Ethics and dental amalgam removal
Article Abstract:
In late 1990, a ''Sixty Minutes'' episode presented a report on illness purportedly resulting from mercury fillings. The airing of the program led to a flood of questions from concerned dental patients. A review is presented of the ethical issues surrounding the removal of dental amalgam (fillings containing mercury) in response to fears on the part of the public that amalgam restorations are hazardous to health. The most important issue is that of initiation of the removal: should it be suggested by the dentist or by the patient? No scientific evidence exists to support dentists' suggesting to patients that these fillings need removal, regardless of the individual practitioner's beliefs. The American Dental Association has formulated clear guidelines on this matter. When a dentist suggests amalgam removal for a patient who is not allergic to the material, he or she violates the principle of beneficence, which includes the concept of ''doing good'' for the patient. Beneficent treatments are not idiosyncratic, but result from common beliefs among dental professionals. When patients request amalgam removal, dentists should consider nonmaleficence and autonomy. Nonmaleficence requires the practitioner to ''first do no harm''; if patients request removal because of incorrect information about amalgam's health consequences, they should be educated. The steps taken in such an educational approach are presented. Recognizing the patient's autonomy means the dentist realizes the patient has the right to self-determination, as well as the right to informed consent. The factors important for informed consent are enumerated. Dentists, too, have autonomy, and may refuse to remove amalgam even if patients, after education, desire it. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Safety of dental amalgam - an update
Article Abstract:
According to a 1983 report from the Council on Dental Materials, Instruments, and Equipment, and the Council on Dental Therapeutics, dental amalgam (filling material composed of mercury mixed with other metals) is safe. The few individuals allergic to mercury are the only people who should consider having their amalgam restorations removed. Although mercury from amalgams is released in the mouth, this amount is much smaller than the amount received in the diet, and far below levels reported to induce symptoms. Dental workers rarely report mercury contact (skin) allergies. To confirm mercury allergy, the patch test is used; but allergy to one mercury compound in a patch test does not mean that other forms of mercury will cause the same reaction. Galvanic currents have been shown to be similar in people with and without the symptoms of galvanic corrosion in the mouth. The recording of electric currents in the mouth have shown no correlation with alleged symptoms of galvanic corrosion. A list of review articles on the topic of mercury and amalgam is provided. At present, there is not enough evidence to support claims that mercury has any adverse effect on dental patients' health. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 1989
User Contributions:
Comment about this article or add new information about this topic:
The amalgam controversy: an evidence-based analysis
Article Abstract:
Mercury dental fillings appear to be safe, according to a dentist who evaluated all the evidence, both pro and con. Dentists are constantly exposed to mercury vapor and have urinary mercury levels two to five times higher than the general public. Yet they are no more likely to have mercury toxicity than the general public.
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 2001
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Can dental products be evaluated faster? Why expand the role of dental staff members? Now is the time to observe and treat dental occlusion
- Abstracts: Electrical safety: steer clear of the most common OSHA violations. Electrical safety 101
- Abstracts: The impact of universal access to dental care on disparities in caries experience in children. Regular dental visits and dental anxiety in an adult dentate population
- Abstracts: Efficacy of dental radiographic practices: options for image receptors, examination selection, and patient selection