American Dental Association Talking Points on Amalgam Safety

3340 American Avenue, Jefferson City, MO 65109
Phone 573-634-3436 Fax 573-635-0764 www.MODENTAL.org
April 9, 2015
We've become aware that an anti-amalgam film is going to be shown April 18-19, 2015 as a part of the Kansas
City Filmfest. Below you can read the press release that was received by the ADA who alerted the MDA. If you
receive patient inquiries about Amalgam safety, please us the attached talking points.
Documentary Exposes Occupational Hazards of Mercury Dental Fillings Premiers at Kansas City FilmFest
KANSAS CITY, Mo., April 8, 2015 /PRNewswire/ -- Do No Harm, LLC, the production company behind You Put What in My
Mouth?, has announced that its independent film will be shown at the Kansas City FilmFest on April 18-19, 2015.
You Put What in My Mouth? follows the lives of three health advocates as they struggle to inform the federal
government and public that vast amounts of mercury vapor and particulate matter are being released during the
removal of "silver" amalgam dental fillings. When the fillings containing 50% mercury are heated by the friction of a
dentist's drill, toxic mercury vapors are released that are invisible, colorless and odorless. "Exposure to these toxic
vapors contribute to a host of adverse health symptoms," said biochemist Boyd Haley, PhD.
Haley went on to explain, "We have visually demonstrated the mercury vapors generated during routine dental
procedures and this shocking footage reveals the peak levels of mercury released during an amalgam removal are vastly
higher than limits at which people are evacuated from buildings."
"Since dental professionals are not taught about the toxicity of mercury amalgam nor of the hazardous vapors it emits,
they are unaware of occupational safety regulations mandating that employees be informed about and protected from
toxic exposures," says Matt Young, DDS. Young, a member of the biological dental organization, the International
Academy of Oral Medicine and Toxicology (IAOMT), is a "mercury safe" dentist. The IAOMT has created a number of
mercury safe protocols to reduce the amount of mercury to which both dental staff and patients are exposed.
Government reviews of mercury have found its toxic effects are broad, variable, idiosyncratic, and often delayed.
Neurological problems, cardiovascular disease, kidney dysfunction, and many other disorders have been linked to
mercury.
The public is invited to attend the showing of You Put What in My Mouth? at the Kansas City FilmFest. The movie will
play April 18-19, 2015 at the Cinemark Palace at the Plaza, 526 Nichols Rd., Kansas City, MO 64112. Tickets are $10 and
can be purchased at the door or at www.kcfilmfest.org.
About the Film, You Put What in My Mouth?
This documentary was created to raise awareness about the toxic effects of mercury dental fillings on patients, staff and
the environment.
Video - http://youtu.be/JUmiRI42KYg
Photo - http://photos.prnewswire.com/prnh/20150406/196727
Media Contact: Randall Moore, Do No Harm, LLC, Phone: (913)731-0164, Email: randall@youputwhatinmymouth.com

Revised July 2013
Dental Amalgam: A Tried and True Filling Option
This document is intended as an educational resource for dentists and others who wish to respond in
accessible language to inquiries from media and consumers about dental amalgam. The information
is to promote public understanding and should be used freely, but the document itself should not be
reproduced or distributed.
Amalgam Talking Points
April 8, 2013
The following are key messages. When you answer a reporter’s question, you should always include a
key message since they are what you want your audience to remember long after the interview is over.
You do not have to use these messages verbatim; in fact, we encourage you to personalize your responses
to reporters.
Health and Safety Key Messages
It’s important to separate fear from facts. People who might be concerned about dental amalgam because
it contains mercury can be reassured that credible scientific studies show no cause for alarm. Study after
study shows amalgam is safe and effective for filling cavities.
Amalgam has unique characteristics, and is sometimes the best option for saving a person’s tooth.
The American Dental Association wants to preserve the right of patients to choose from the full range
of cavity filling materials that science has shown is safe to use.
Environment Key Messages
As a dentist, I’m a member of the community. Protecting the environment is just as important to me as
it is to my neighbors.
Less than one percent of mercury released to the environment from man-made sources comes from
dentistry, according to the Environmental Protection Agency.
The American Dental Association and dentists across the country are committed to recycling amalgam
to help protect the environment.
