adam

Dental amalgam has been successfully used for the restoration of carious lesions for more than 180 years. It is clinically characterized by high longevity and low technique sensitivity. For decades, dental amalgam has been discussed in the public, especially due to its roughly 50% mercury content. Since the Minamata Convention was published in 2013 with the primary goal of reducing the anthropogenic mercury release into the environment, the previously muted amalgam discussion has received fresh impetus. Another considerable disadvantage of amalgam is its silver/greyish color, which simply no longer matches patients’ esthetic demands.The present paper describes the basic problems with amalgam against the background of multiple biological, clinical, and health policy factors. Possible consequences of the Minamata Convention concerning legal regulations as well as the use of dental biomaterials and therefore also relating to the future national healthcare system are discussed. Finally, possible amalgam alternatives and the urgent need for biomedical research towards restorative dentistry are presented, embedded into the crucial question of whether we are actually conducting the correct debate.

In 2013, the Minamata Convention on Mercury supported a gradual phase down of dental amalgam usage in restorative dental treatment. It was adopted in 2017 making it necessary to plan and act strategically to reduce the need for dental amalgam for restorative treatments. The Convention also
emphasized the need to strengthen dental curricula towards disease prevention and health promotion as well as teaching alternative restorative materials and techniques, including the minimum intervention approach as appropriate

Background: Approximately 50% of dental amalgam is elemental mercury by weight. Accumulating body of evidence now shows that not only static magnetic fields (SMF) but both ionizing and non-ionizing electromagnetic radiations can increase the rate of mercury release from dental amalgam fillings. Iranian scientists firstly addressed this issue in 2008 but more than 10 years later, it became viral worldwide.

Objective: This review was aimed at evaluating available data on the magnitude of the effects of different physical stressors (excluding chewing and brushing) on the release of toxic mercury from dental amalgam fillings and microleakage.

Material and methods: The papers reviewed in this study were searched from PubMed, Google Scholar, and Scopus (up to 1 December 2019). The keywords were identified from our initial research matching them with those existing on the database of Medical Subject Headings (MeSH). The non-English papers and other types of articles were not included in this review.

Results: Our review shows that exposure to static magnetic fields (SMF) such as those generated by MRI, electromagnetic fields (EMF) such as those produced by mobile phones; ionizing electromagnetic radiations such as X-rays and non- Ionizing electromagnetic radiation such as lasers and light cure devices can significantly increase the release of mercury from dental amalgam restorations and/or cause microleakage.

Conclusion: The results of this review show that a wide variety of physical stressors ranging from non-ionizing electromagnetic fields to ionizing radiations can significantly accelerate the release of mercury from amalgam and cause microleakage.

Objective: Mercury (Hg)-based amalgam is a dental restorative material in common use. This hypothesis-testing study evaluated the relationship between dental amalgam exposure and the risk of reported asthma diagnoses in American adults. Methods: A total of 97,861,577 weighted-persons with one or more dental amalgam surfaces (exposed group) and 31,716,558 weighted-persons with one or more other dental surfaces (no dental amalgams, unexposed group) were examined in the 2015-2016 National Health and Nutrition Examination Survey. All persons were 20-80 years old and with known reported asthma status (only newly diagnosed asthma cases were examined). Survey logistic regression and survey frequency modeling in SAS were employed to evaluate the relative incidence rate of reported asthma diagnoses among those in the exposed group compared to the unexposed group. Covariates of gender, race, socioeconomic status, educational status, country of birth, and tobacco exposure were considered. Results: Survey logistic modeling revealed a significantly increased incidence rate of reported asthma in the exposed group as compared to the unexposed group in unadjusted (4.46-fold) and adjusted (4.84-fold) models. A dose-response relationship was observed for the risk of reported asthma per dental amalgam filling surface in unadjusted (1.073) and adjusted (1.076) models. Survey frequency modeling revealed that the frequency of reported asthma (per 10,000 weighted-person years) was 3.66-fold significantly increased in the exposed group (2.06) as compared to the unexposed group (0.56). Conclusion: Increased dental amalgam exposure was associated with an increased risk of reported asthma diagnoses in American adults, but future studies should further evaluate this relationship.