Last month, a study published in the European Journal of Paediatric Dentistry found that composite and glass ionomer fillings failed more often than amalgam in children between the ages of 6 and 12. While most of the 300 cases the authors reviewed were successful, a little more than 20% required either the filling re-done or the tooth extracted.
By far, ionomer fillings fared worst, accounting for about half of all failures. Approximately 30% involved composites. The rest were mercury amalgams.
But this hardly means, “Yay, amalgam!” As Dr. Bicuspid reports,
The authors pointed to a comparative health risk evaluation of amalgam- and resin-based restorative materials that was presented at the 2013 Minamata Convention on Mercury. The report supports the World Health Organization’s position in advocating a phase down of dental amalgam, but it also highlights the need for improvements in the quality of alternative materials.
They added that countries with low levels of dental disease have very limited use of amalgam, and since all currently available materials have their drawbacks, effective prevention is the optimal way forward.
Effort would be better spent, they added, in “comparing performance and safety of the newer materials in primary teeth.”
Indeed. And in this sense, amalgam fails.
After all, it’s mercury we’re talking about – and kids, whose brains are still developing and who are much more susceptible to the effects of mercury. There is no argument that mercury is neurotoxic. There should be no argument that it has no place in dentistry, especially in the mouths of one of our most vulnerable populations; especially not when there are ever more alternatives available – including strong, durable resins that are fluoride-free, BPA-free and broadly biocompatible.
But as the authors note, the best solution of all is effective prevention, side-stepping the need for restorative materials all together. Simply, you don’t need to restore teeth that don’t become decayed.