The NobleDentist Blog

This is anrticle by Michael Riley that appeared recently in the Asbury Park Press.

Dr. Robert Hersh, a periodontist and newly elected president of the New Jersey Dental Association, opened up and said “Ahhh!” about various cavity-filling techniques and the controversary surrounding at least one of those fillings.

“There are,” says Hersh, of The Center for Oral Health in Freehold, “two types of dental restorations — direct and indirect.”

Direct restorations are fillings placed immediately into a prepared cavity. They include dental amalgam, glass ionomers, resin ionomers and some resin composite fillings.

Indirect restorations include inlays, crowns and bridges.

The controversary that has gotten some people down in the mouth concerns the stuff that amalgam fillings are made of.

One of the typical ingredients in amalgam fillings is mercury.

“Mercury is a toxic element,” Hersh says. “Everybody knows it. Some people have come to believe that silver-colored amalgam fillings can cause harm, either by mercury vapor being inhaled or mercury being swallowed through chewing.”

The problem with that theory, Hersh says, is that The Centers for Disease Control, the National Institutes of Health, The Food and Drug Administration, and the World Health Organization have all concluded that there is an absense of evidence that the mercury in filling material poses a threat to the individual with the fillings. There are, he says, a small number of people who have an allergic reaction to amalgam fillings.

“As the years go by, this will become less of an issue,” Hersh says.

Flouridation of water and increased dental hygiene, he says, have resulted in smaller cavities more able to be filled by non-almagam materials.

Still, there are dentists so concerned about the issue that their offices, and the mouths of their patients are “mercury-free.”

According to her office staff, Dr. Elizabeth Piela of Lakewood is a dentists who will not use mercury fillings.

But, even if one believes that the mercury in cavity-filling material is safe, because its combination with other materials renders it stable and harmless in your mouth, the environmental threat from all that mecury in dentists’ offices and spit sinks is something that needs to be reckoned with, Hersh says. “Dentistry contributes about 1 percent of all the scrap mercury which makes its way into the water system,” he says.

Theoretically, dental waste is caught with other waste in water treatment plants and burned. But, according to Hersh, the New Jersey legislature is going to require dental offices to use new technology to trap the mercury and have it picked up by a specialized agency or company.

“Dentists want to do their part for the environment we all share,” says Dr. James B.Bramson, executive director of the American Dental Association.