More data needed on silver tooth fillings: panel
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A U.S. advisory panel on Thursday said a government report that found no evidence of health problems from silver, mercury-based dental fillings was incomplete and urged more study.
The panel of outside experts did not vote specifically if the silver fillings in the mouths of millions of Americans, also called amalgams, were safe. But the panel chairman said members agreed most people would not suffer ill effects.
“The key message is for the vast majority of the general population there is good evidence that amalgams are safe,” panel chairman Dr. Karl Kieburtz said in an interview.
He said a Food and Drug Administration draft report that the panel reviewed “needed more information about the areas of uncertainty,” such as the impact of silver fillings on the developing fetuses of pregnant women.
He also said it was unclear if a small percentage of people may be especially sensitive to mercury.
The FDA report analyzed research since 1997, when the U.S. Public Health Service said data did not support claims that silver fillings caused serious health problems. A review of 34 studies found nothing to contradict that, the FDA said.
Panelists voted 13-7 that the FDA’s conclusions were not “reasonable,” saying the authors did not review all available information or note areas where knowledge was lacking.
“There are too many things we don’t know and too many things we have excluded,” said panel member Michael Aschner, professor of pediatrics and pharmacology at Vanderbilt University.
In a separate 13-7 vote, the panel said the agency did not objectively and clearly present the current state of knowledge about patient exposure to mercury from silver fillings and the health effects.
Silver fillings used to patch cavities are about half mercury and half a combination of other metals. Makers of include Dentsply International Inc and Danaher Corp. unit Kerr.
Some patients, consumer groups and lawmakers believe mercury in the fillings is linked to a range of problems such as multiple sclerosis and Alzheimer’s disease.
Certain levels and forms of mercury are known to cause brain and kidney damage, but health officials say the mercury vapors emitted from fillings are too small to be dangerous.
Panel member Dr. Ralph Sacco said patients should not interpret the concerns about the FDA report as a reason to have their silver fillings removed.
“I’d hate to see an overreaction and a panic,” said Sacco, a neurologist and epidemiologist at Columbia University.
Patients who have been campaigning against silver fillings declared victory, saying they thought the panel vote would raise awareness about their concerns and lead to the end of mercury use in dentistry.
“I think this is a turning point,” said Freya Koss, founder of the Pennsylvania Coalition for Mercury-Free Dentistry.
Koss told the panel she had a sudden onset of double vision seven days after she had a silver filling removed and replaced with a new one. Other serious neurological problems developed but eased after she had her silver fillings removed, she said.
Use of silver fillings has been on the decline as newer materials become available that are closer to tooth color.
The American Dental Association said only 30 percent of fillings placed in 2003 were the silver version.
The dentists’ group said it welcomed the call for additional study but believed the fillings were safe and more durable than alternatives.
In some cases, such as filling cavities below the gum line, they are the only effective option, some dentists told the panel.
Dentsply executive William Jellison said the company agreed with the FDA view that no evidence has been found to show the silver fillings are dangerous.
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