Dental exam

When an employee needs a tooth filled, the dentist can perform this procedure by using a metal-based amalgam or a composite material. The U.S. Food and Drug Administration recently advised against the use of dental amalgam in high-risk groups. What do these recommendations mean for your employees? Let’s consider the facts about amalgam.

What is the case against dental amalgam?

Amalgam fillings contain a mixture of mercury and a powdered alloy containing silver, tin and copper.

In its recommendations released Sept. 24, 2020, the FDA suggested that certain groups of people, including pregnant and nursing women, children under 6 and people with allergy, pre-existing neurological disease or impaired kidney function may experience harmful effects of mercury exposure.

The FDA cited “uncertainties about the acceptable reference exposure levels for mercury vapor” and the potential for negative health outcomes. The FDA did not cite any new scientific evidence for this position.

What is Delta Dental’s position on dental amalgam?

Amalgam is a long-lasting, clinically effective tooth restorative material and has a proven track record of over 150 years. Based on the scientific evidence available, amalgam fillings do not pose a health risk to children or adults, except the small group of people who are allergic to the metal components of amalgam.

The mercury in fillings is safe in its bound form. When it breaks down, however, mercury can be released as vapor. Exposure to high levels of mercury vapor — higher than those in fillings — can cause damage to the kidneys and brain, according to industrial studies.

Make sure your employees, who may be in risk groups or otherwise have health concerns, know that they have treatment options. The use of amalgam has declined, due to application of alternative materials, according to the recent FDA statement.

There are no changes to Delta Dental’s coverage of restorative treatments such as amalgam and composite fillings.

When should amalgam fillings be removed?

The FDA advises against removing or replacing existing amalgam fillings that are in good condition unless medically necessary. This aligns with Delta Dental’s recommendation.

If an employee has an amalgam filling in good condition, with no nearby decay present in the tooth, the filling should not be removed. Removal may result in loss of tooth structure and unnecessarily releases mercury vapor.

If, however, amalgam removal is warranted, dental offices are required to follow a 2017 ruling from the Environmental Protection Agency regarding procedures and disposal, so your employees can have it safely done.