Mercury in Dentistry: Facts, Risks, and Safety Guidelines
Elemental mercury is a naturally occurring heavy metal that has been used in dentistry for decades, primarily in the form of dental amalgam fillings. While it has historically been a reliable material for tooth restorations, concerns about its health effects and environmental impact have led to increased regulation and awareness, particularly in Ontario. Understanding how mercury is used in dentistry, its potential risks, and the guidelines set by Ontario health authorities can help both patients and dental professionals make informed decisions.
What is Mercury and How is it Used in Dentistry?
Mercury exists in different forms, each with distinct properties. In dentistry, metallic mercury is combined with other metals such as silver, tin, and copper to create dental amalgam, a durable material used to restore decayed teeth. This mixture has been widely used for over a century due to its strength and longevity.
However, mercury can also be found in other forms, such as inorganic mercury compounds, which may be present in certain industrial products, and organic mercury (methylmercury), which accumulates in fish and seafood. While amalgam fillings contain metallic mercury, concerns arise because they release small amounts of mercury vapor over time, particularly during placement or removal.
How Do Patients and Dentists Get Exposed to Mercury?
Exposure to mercury in a dental setting can happen in several ways:
- Through dental amalgam fillings: Since these fillings contain about 50% mercury, they release low levels of vapor, which can be inhaled. Normal activities such as chewing, teeth grinding (bruxism), and drinking hot liquids can release mercury particles and vapor.
- During amalgam removal or placement: Drilling into existing fillings can increase the release of mercury vapor.
- Occupational exposure for dental professionals: Dentists and their staff may be exposed to mercury vapor if proper handling protocols are not followed.
Although the levels of exposure from dental fillings are generally low, some individuals, such as pregnant women and those with certain health conditions, may prefer to avoid amalgam fillings altogether.
What Are the Potential Health Risks of Mercury Exposure?
Scientific studies have linked mercury exposure from dental fillings to several health conditions, including:
- Neurological disorders – Alzheimer’s disease, Parkinson’s disease, multiple sclerosis (MS)
- Autoimmune diseases – Lupus, thyroiditis, and immune system dysfunction
- Kidney disease
- Cardiovascular problems
- Chronic fatigue syndrome and fibromyalgia
- Gastrointestinal disorders – Irritable bowel syndrome (IBS)
- Mental health issues – Depression, anxiety, and suicidal ideations
- Reproductive health concerns – Infertility and hormonal disruptions
The risk varies among individuals based on genetic predispositions, overall toxin exposure, and sensitivity to mercury. Ontario’s Ministry of Health advises reducing mercury exposure where possible, particularly for vulnerable groups such as pregnant women and children.
Ontario Regulations and Guidelines for Mercury Use in Dentistry
Ontario has taken a proactive approach to managing mercury use in dentistry:
- Health Canada and Ontario’s Ministry of Health recommend limiting the use of dental amalgam in vulnerable populations.
- The Royal College of Dental Surgeons of Ontario (RCDSO) provides guidance on the safe use and disposal of mercury-containing dental materials.
- Ontario environmental regulations require dental offices to install amalgam separators to prevent mercury from entering municipal water systems.
- Ontario dentists follow strict protocols for mercury disposal, ensuring compliance with provincial waste management regulations.
These regulations help ensure that dental clinics in Ontario minimize mercury exposure and its environmental impact.
SMART (Safe Mercury Amalgam Removal Technique)
For patients looking to remove their mercury fillings, the Safe Mercury Amalgam Removal Technique (SMART), developed by the International Academy of Oral Medicine and Toxicology (IAOMT), provides a strict protocol to minimize mercury exposure during the procedure.
SMART-certified dentists follow these key safety measures:
- Use of an isolation system such as rubber dam to reduce mercury vapor inhalation.
- High-volume suction and filtration systems to capture airborne mercury particles.
- Oxygen supply for the patient to prevent inhaling mercury vapors.
- Protective barriers and clothing for both the patient and dental team.
IAOMT is an organization that advocates for biologically safe dentistry and promotes mercury-free practices. They provide research and guidance on the potential risks of dental mercury and support the transition to alternative materials.
Safe Handling and Disposal of Mercury in Ontario Dental Clinics
Dental offices across Ontario adhere to strict safety measures to reduce mercury exposure and prevent contamination. These include:
- Mandatory use of amalgam separators in dental offices to prevent mercury waste from entering the water supply.
- Following Ontario’s hazardous waste disposal laws for mercury-containing materials.
- Offering mercury-free alternatives for patients who prefer non-metal restorations.
Patients who are concerned about their existing mercury fillings should consult with their dentist before deciding on removal, as improper removal can actually increase exposure to mercury vapor. Choosing a SMART-trained dentist ensures that mercury removal is done as safely as possible.
Are Mercury-Free Alternatives Available?
For those who prefer to avoid dental amalgam, mercury-free alternatives are widely available and include:
- Composite Resin: Tooth-colored and highly durable, composite resin is one of the most popular choices for replacing amalgam fillings. It is strong, durable, mercury-free and biocompatible.
- Porcelain: Porcelain inlays, onlays or crowns are strong and long-lasting, making them ideal for patients looking for a durable and natural-looking option.
- Glass Ionomer: This material releases fluoride over time, helping to protect the tooth from further decay. While not as strong as composite resin, it is an excellent choice for small fillings or patients with special dental needs.
Final Thoughts: Should You Be Concerned About Mercury in Dentistry?
For most patients, dental amalgam fillings are considered safe, but mercury-free dental options are becoming increasingly popular in Ontario. If you have concerns about mercury exposure or are considering alternatives, speak with your dentist to find the best option for your oral health.
At Atlas Dental, we prioritize patient safety and offer mercury-free dental solutions in Toronto for those seeking alternative treatments. We also follow SMART guidelines for safe mercury removal. Contact us today to learn more about safe dental materials and how we can help you maintain a healthy smile.
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