Health and Safety
Dentists have used amalgam for more than 150 years, and we have learned a great deal about its durability,
reliability and safety.
Untreated cavities can lead to serious health consequences. Over the years, dental amalgam has helped
millions of people save their teeth and their health.
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People who might be concerned about dental amalgam because it contains mercury can be reassured that
credible scientific studies show no cause for alarm:
• Two key studies published in the April 2006 Journal of the American Medical Association found
no difference in I.Q., behavior and kidney function between the group with amalgam fillings compared
to the group with tooth colored fillings.
• Another study published in November 2011 Journal of the American Dental Association found no support
for the hypothesis that prenatal mercury exposure arising from maternal dental amalgam restorations re-
sults in neurobehavioral consequences in the child (http://jada.ada.org/content/142/11/1283.abstract).
• Based on scientific findings and clinical data, the U.S. Food and Drug Administration concluded in July
2009 that the exposures to mercury vapor from dental amalgam do not put individuals age six and older
at risk for mercury-associated adverse health effects.
• A 2003 article in the New England Journal of Medicine states that “the available evidence shows no
connection” between amalgam and degenerative diseases. To put the issue into perspective, one expert
said a person would need to have nearly 300 amalgam fillings to experience even the mildest symptoms
in the most sensitive patient.
No properly designed, scientific study demonstrates that dental amalgam causes any long-term health effects
or disease. The ADA welcomes continued research on all dental filling materials and would promptly inform the
public if the scientific community determined that any cavity filling material was unsafe for patients.
Moreover, leading U.S. public health agencies have reviewed a wealth of scientific studies on dental amalgam
and determined it is a safe and effective cavity filling material. These organizations include the Food and Drug
Administration, U.S. Environmental Protection Agency and the Centers for Disease Control and Prevention.
Is Amalgam Hazardous?
Whether you’re considering its effect on the body or on the environment, you cannot compare exposure
to amalgam to exposure to an equivalent amount of mercury.
Amalgam fillings release an extremely small amount of mercury vapor — so small it’s measured in billionths
of an ounce. This tiny amount is well within levels considered safe.
Even in adults and children ages 6 and above who have 15 or more amalgam surfaces, mercury exposure
due to dental amalgam fillings has been found to be far below the lowest levels associated with harm,
according to the U.S. Food and Drug Administration.
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Patient Choice
There are a number of dental fillings available.
• Dental amalgam, which is silver-colored, is the most durable and affordable
• It combines a mixture of mercury with silver, copper, tin and zinc
• Because it is made of a combination of metals, amalgam has entirely different properties than mercury
• Amalgam is often the best choice to fill cavities below the gumline or for large cavities in back teeth
• Because it’s less technique sensitive, amalgam is also a useful material for children and special needs
people who might be restless or can’t control their motor functions
• Dental amalgam use is declining, as more people choose newer, more natural-looking, tooth-colored
fillings. If trends continue, newer materials eventually may replace dental amalgam entirely
• But for now, dentists and patients still value amalgam in numerous instances, and the ADA is
therefore committed to protecting their right to choose this safe, durable, and cost-effective
cavity filling material
• Tooth-colored fillings composite fillings are great for smaller cavities or if you want the filling to look
more natural
• They are more expensive than amalgam and not all insurance plans cover them
• Some studies show that composite fillings need to be replaced more often than amalgam fillings
• Tooth colored fillings are now used more often than amalgam or gold fillings probably due to esthetics
• Gold fillings are the most durable, but they are also the most expensive and they do not match tooth color
In July 2009, the U.S. Food and Drug Administration decided not to place any restriction on the use of
dental amalgam and categorized it as a class II medical device, placing it in the same class as gold and tooth-
colored composite fillings. The ADA has supported a class II designation for dental amalgam since 2002
when first proposed by the FDA.
Ethics
The ADA Code of Ethics states that a dentist who removes a serviceable amalgam from a non-allergic
patient, claiming that doing so will remove toxic substances from the body to improve or cure a health condi-
tion or disease, is acting unethically by misleading the patient about the therapeutic value of the treatment.
The ADA supports and defends the right of dentists to discuss freely, appropriately and accurately all
aspects of dental care with their patients. Information that a dentist gives a patient should be consistent
with accepted science and the applicable standard of care governing clinical practice.
