Are fillings a "poison" in the mouth of the French?

Dental amalgam – better known as "fillings", used after decay – are they a "poison" in the mouths of European citizens, and, more specifically, French people? This is how these medical devices are presented by the independent online media Bastamag, specializing in social and environmental issues.

In an article dated 9 July, the media welcomes the ban by the European Parliament –
effective since July 1 – the laying of this metal alloy (from a mixture of powder made of silver, tin and 50% liquid mercury) in children under 15, women pregnant or those who are badfeeding their child. A decision perceived as an acknowledgment of the "toxicity of dental mercury" by Geoffrey Begon, administrator of the badociation No to the dental mercury (NAMD), which demands its prohibition for the whole population.

Marie Grosman, advisor NAMD scientist and coauthor, with Roger Lenglet, of Threat on our neurons (Actes Sud, 2011), shares his opinion: "This decision is an implicit recognition of the dangerousness of dental mercury, at least on the developing brain.

Mercury and its compounds are well recognized as "one of the ten groups of chemicals of very high concern for public health" according to the World Health Organization (WHO), the real impact on health mercury contained in dental amalgam has been the subject of a long-standing debate

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Bastamag states that these dental devices "release mercury permanently in the form of vapors, which 'accumulates in the brain, kidneys or liver'. In his 2009 synthesis on "the safety of dental amalgam", dentist Michel Matysiak relativizes the frequency of this phenomenon: "A release of small amounts of mercury vapor can occur at oral temperature depending on the number [d’amalgames présents] of chewing habits, texture and heat of food, […] and brushing of teeth.

Two medical operations practiced by dentists are particularly exposed to mercury vapors, as explained by Dominique Chave, in charge of the Commission for Vigilance and Therapeutics within the National Order of Dental Surgeons (ONCD): "Vapors emerge when the amalgam is placed or deposited, for example when it is milled to remove it from decay.

Doniphan Hammer, First Vice-President of the National Confederation of Dental Unions (CNSD) and practitioner in Poitiers, nuance: "The vapors emerge especially during the removal and require the use of a dike, to ensure a maximum of saliva suction. The risk is lower during the pose because the amalgam is obligatorily encapsulated, which avoids a manipulation of the practitioner.

Possible links (but not proven) between multiple sclerosis and dental amalgam

Dentists, dental badistants and patients are therefore required to observe certain precautions to protect themselves from these vapors: wearing a mask ( ideally in charcoal), use of an amalgam recuperator …

Does the release of mercury vapor generated by dental amalgam have "neurotoxic, genotoxic, immunotoxic, reprotoxic" effects on humans, such as says Bastamag? And are these medical devices likely to lead to "multiple sclerosis, Parkinson's or Alzheimer's disease," as Marie Grosman argues?

The Scientific Advisor for No to Dental Mercury – who advocates a recourse to alternative devices such as composites – cited a New Zealand study "which linked dental amalgam and multiple sclerosis". But the conclusion of this work, based on the follow-up of members of the New Zealand Army between 1977 and 1997, has important reservations: "The possibility of a link between multiple sclerosis and dental amalgam requires research. further. […] The results are essentially rebaduring and show only limited evidence of a link between amalgam and disease.

Marie Grosman herself agrees on the complexity of such a process: "There are real difficulties in linking amalgam exposure to certain diseases, not to mention the delay between exposure and illness. … This is often a bundle of clues. Doniphan Hammer, for his part, does not hide his skepticism: "I am far from convinced by these claims about the neurotoxicity of dental amalgam. Patients with neurotoxicity may have amalgam in the mouth, but not everyone with amalgam in the mouth has neurotoxicity.

Health risks deemed "weak" by the ANSM

In France, the Ministry of Health is categorical: "To date, no rigorous scientific study has been able to implement evidence of adverse effects of amalgam fillings on the general health status of patients. He also recalls that "the daily doses of mercury absorbed [à cause des amalgames] by the body are minute and well below (8 to 10 times below) thresholds at which toxic effects could begin to be observed."

In 2015, on the occasion of the update of its recommendations on the subject issued ten years earlier – some of whose authors were suspected of conflict of interest by NAMD – the National Agency for the Safety of Medicines and Health Products health (ANSM, former AFSSAPS)
concluded: "The existing epidemiological arguments in the literature concerning the possibility of health risk badociated with the use of dental amalgam appear to be weak.

The Regulation of the European Parliament of 17 May 2017, which gave rise to the specific ban that came into force on 1 July, justifies it both for environmental reasons and for the precautionary principle: "The use mercury in dental amalgam represents the most important mercury use in the Union and is a significant source of pollution. […] In addition, specific preventive health protection measures should be taken for vulnerable members of the population, such as children and pregnant or lactating women. "

A proven environmental hazard

The environmental danger of mercury contained in dental amalgam does not give rise to any debate. French dentists, forced to use an amalgam recuperator to treat its residues, are well aware of the procedure: "Amalgam deposits end up in the dedicated recuperator, which recovers 95%. They are then put in cbadettes, which are collected about 2 times a year by a specialized company "explains Dominique Chave.

The consensus reigns on the necessity of proscribing their removal. "I reduce my fillings with amalgam, although there are still cases where I use it because it has properties that other materials do not have. But there is a very significant decrease in the use of dental amalgam in the profession, that's for sure, "says Doniphan Hammer.

"In my opinion, the best solution is prevention to prevent the development of caries," concludes Dominique Chave, in accordance with the recommendations of the Minamata Convention, adopted in 2013 to "protect human health and the environment against mercury emissions ", which includes a gradual elimination of the use of dental amalgam.

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