Sunday, October 26, 2014
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Are ALL dental fillings dangerous?

If you've said yes to higher-priced "white" fillings when it's time to fix cavities in your kids' teeth - because they look better or get around lingering worries about mercury in silver-colored fillings - here's news.

Are ALL dental fillings dangerous?

(AP Photo)
(AP Photo)

by Sari Harrar

If you’ve said yes to higher-priced “white” fillings when it’s time to fix cavities in your kids’ teeth— because they look better or get around lingering worries about mercury in silver-colored fillings — here’s news: A new study says there may be a link between the plastics chemical BPA used in some composite fillings and behavior and emotional problems in kids.

The story’s grabbing headlines. But the link is tenuous. Researchers analyzed data for 534 kids, age six to 10, who had cavities and were randomly chosen to get amalgam fillings or one of two different types of composite fillings.  BisGMA -- a plastic made with bisphenol A (BPA) — was used in one of the composites. Urethane was used in the other.

After five years, parents and kids answered a series of questions about anxiety and depression, attitude at school and general behavior. Kids with several BisGMA fillings scored 2 to 6 points higher on a 100-point behavior check than those who didn’t have them or who’d had them for a short period of time.

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Used in hard plastics and in the linings of metal and aluminum cans, BPA’s been voluntarily phased out of many plastics products including baby bottles and water bottles in the wake of concerns about its effects on kids’ brains, behavior and the prostate glands of boys, according to a report released by the  National Toxicology Program.  An endocrine disruptor, BPA is also being investigated for potential role in the development of heart disease in adults.  

It’s important to know that the study didn’t prove a connection. Researchers didn’t measure how much BPA kids were exposed to or whether it was absorbed into their bodies. The behavior differences were small — though consistent. And the study looked at composites used between 1997 and 2005, which may be different from current types. Still, the potential link is troubling.  About 16 percent of kids with the most bisGMA fillings had behavior problems, compared to 6 percent who had few or none. And there were no behavior differences in kids with high versus low numbers of amalgam or urethane composite fillings.

The study led pediatric dentist Burton Edelstein, a professor of dentistry at Columbia University, in New York City, to suggest parents re-consider silver-colored amalgam fillings. “This study raises enough concern about the alternative of amalgam to revisit the value of amalgam," Edelstein told HealthDayNews. There is no reason at this point to be concerned about the health effects of amalgam, or the stainless steel crowns that are sometimes placed on top of a tooth with a cavity, he added.

Are they safe? So far, the answer is yes — despite plenty of concern in recent years. According to the American Academy of Pediatrics ,  “Although dental amalgams are a source of mercury exposure and are associated with slightly higher urinary mercury excretion, there is no scientific evidence of any measurable clinical toxic effects other than rare hypersensitivity reactions. An expert panel for the National Institutes of Health has concluded that existing evidence indicates dental amalgams do not pose a health risk and should not be replaced merely to decrease mercury exposure.”

Which type of dental filling do you choose for your kids? Why?

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Mario Cruz, M.D. St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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