The legal position of the
American Dental Association (ADA) on the safety of
mercury containing dental amalgam and the use of the
material by dentists in the United States was recently
stated as follows:
"The ADA owes no legal duty of care to
protect the public from allegedly dangerous
products used by dentists. The ADA did not
manufacture, design, supply or install the
mercury-containing amalgams. The ADA does not
control those who do. The ADA's only alleged
involvement in the product was to provide information
regarding its use. Dissemination of information
relating to the practice of dentistry does not create
a duty of care to protect the public from potential
injury".
Source: Legal brief filed in 1995 by attorneys for
the ADA in W.H. Tolhurst vs. Johnson and Johnson
Consumer Products, Inc.; Engelhard Corporation; ABE
Dental, Inc.; the American Dental Association, et al.,
in the Superior Court of the State of California, in and
for the County of Santa Clara, CA, Case No. 718228.
This legal position adopted by the ADA seems to
contradict the organization's publicly stated mission.
According to their own web site (www.ada.org):
"The ADA is the professional association of
dentists dedicated to serving both the public and the
profession of dentistry. The ADA promotes the
public's health through commitment of member
dentists to provide quality oral health care,
accessible to everyone. The ADA promotes the
profession of dentistry by enhancing the integrity and
ethics of the profession, strengthening the
patient/dentist relationship and making membership the
foundation of successful practice. The ADA fulfills
its public and professional mission by providing
services and through its initiatives in education,
research, advocacy and the development of
standards."
Somehow the ADA's stated mission of promoting public
health does not require the organization to protect the
public even when their own member dentists are following
ADA guidelines and standards of care for the use of
mercury containing dental amalgams.
For the uninformed public, most dental amalgam
contains approximately 50% elemental mercury by weight
(see amalgam composition)
To find out what the ADA "really meant" by
its statements regarding the use and safety of dental
amalgam in the Tolhust case see http://www.ada.org/prac/position/bioprobe.html
In contrast to what they say, the American Dental
Association has endorsed Crest toothpaste and at least
1,300 other products. (NYT, 8/13/97) according to the
Integrity in Science project of the Center
for Science in the Public Interest, a non-profit
group in Washington, D.C. CSPI is funded largely by its
many members and somewhat by philanthropic foundations;
CSPI receives no corporate or government funds. The
project is directed by Ronald
Collins (ronc@cspinet.org)..
http://www.cspinet.org/integrity/corp_funding.html.
In the class-action lawsuit recently brought by
500,000 smokers in Florida against the tobacco
industry, Robert Heim, the lead attorney for
Philip Morris, stated the tobacco industry could not be
held accountable for the health consequences caused by
cigarettes because of the following:
"The basic common sense of the American people
for the most part is: You knew the risk, you took the
choice and you should be responsible".*
*Source: Associated Press article, dated 10/20/98,
written by Tracy Fields.
Maybe someone should ask the American people these
same three questions concerning the health consequences
resulting from the mercury released from dental amalgam
fillings.
Did you know there was a risk?
Were you given a choice?
Who should be held responsible?
What
Does the ADA Seal of Acceptance Really Stand For?
For more than 125
years, the ADA has sought to ensure the safety and
effectiveness of dental products. As early as 1866, an
ADA committee prepared a statement on dentifrices
(toothpaste).
The first Seal of
Acceptance was awarded in 1931. Although
it is strictly voluntary, about 350 companies
participate in the Seal program. The ADA Seal generally
is awarded for a three-year period.
More than 100
consultants, including members of the ADA's Council on
Scientific Affairs and ADA staff scientists, review and
declare oral care products safe,
effective and worthy of the ADA Seal.
The Seal on a product
is an assurance for consumers and dentists against
misleading or untrue statements concerning a product,
its use, safety and
effectiveness.
http://www.ada.org/public/topics/seal.html
Don't remove amalgam fillings, urges
American Dental Association
The Lancet, Volume 360, Number 9330, 03 August 2002
http://www.thelancet.com/journal/journal.isa
The American Dental Association (ADA) has launched a
media campaign aimed at discouraging patients from having
amalgam [silver-coloured] fillings removed and physicians
from recommending the intervention, says Frederick
Eichmiller (Paffenbarger Research Center, Gaithersburg,
MD, USA). "We're seeing more and more patients with
multiple sclerosis, Alzheimer's disease, and autism
thinking that the conditions can be corrected by removing
amalgams. Their physicians don't know how to advise them,
and so they say 'go ahead and try it' when the evidence
isn't there. So patients are being given false hope, plus
there are risks and often huge costs associated with
removing and replacing the fillings", he warns.
Concerns about amalgam arose in large part because the
material contains mercury, explains Eichmiller. But when
mercury is mixed with such metals as silver, "it
forms a stable alloy, similar to the way that sodium and
chlorine--both hazardous in their pure state--combine to
form ordinary table salt." Although a
"minute" amount of mercury vapour may be
released by amalgam fillings as a result of vigorous
chewing and grinding, "a person would have to have
almost 500 amalgam fillings in his mouth to see subtle
symptoms, even if he were the most mercury-sensitive
patient", asserts Eichmiller.
The ADA Code of Ethics prohibits member dentists from
telling patients that removal of any type of dental
filling will cure various diseases because such a
statement cannot be substantiated scientifically,
Eichmiller continues. Furthermore, "every time you
remove fillings, you risk damaging the teeth. Each time
you replace a filling it has to be a little bit larger.
And the more often we surgically intervene on a tooth, the
higher the risk of adverse reactions or the need for a
root canal. Plus, it could cost tens of thousands of
dollars to do this in some cases. So patients are making
this large investment and not really seeing any
relief", he emphasises.
The US National Institutes of Health are 2 years into a
7-year, multicentre clinical trial of children aged 6 to
10 years to see whether any adverse health effects result
from amalgam fillings (http://www.clinicaltrials.gov;
search on "amalgam"). "Of course, they
can't release any findings yet, but they have told us that
there are no indications right now that would cause them
to discontinue the trial", says Eichmiller. "And
we know from the recent
oestrogen trial [see Lancet 2002; 360: 146]
that if there were any adverse responses, they'd pull the
plug in a hurry, especially in children."
Marilynn Larkin
ADA
Statement on Dental Amalgam
Revised
Oct 14, 2002
http://www.ada.org/prof/prac/issues/statements/amalgam.html
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 Alzheimer’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 in March 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."
Page Updated: November 09, 2004
More on Amalgam from
the ADA
http://www.ada.org/prof/prac/issues/topics/amalgam.html
Dental
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