm, and our twitter feed at hcwithoutharm.