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One of the American Dental Association’s greatest concerns is that vulnerable people with incurable diseases
are being preyed upon and told that removal of their amalgam fillings can “cure” them. There isn’t a single
credible scientific study to back up that claim.
If dentists believed that we could cure disabling diseases by removing people’s amalgam fillings, we would
shout it from the rooftops. The fact is we can’t. But we can act as responsible health professionals and
provide information to people that is consistent with accepted science and the appropriate standard of
care for clinical practice.
ADA Seal of Acceptance Program and Patents on Dental Amalgam
The ADA has never profited from dental amalgam. ADA Foundation obtained two patents for a particular
formulation of dental amalgam in the early 1970s by scientists working for the Foundation. These patents
have long since expired. Neither the ADA nor the ADA Foundation earned any money from the patents. No
products based on these patents were ever made.
In the past, the ADA charged a modest fee to manufacturers to help cover a small part of the cost of evaluating
products submitted to the ADA’s Seal of Acceptance program. Participation was strictly voluntary, and the fee was
charged regardless of whether the product was accepted or not. The ADA receives no money from the sale of an
accepted product.
Fees paid by amalgam manufacturers to the Seal program totaled about $5,100 per year, or less than
one-half of one percent of the program’s total costs. ADA members paid most of the cost of operating
the Seal program though their membership dues as a service to the public and the profession.
In 2002, the ADA eliminated fees for evaluating all professional products, including dental amalgam and
in 2007, the ADA discontinued its Seal of Acceptance program for professional dental products and focused
instead on the Professional Product Review, a product evaluation newsletter for ADA member dentists.
Environment
Dentists and their families are part of communities across the country and protecting the environment
is just as important to us as it is to our neighbors.
Just as people increasingly are recycling at home, the American Dental Association encourages recycling
in the dental office, and we provide dentists with the “how tos” in order to do it.
The ADA and its member dentists are committed, both as health professionals and as members of their
communities, to using “best management practices” which include recycling and the use of amalgam separa-
tors to minimize the amount of amalgam discharged by dental offices to wastewater treatment plants.
Just as every dentist should use a surgical mask and gloves when caring for patients, the ADA hopes all
dentists who use amalgam will follow best management practices to help protect the environment.
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Revised July 2013
Waste amalgam is not a significant source of mercury pollution. According to the EPA, less than 1 percent
of the total amount of mercury released to the environment from human activity comes from dentistry.
Nevertheless, the ADA encourages dentists to help protect the environment we all share by capturing and
recycling amalgam waste.
Dental amalgam waste occurs when dentists place or remove amalgam fillings. Standard dental office
equipment captures up to 80 percent of amalgam waste and most of the remaining 20 percent is captured
at wastewater treatment plants.
If the dental office has an amalgam separator, 95 percent of amalgam waste is captured and can be
recycled, preventing its release to the environment. The ADA recommends that dentists recycle amalgam
captured in dental offices to help protect the environment.
There’s a big difference between mercury and dental amalgam and an even bigger difference between
dental amalgam and methylmercury — the form of mercury that is of greater concern to the environment.
Methylmercury is created when mercury is deposited into surface waters (like lakes and ponds) and
transformed by bacteria in the soil. Fish can then ingest methylmercury and become contaminated.
If amalgam is incinerated, mercury can be released into the air. Dentists across the country are becoming
much more aware about the importance of capturing and recycling amalgam waste to help protect our
environment.
The ADA serves as a clearinghouse for state dental societies seeking information and advice on environmental
issues. The ADA encourages state dental societies to work cooperatively with state and local environmental
regulators to develop effective programs to reduce amalgam waste discharges.
Cremation
Some have suggested that, as an alternative to emission controls at crematoria, teeth containing amalgam den-
tal fillings should be removed from the deceased prior to cremation in an effort to protect the environment.
The American Dental Association (ADA) believes that this is a highly personal and complex issue that includes
not just environmental, but also cultural and religious considerations. As such, the ADA defers to the
expertise of the funeral profession, believing it will act responsibly, in compliance with all applicable laws
and regulations, and with its characteristic sensitivity to grieving loved ones.
