Why The FDA Cautions Rare Neurological Disease Patients About Dental Amalgams

In a press release from the FDA; the FDA has new recommendations for a common mercury-based filling, dental amalgams. While the mercury in the tooth treatment isn’t significant enough to impact most people, for those who are sensitive to mercury due to neurological disorders like Parkinson’smultiple sclerosis, and Alzheimer’s, the FDA now advises avoiding these fillings. If you are a patient who already has this type of filling, you should leave it in place, as the exposure comes during the insertion and removal process. They report that evidence suggests that the filling are causing patients to experience heath consequences and suggest people with these disorders use other filling options.

Parkinson’s Disease, Multiple Sclerosis, and Alzheimer’s

Parkinson’s disease is a progressive neurological disorder in which the person’s brain cannot properly administer dopamine, causing issues with movement. This disorder affects the central nervous system- first making patients have stiffness and instability on one side of their body, then this pain and weakness increases over time. Eventually, movement is so difficult for the person such that independent daily life isn’t possible.
Multiple sclerosis is a rare neurological disorder which causes the person’s immune system to damage nerve cells, which are responsible for communication between the brain and body. In serious cases, the immune systems attacks can permanently kill these vital cells. The disease affects patients very differently depending on which part of the body is attacked. However, the diseases commonly affects the eyes and muscles in the extremities.  Symptoms include weakness, numbness, imbalance, difficulty with speech, vision issues, and lack of bladder control. Symptoms can come in episodes with periods of remission or continue to worsen progressively over time.
 Alzheimer’s disease is a progressive disease that causes brain cells to die, causing the characteristic memory loss and damaging daily functioning. Over time, this grows into issues with thinking, reason, planning, and completing normal tasks. The disease is influenced by age, with most people only developing the disease after age 65. While there is no cure, there is symptomatic treatment.

The FDA Decision: No More Dental Amalgams

The dental fillings in question, sometimes misleadingly called the ’silver filing’, are made of about 50% mercury, with the rest made of a mixture of the elements silver, tin, and copper. As the filling becomes integrated into the patient’s tooth, it naturally releases some amount of mercury over its lifetime. However, normally, that’s not such a big deal.
In a press release, FDA director Jeffrey E. Shuren, MD, explained,
“While small inhaled amounts are generally not harmful to most people, this can pose an increased health risk to susceptible individuals. How much vapor is released may depend on the age of the filling and habits such as teeth grinding.”
For people who are more sensitive to mercury, such as those with rare neurological disorders, the risk of experiencing adverse health consequences increases. This includes the build up of mercury in the body’s tissues and fluids that can damage motor skills, cause insomnia, memory loss, emotional instability and slow reflexes.
Now, people with these disorders join the list of at risk groups recommended to stay away from the fillings, which includes pregnant women, nursing women, children, those with impaired kidney functioning, and those with an allergy to mercury.
While the new warning heeds caution when getting new fillings, they do not recommend removing any existing amalgams fillings, unless necessary for another medical reason.  In a press release by the FDA, they explain that mercy vapor release is at its highest when dentists remove or place the filling. They suggest leaving the filling in its place unless it is absolutely medically necessary, as it could lead to more risks than benefits. 
Instead, they recommend people with these diseases get fillings made of alternatives like resin and glass ionomer cement fillings.
This recommendation brings the American policy closer to our European counterparts, many of whom already have stricter regulation for the dental amalgams.  Already, the European Commission has been investigating whether it could phase out amalgam fillings by 2030 altogether. Now, they’re phasing them out as new options become more feasible. 

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