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Public Health (08-05-2015)

Safety of dental amalgam and its alternatives: Final Opinion

Today, the European Commission and its non-food Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR), have published the final Opinion on the safety of dental amalgam and alternative dental restoration materials for patients and users.

The Opinion, which updates SCENIHR’s previous Opinion of 2008, aims to assess the safety and effectiveness of both dental amalgam and its possible alternatives1 by evaluating the scientific evidence on the potential association between amalgam and its alternatives, and allergies, neurological disorders or other adverse health effects.

The SCENIHR concludes that current evidence does not preclude the use of either amalgam or alternative materials in dental restorative treatment. However, the choice of material should be based on patient characteristics such as primary or permanent teeth, pregnancy, the presence of allergies to mercury or other components of restorative materials, and the presence of impaired renal clearance.

The SCENIHR recognises that there is a need for further research, particularly (i) to evaluate the potential neurotoxicity of mercury from dental amalgam and the effect of genetic polymorphisms on mercury toxicity; and (ii) to expand knowledge of the toxicity profile of alternative dental restorative materials. Furthermore, there is a need for the development of new alternative materials with a high degree of biocompatibility.

Currently in the EU, there is a shift away from the use of dental amalgam in oral health care towards an increased use of alternative materials. This change is not only for technical and aesthetic reasons, but also reflects the increasing concern about the use of mercury – a major component in dental amalgam - and the general aim to reduce mercury use within the EU. To reduce the use of mercury-added products in line with the intentions of the Minamata Convention (reduction of mercury in the environment) the Opinion recommends that for primary teeth, and in pregnant patients, alternative materials to amalgam should be the first choice.

1 E.g. resin-based composites, glass ionomer cements, ceramics and gold alloys.