According to U.S. Environmental Protection Agency testing data, all U.S. crematories combined emitted
a total of 238 pounds of mercury in 1999 — a miniscule percentage (less than 0.3 percent) of the more
than 45 tons of mercury emitted from coal-fired utilities.
Out of concern for the environment, the American Dental Association provides guidelines to its member
dentists concerning the handling and recycling of dental amalgam within the dental office. The ADA has
shared information with the funeral profession about dental amalgam, and stands ready to serve as a
resource to the profession in this delicate matter.
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Revised July 2013
In the matter of human cremation and the impact it may have upon the environment, the American Dental
Association believes the funeral profession is best suited to address this issue with the families they serve.
Other Organizations
Other organizations concerned about public health, including the Alzheimer’s Association, the National
Multiple Sclerosis Society and the American Academy of Pediatrics, have publicly stated that there is no
scientific evidence linking dental amalgam with any disease or syndrome.
Health Canada’s amalgam advisory clearly states that current scientific evidence does not indicate that
dental amalgam is causing illness in the general population. It also states that neither a ban on amalgam
or removal of existing sound amalgam fillings is justified.
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Revised July 2013
What Others Say About Dental Amalgam
Updated: July 8, 2013
Outside Organizations
Alzheimer’s Association
“According to the best available scientific evidence, there is no relationship between silver dental fillings
and Alzheimer’s … Public health agencies, including the FDA, the U.S. Public Health Service and the
World Health Organization, endorse the continued use of amalgam as safe, strong, inexpensive material
for dental restorations.”
Source: Alzheimer’s Association website
American Academy of Pediatrics
“Although dental amalgams are a source of mercury exposure and are associated with slightly higher
urinary mercury excretion, there is no scientific evidence of any measurable clinical toxic effects other
than rare hypersensitivity reactions. An expert panel for the National Institutes of Health has concluded
that existing evidence indicates dental amalgams do not pose a health risk and should not be replaced
merely to decrease mercury exposure.”
Source: American Academy of Pediatrics website
Autism Society of America
“There is no known single cause for autism, but it is generally accepted that it is caused by abnormalities in
brain structure or function. Brain scans show differences in the shape and structure of the brain in children
with autism versus neuro-typical children. Researchers are investigating a number of theories, including the
link between heredity, genetics and medical problems. In many families, there appears to be a pattern of
autism or related disabilities, further supporting a genetic basis to the disorder. While no one gene has been
identified as causing autism, researchers are searching for irregular segments of genetic code that children
with autism may have inherited. It also appears that some children are born with a susceptibility to autism,
but researchers have not yet identified a single “trigger” that causes autism to develop.”
Source: Autism Society of America website
U.S. Environmental Protection Agency
“Since the 1990s, several federal agencies have reviewed the scientific literature looking for links between
dental amalgam and health problems. According to the Centers for Disease Control and Prevention (CDC),
there is little scientific evidence that the health of the vast majority of people with dental amalgam is com-
promised, nor that removing amalgam fillings has any beneficial effect on health.”
Source: U.S. Environmental Protection Agency website
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Revised July 2013
Mayo Clinic
“Amalgam fillings are safe. A great deal of research has examined these fillings and found them to be an
effective, long-lasting treatment for dental decay. Amalgam, or silver, fillings are made with mercury, silver,
tin and copper. In some cases, other metals may be included in amalgam fillings, too. Amalgam has been used
for many years to replace decayed areas within teeth. It’s an excellent material for this purpose. Amalgam
is a strong, stable substance that holds up well when placed in a moist environment. It’s also a good choice
because it can tolerate the dramatic changes in temperature within your mouth.”
Source: “Amalgam is a safe and durable choice for fillings” in Medical Edge from Mayo Clinic, January 28, 2013
Mayo Clinic website
National Multiple Sclerosis Society
“There is no scientific evidence to connect the development or worsening of MS with dental fillings
containing mercury, and therefore no reason to have those fillings removed. Although poisoning with
heavy metals-such as mercury, lead, or manganese can damage the nervous system and produce
symptoms such as tremor and weakness, the damage is inflicted in a different way than occurs in
MS and the process is also different.”
