ADA STATEMENT ON DENTAL AMALGAM
Revised January 8, 2002
Dental amalgam (silver filling) is considered a safe, affordable
and durable material that has been used to restore the teeth of
more than 100 million Americans. It contains a mixture of metals
such as silver, copper and tin, in addition to mercury, which
chemically binds these components into a hard, stable and safe
substance. Dental amalgam has been studied and reviewed extensively,
and has established a record of safety and effectiveness.
Issued in late 1997, the FDI World Dental Federation and the
World Health Organization consensus statement on dental amalgam
stated, "No controlled studies have been published demonstrating
systemic adverse effects from amalgam restorations." The document
also states that, aside from rare instances of local side effects
of allergic reactions, "the small amount of mercury released from
amalgam restorations, especially during placement and removal, has
not been shown to cause any adverse health effects."
The ADA's Council on Scientific Affairs' 1998 report on its
review of the recent scientific literature on amalgam states: "The
Council concludes that, based on available scientific information,
amalgam continues to be a safe and effective restorative material."
The Council's report also states, "There currently appears to be
no justification for discontinuing the use of dental amalgam."
In an article published in the February 1999 issue of the
Journal of the American Dental Association,
researchers report finding "no significant association of Alzh eimer's
Disease with the number, surface area or history of having dental
amalgam restorations" and "no statistically significant differences in
brain mercury levels between subjects with Alzheimer's Disease and
control subjects."
The U.S. Public Health Service issued a report in 1993
stating there is no health reason not to use amalgam, except in the
extremely rare case of the patient who is allergic to a component
of amalgam. This supports the findings of the Food and Drug
Administration (FDA), the National Institutes of Health Technology
Assessment Conference and the National Institute of Dental and
Craniofacial Research, that dental amalgam is a safe and effective
restorative material. In addition, in 1991, Consumer Reports noted,
"Given their solid track record . . . amalgam fillings are still
your best bet."
In 1991, the FDA's Dental Products Panel found no valid data
to demonstrate clinical harm to patients from amalgams or that
having them removed would prevent adverse health effects or reverse
the course of existing diseases. The FDA's most recent reaffirmation
of amalgam's safety was published on December 31, 2002.
The reaffirmation reads, "FDA and other organizations
of the U.S. Public Health Service (USPHS) continue to investigate
the safety of amalgams used in dental restorations (fillings).
However, no valid scientific evidence has ever shown that amalgams
cause harm to patients."
It continues, "Also, USPHS scientists analyzed
about 175 peer-reviewed studies submitted in support of three citizen
petitions received by FDA after the 1993 report. They concluded
that data in these studies did not support claims that individuals
with dental amalgam restorations will experience problems, including
neurologic, renal or developmental effects, except for rare allergic
or hypersensitivity reactions."
The U.S. Public Health Service found in 1993 "no persuasive
reason to believe that avoiding amalgams or having them removed
will have a beneficial effect on health." In fact, it is
inadvisable to have amalgams removed unnecessarily because it can
cause structural damage to healthy teeth.
The ADA supports ongoing research in the development of new
materials that it hopes will someday prove to be as safe and effective
as dental amalgam. However, the ADA continues to believe that amalgam
is a valuable, viable and safe choice for dental patients and concurs
with the findings of the U.S. Public Health Service that amalgam
has "continuing value in maintaining oral health."