The Safety of Amalgam Restorations in Malaysia
Dental Amalgams are used in both the public and private sector in Malaysia. Although the popularity of Amalgam in general is declining especially in the private sector due to advances in composite restoration materials, dental amalgam are continued to be used widely in the public / government sector showing excellent lifespans compared to composites.
In the United States of America, quite a number of independent health agencies have reviewed the issues of safety and efficacy of amalgam in recent years and have all concluded that current available data does not justify either the discontinuance of use of amalgam or the removal of exisiting amalgam restorations.
These agencies include
- the U.S Food and Drug Administration (FDA) in 1991 and 2002 (http://www.fda.gov/cdrh/consumer/amalgams)
- The World Health Organization (WHO) along with the FDAin 1997
- The National Institutes of Health (NIH) and the National Institute of Dental Research (NIDR) in the USA in 1991
- The U.S.A's Public Health Services (USPHS) in 1993
- The Natioanal Council Against Health Fraud (NCAHF) in the USA in 1993
The NCAHF warns consumers about dentists recommending unnecessary removal of servicable amalgam restorations and states that: (www.ncahf.org)
Promoting a dental practice as mercury free is unethical because it falsely implies that amalgam fillings are dangerous and that mercury-free methods are superior
The Life Sciences Research Organization (LSRO), a not for profit scientific organization in Bethesda, MD, released results of it's independent review of all articles published on this topic between 1993 - 2003, of 950 published articles, 300 were accepted on the basis of scientific methodology. The report concluded that: (www.lsro.org)
There is little evidence to support a causal relationship between silver (amalgam) fillings and human health provlems
An extensive literature review on dental amalgam fillings and health effects was published by the ADA council on Scientific Affairs which is last updated on September 2010. 185 articles on the topic of dental amalgam was chosen and reviewed. Abstracts of these 185 articles were identified and reviewed. The findings concluded that there were no consisten evidence of harm associated with dental amalgam fillings. (http://www.ada.org/~/media/ADA/Member%20Center/FIles/amalgam_literature_review_1009.ashx)
Meanwhile in Malaysia, the Malaysian Dental Council (MDC) have released a "position statement" on the usage of dental amalgams:
POSITION STATEMENT ON THE USE OF DENTAL AMALGAM 2013
The Malaysian Dental Council (MDC) continues to support dental amalgam as a restorative material especially in load-bearing areas of the mouth such as for posterior permanent teeth. This position is taken after a review of current evidence, from which it is concluded that dental amalgam is still effective, viable and safe choice for patients if used properly. The Position Statement takes into cognisance the stands of the World Health Organisation (WHO) and the Federatione Dentaire Internationale (FDI) for the continued use of dental amalgam. The MDC will continue its vigilance on current worldwide literature on the use of dental amalgam.
Hence, We would like think Amalgam is in fact safe to be used as a reliable restoration for patients. However, it is essential that Amalgam wastes are properly disposed of in accordance to the Guidelines of Chemical Waste Disposal (Malaysia). (http://www.moh.gov.my/images/gallery/Garispanduan/Guidelines_on_Chemical-1.pdf)
Best Management Guide on Dental Amalgam Waste taken from ADA: (http://www.ada.org/~/media/ADA/Member%20Center/Files/topics_amalgamwaste_brochure.ashx)