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Is it possible for North America to follow the lead of several European countries and phase out mercury fillings? Sweden or Switzerland would be good countries to emulate. They phased mercury amalgams out of government-assisted dental plans over a four or five year period.

The big differences are that North America is so prone to law suits, and that the American Dental Association was founded on the acceptance of mercury fillings.

If this material were banned, or a program instituted to phase it out of dentistry, it would be an admission that components of mercury amalgams are in fact a health risk.

Could this be done without incurring legal action? Could an act of government protect the companies and agencies, who have advocated mercury fillings from being sued? This is a legal question which I cannot answer. However, in light of the cigarette companies in the United States reaching a recent settlement of $246 billion US with the individual states, it's a question that needs to be addressed.

If we have something in our bodies which is detrimental to our health, its removal is paid for by our medical insurance. We have to know if medical insurance would cover the cost of removing mercury amalgam fillings. This may cause dental insurance premiums to rise.

Also, there are tens of thousands of dentists and staff who have been exposed to this material over the years. The declaration of the toxicity of mercury amalgam may open a huge can of worms for worker's compensation. [Editor's note: It will be interesting to follow the legal consequences of the smoke-free workplace legislation in British Columbia.]

As mercury amalgams are phased out, replacement procedures have to be phased in. Currently, half of the dental schools in North America are teaching composite restorations in molar teeth. At the moment these composites (a mixture of glass and resin) are the most common alternative to mercury amalgams.

The cost of materials in doing a composite filling is about five times as much as doing a mercury amalgam filling. A composite procedure also takes about 50 per cent longer than a mercury amalgam. The cost for composite dentistry is almost twice that for mercury amalgam. In British Columbia, patient cost for composite fillings is about 50 per cent higher than mercury amalgam. This pays for the extra time a dentist spends doing the procedure, but doesn't cover the added cost of the materials. Most dentists absorb the extra cost.

While Canadians wait for systemic change, it's up to the consumer to make a difference.

In 1991, seven percent of North American patients expressed unsolicited concerns regarding mercury in their mouths to their regular dentist. Two and a half percent chose removal. In 1996 these figures doubled to 13 percent and six percent, respectively. If this pattern holds true, in 2001 roughly 25 percent of dental patients will voice concerns and 12 percent will remove mercury from their mouths.

I hold great optimism for the future because of the way the dental schools are introducing alternatives to mercury amalgams. The next generation of dentists will be far more proficient in the handling of newer materials than present dentists who are stuck in the mercury amalgam rut.

Now it falls on you, the consumer, to support those dentists who are presently mercury free. These dentists are being ostracized by their colleagues and scrutinized by their licensing bodies. They need your encouragement, support and recommendations.

Source: alive #209, March 2000