Source: National Multiple Sclerosis Society website
“There have been claims over the years that mercury leaking from amalgam dental fillings damages the
immune system and causes a broad range of diseases, including MS. While the cause of MS remains
unknown, there is no scientific evidence that heavy metal poisoning is responsible for either the onset
or worsening of MS. There is no reason to have your dental fillings removed or replaced. This is a very
expensive procedure with no proven benefit for people with MS.”
Source: National Multple Sclerosis Society website — ”Dental Health” brochure
U.S. Food and Drug Administration
“FDA has reviewed the best available scientific evidence to determine whether the low levels of mercury
vapor associated with dental amalgam fillings are a cause for concern. Based on this evidence, FDA considers
dental amalgam fillings safe for adults and children ages 6 and above. The amount of mercury measured in
the bodies of people with dental amalgam fillings is well below levels associated with adverse health effects …
FDA concludes that the existing data support a finding that infants are not at risk for adverse health effects
from the breast milk of women exposed to mercury vapor from dental amalgam. The estimated daily dose
of mercury vapor in children under age 6 with dental amalgams is also expected to be at or below levels that
the EPA and CDC consider safe.”
Source: U.S. Food and Drug Administration website
New England Journal of Medicine
“Current concern arises from claims that long-term exposure to low concentrations of mercury vapor
from amalgams either causes or exacerbates degenerative diseases such as amyotrophic lateral sclerosis,
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Revised July 2013
Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease. Speculation has been most intense with
respect to Alzheimer’s disease after a report that the brains of patients with Alzheimer’s disease had
elevated mercury concentrations. However, several epidemiological investigations failed to provide
evidence of a role of amalgam in these degenerative diseases ... Patients who have questions about
the potential relation between mercury and degenerative diseases can be assured that the available
evidence shows no connection.”
Source: New England Journal of Medicine 349;18, October 30, 2003, pp.1731-1737.
International Journal of Dentistry
“According to the available articles and data reviewed in this paper, the following conclusions can be
drawn: 1) Mercury released from dental amalgam restorations does not contribute to systemic disease
or systemic toxicological effects, 2) Allergic reactions to mercury from dental amalgam restorations
have been demonstrated, but these are extremely rare, and 3) Available scientific data do not justify the
discontinuation of dental amalgam use from clinical practice or the replacement with other single-tooth
restorative dental materials.”
Source: “Biocompatibility of Dental Amalgams”, November 2011
National Council Against Health Fraud
“The National Council Against Health Fraud believes that amalgam fillings are safe … ”
“There is no logical reason to worry about the safety of amalgam fillings.”
Source: National Council Against Health Fraud website, 2002
The National Institute of Dental and Craniofacial Research (NIDCR – part of the National
Institutes of Health)
“Both studies — one conducted in Europe, the other in the United States — independently reached the
conclusion: Children whose cavities were filled with dental amalgam had no adverse health effects. The
findings included no detectable loss of intelligence, memory, coordination, concentration, nerve conduction,
or kidney function during the 5-7 years the children were followed.”
Source: “Studies Evaluate Health Effects of Dental Amalgam Fillings in Children”, 2006
American Cancer Society
“The American Cancer Society has no formal position on the use of mercury in dental fillings. We did have
a document called Biological Dentistry on our site that discussed the studies and science around mercury
fillings, which stated there was no good evidence that dental amalgams cause health problems in most
people. It cited studies that found no link between mercury-containing fillings and the development of
cancer and other diseases.”
Source: Complete Guide to Complementary and Alternative Cancer Therapies, 2nd edition, 2009,
pp.164-166.
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Lupus Foundation of America
“At the present time, we do not have any scientific data that indicates that dental fillings may act as a trigger
of lupus. In fact, it is highly unlikely that dental fillings aggravate or cause SLE.”
Source: Lupus Foundation of America website
WebMD
“The cause of autism, Alzheimer’s disease, and multiple sclerosis remains unknown. Additionally, there is no
solid, scientific evidence to back up the claim that if a person has amalgam fillings removed, he or she will
be cured of these or any other diseases … Although amalgams do contain mercury, when they are mixed
with other metals, such as silver, copper, tin, and zinc, they form a stable alloy that dentists have used for
more than 100 years to fill and preserve hundreds of millions of decayed teeth.”
Source: WebMD website
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American Dental Association Talking Points on Amalgam Safety

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