As reported by The Hartford Courant, May 26, 2005.

Mercury's Silver Lining Fades

State Considers Ban On `Silver' Amalgam Tooth Fillings

By Garret Condon

Connecticut's 2002 anti-mercury law definitely has teeth. But do those teeth have silver fillings?

Commissioner Gina McCarthy of the state Department of Environmental Protection will decide in the next few months whether dental amalgam - the "silver" tooth-filling material that is a mixture of liquid mercury and alloy powder - should be banned along with most other mercury products that are being phased out as part of the state's 2002 Mercury Education and Reduction Act. No other state has banned the material.

Advocates on both sides of the debate about the impact of amalgam fillings on both the environment and the health of individual dental patients are expected at a hearing on the issue tonight in Hartford.

"I believe that this law bans all mercury-added products, and mercury amalgam is not specifically exempt, therefore it is banned," said Kathleen Bailey, a West Hartford lawyer and teacher who is chairwoman of the Coalition to Enforce Connecticut's Zero Mercury Law. Her group prompted the DEP to rule on mercury-containing dental material.

But Dr. Robert Kelly, professor of oral rehabilitation and biomaterials at the University of Connecticut Health Center, said that legislators did not intend to ban the use of dental amalgam. He said that there are exemptions in the law for mercury contained in a "pharmaceutical product," and that the law requires "best management practices" for dental offices. As a result, Connecticut dentists must now use separators - devices that collect most of the mercury that washes down dental-office drains.

No one disputes that mercury at certain doses can cause neurological damage to fetuses and children and affect the brain, heart, kidneys, lungs, and immune systems of people of all ages. Americans are most commonly exposed to mercury - a form called methylmercury - by eating fish. Airborne mercury, much of it from coal-powered power plants, settles in water. There, it becomes concentrated in certain kinds of fish.

Nationally, dental practices are the biggest mercury polluters of wastewater, according to the New England Zero Mercury Campaign, which issued an April report on anti-mercury progress made by New England states.

Separators now in use in Connecticut and some other states are capable of removing up to 95 percent of amalgam, according to Kelly. But Bailey said that the mercury in teeth doesn't go away. "It ends up being excreted by the patient's body and ends up in the wastewater stream," she said. "Not to mention cremation, where it goes into the environment through burning it up."

The use of dental amalgam in the United States has been declining steadily since the 1970s due both to a decline in cavities among schoolchildren and young adults and improvements in alternative materials, especially resin-based composite, a tooth-colored durable plastic. Kelly said that amalgam accounted for 68 percent of fillings in the U.S. in 1990 and now accounts for about 30 percent, and its use is dropping.

However, Kelly said that amalgam is half the price and more long-lasting than composite and is better suited than composite for some uses. Ceramic fillings, a third option, are as durable as amalgam, said Kelly, but considerably more expensive than composite.

A ban on amalgam would have a major public health impact, said Kelly. "It's the most inexpensive and effective filling material that we have," he said.

The DEP is not considering the health impact of fillings on individual patients, although DEP Ombudsman Bob Kaliszewski said that some speakers at tonight's hearing undoubtedly will raise that issue.

Kelly said that years of research have failed to find a solid, well-supported tie between the use of dental amalgam and the various illnesses that have been associated with it.

"The lack of any link with health problems isn't because people haven't gone looking for it," he said. Major national organizations that represent various diseases, patients and researchers - from the Autism Society of America to the National Multiple Sclerosis Society - acknowledge no proven association between mercury fillings and illness.

The most recent major review of scientific literature on the topic, completed in December by the independent Life Sciences Research Office for a federal, inter-agency working group, showed that although mercury vapor is released by fillings and absorbed by the body, it apparently is not a high enough dose to make most people sick. But the authors added that more research should be done - especially studies looking at the effects of low-level mercury exposure.