Researchers at the University of Georgia have rekindled the dental amalgam debate by releasing the results of a study involving more than 15,000 individuals.
The very robust study, reported in September, showed that persons with eight or more silver amalgam fillings had 1.5 times the level of mercury compared to people with no silver fillings. The study controlled for confounding factors such as gender, ethnicity, race, smoking, seafood consumption, age, and education.
The report also notes that people with eight or more amalgam fillings had higher levels of the most toxic form of mercury, methyl mercury. Recent research suggests that methyl mercury may be dangerous even at low levels.
This study is almost certain to rekindle the debate around the dangers of silver amalgam fillings. As a dental professional, part of your job is to translate research findings into workable courses of action for your patients. With that in mind, here are some thoughts.
First, calm the panic. There’s a significant percentage of the population that will panic at the suggestion that anything might hazardous to their health. When dietary fat was being demonized, a number of people decided that if too much fat was bad, they’d eat as little fat as possible. That didn’t end well for them because dietary fat plays a number of important roles in maintaining our nervous systems, among other things.
It’s important to point out that the researchers found the raised mercury levels in people with eight or more amalgam fillings. You almost certainly have some of those people in your practice. For them, you might consider suggesting replacement of at least some of the amalgam fillings with composite restorations to lower their risk of mercury exposure.
But for those with one or even several amalgam fillings, there’s no evidence, even from this large-scale study, that’s there’s a serious health risk. Still, there’s no real reason why amalgam fillings can’t be replaced with composite, so if your low-risk patients insist, you can accommodate them.
Second, in light of these findings, you might consider setting up a somewhat discounted fee structure for those patients with eight or more fillings. Yes, you won’t make as much money, but being seen to act to safeguard your patients’ health can pay bonus dividends in how your patients and prospective patients view you.
Third, use this as an opportunity to educate your entire patient base about the risk of mercury exposure. Some of your patients may eat large amounts of seafood, which can increase their mercury levels. Others may be at heightened risk due to environmental exposure, including smoking or inhaling high levels of secondhand smoke.
You should be able to run several articles in your newsletter or send out several emails around this topic and the findings of the study.
The University of Georgia study won’t be the last word on the potential dangers of amalgam fillings. Your patients and prospects will look to you as the trusted dental expert to explain later findings and recommend different courses of action to suit your patients’ needs.
Don’t let this opportunity pass you by, for your patient’s sakes as well as your bottom line.