FDA Proposal to End Mercury Fillings Denied

The US government denies FDA proposal for tighter regulations on mercury amalgam fillings. But what does it mean for the future of the dental industry?

FDA Proposal to End Mercury Fillings Denied

Image by David Joyce on Flickr.

In July last year, the US dental industry found itself in the midst of a government scandal. It would rock the Department of Health and Human Services to its core and raise serious questions about the legitimacy of state health recommendations. It all started with a proposal from the Food and Drug Administration (FDA), the government body responsible for the regulation and control of materials sold to the general public.  

It is the job of the FDA to closely monitor the safety of everything from GMOs to prescription medications, cosmetics, and vaccines. If it finds evidence that a material has the potential to negatively impact health, it can lobby for tighter control or advise that it be completely removed from the market. It lodged such a proposal in response to evidence that mercury, which is still regularly used by some dentists to create fillings, can cause serious physical harm.

Now, this is not the first time that the safety of mercury has been called into question. In fact, ever since the dental industry first began to use it in amalgam fillings in the thirties, activists and safety experts have protested. A great many studies have investigated the toxicity of this material. It has been linked to everything from memory loss to autoimmune disease, kidney failure, depression, autism, nerve damage, and more.

The Complex World of the FDA

So, if all of this evidence points to mercury being highly toxic, why has it been allowed to remain in use (particularly as part of dental fillings) for the better part of seventy years? This is a very important question and one which has been complicated by the stance of the FDA. It is only recent years that the FDA has started to doubt its own claims about the safety of mercury amalgam fillings.

For a very long time, the government body was the loudest defender of its use, even as activists and protestors gathered mounting evidence to the contrary. However, it has now been revealed that, in 2011, the FDA proposed the introduction of much tighter controls on mercury fillings, due to concerns about safety. It recommended that mercury fillings not be offered to pregnant women, nursing mothers, infants, or anybody with a kidney disease or a neurological disorder.  

While the proposal did not call for a complete ban on mercury within the dental industry, it did go as far as to strongly advise all dentists to discontinue mercury amalgam fillings. This is quite the turnaround from the FDA and as the primary food and drug authority in the country, it would be rare for government officials not to take it seriously. Yet, that is exactly what they failed to do in July 2015.

Senior Officials Veto Health Proposal

It is has now been revealed that the proposal was passed on to senior US health officials for consideration. And, in spite of all the evidence, it was quietly quashed. Unsurprisingly, this has angered health experts and raised questions about why the proposal was only made public three years after its submission. The suspicion is that cost evaluations did not favour tighter regulations for mercury fillings.

The move looks worse in the wake of multiple European bans on the most harmful mercury compounds. In Denmark, Norway, and Sweden, tighter controls have been introduced to curb the use of mercury in dental fillings and other products. In America, many dentists have voluntary chosen to abandon the material due to safety concerns. The problem is that around 50% of all dentists still offer some kind of cheap mercury amalgam filling.

The statistics are more concerning when you take a closer look at the type of dentists which continue to use mercury. As the material is so affordable, it is prevalent among dental care programs for the elderly, unemployed, low income earners, soldiers, and prisoners. It is becoming increasingly rare for premium dentists to offer this kind of filling. This is the root of the issue and the reason why activists are demanding that government officials reconsider.

How Mercury Became a Social Issue

At current prices, the cost difference between a popular budget filling (containing mercury) and a more premium filling (not containing mercury) is around $100. In most low income neighbourhoods, mercury amalgam fillings are the only viable option. And, since the FDA has spent so many years defending their use and promising their safety, it is certainly not surprising that so many patients would continue to choose them.

According to activists, the government is putting the health of these people at risk in order to make a profit. Yet, on the other hand, the government claims that forcing low income patients to invest in more expensive fillings is unfair. It believes that low earners will simply neglect the health of their teeth and choose not to go to the dentist if prices go up. It has also denied accusations that it tried to conceal the existence of the FDA proposal.  

This leaves many unanswered questions. It is not entirely clear why the Department of Health and Human Services has seemingly refused to even consider the proposal. Or, at least, to maintain a façade of having done so before flatly rejecting it. The secrecy of the move has troubled medical ethics experts, who are now worried that misinformation and half-truths (in the absence of a clear stance from the government) will cause harm to patients.

The Story of Mercury and the Regulators

As aforementioned, mercury has been a major issue for health and safety campaigners for many years. These efforts have, for the most part, been focused on its impact on seafood. It is now widely agreed that consuming too much fish is dangerous for the health, due to the rising levels of mercury in the sea and its inhabitants. It can lead to mercury poisoning, which causes an array of health problems if left untreated.

Once in the lungs, mercury travels through the blood stream and can build up in the kidneys, liver, and brain. There, it causes damage to the central nervous system. Symptoms include memory loss, autoimmune disease, vision problems, kidney failure, depression, autism, and more. In some very severe cases, mercury poisoning can be lethal. In fact, evidence to support the detrimental impact of mercury is so convincing that, in 2013, the US actually signed a treaty calling on governments to curb its use.

So, why is it happy for dentists to continue using mercury fillings? And what would it mean for the dental industry if the government was to reverse its decision? Well, the American Dental Association has taken a typically hard line on the issue. This is no surprise, however, as many dentists fear legal action if mercury fillings were to be outlawed because of safety issues. It issued a statement advising members that it would be unethical for them to recommend that patients get mercury fillings removed.

Getting to Grips with Mercury Fillings

It is time to take a closer look at mercury fillings. If you think that you have had or still have mercury amalgam dental work, the first step is to get informed. Then, you can make an independent decision about the future health of your teeth. It is important to note that some patients will never have been offered mercury fillings, because their dentist has already made the decision not to use them.

The amalgam mercury filling is made up of 50% mercury and 50% other metals. It is commonly referred to as a ‘silver filling’ due its colour. This type of product is not like a resin filling, which can be coloured to match natural teeth; it remains a shiny silver tone. While it is true that the majority of the mercury is sealed inside the filling (or ‘encapsulated’), small amounts are still released from the tooth. This dispersed mercury fills the mouth and it then inhaled.  

According to safety campaigners, it then contributes to the degeneration of health. This type of sickness can be very deceptive, as it develops gradually. A person may feel consistently weak and under the weather, but not necessarily describe themselves as ill or choose to visit the doctor. For those on low incomes, this is a particular danger, as it means that mercury levels are allowed to rise unchecked because people do not want to take time off work.

Making the Right Dental Decisions

If you are sure that you do not have mercury fillings, there is no need to worry. If you are concerned in any way about whether or not your dentist provides mercury amalgams, you have a legal right to ask and be given an honest answer. Ultimately, a reliable surgery or dental specialist will never evade questions about the safety of their methods or equipment.

If you are having trouble paying for a more expensive type of filling, it is always worth discussing payment options with your dentist. It is their job to provide a high quality service and take care of patients. They should do everything in their power to put together a payment schedule which is right for you. And it should not include any compromises on safety either.

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