Issue link: http://www.wacmagazine.com/i/117128
Wellness By Paul Rubin, DDS Tamela Thomas, Wellness Manager tamelat@wac.net 206.464.4639 Catching up with my old cavities I can���t be sure why I had so many cavities as a kid, but I did. By the time I was 9, I knew every person who worked in my dentist���s office on a firstname basis. Fast-forward a few years (OK ��� a few decades), and today I���m faced with replacing many of these old ���silver��� fillings. After learning the potential risks of amalgam fillings, I started thinking about how to best protect myself from the mercury these fillings contain. Dr. Paul Rubin, a member of the International Association of Mercury Safe Dentists, has published research on this topic and lectures widely to professional and lay groups on the environmental effects of dental amalgam mercury. Dr. Rubin has some great advice in the following article for anyone, like me, still dealing with amalgam fillings. 20 | Washington Athletic Club Magazine | APRIL 2013 Exploring the options for dental fillings Potential risks exist but can be mitigated P erhaps you have seen mercury in the news or heard about some of its dangers. While many articles focus on mercury in the environment���especially in waterways and in fish���another source of potential mercury exposure hits even closer to home: dental fillings. In fact, mercury is a major component of ���silver��� dental fillings, also known as amalgam fillings. Dentists have been discussing mercury in fillings for many years, and some very good dentists hold very differing opinions on the subject. For the record, the American Dental Association (ADA) still supports amalgam fillings as an appropriate dental treatment. Regardless of one���s philosophy or professional opinion on the use of amalgam fillings, there remains an often-overlooked hazard of mercury exposure in the dental office. This risk happens when old mercury fillings are removed, possibly exposing patients, dentists, and dental staff to mercury vapor levels exceeding the exposure limits set by the Occupational Safety & Health Administration (OSHA). Although many dentists aren���t trained about this risk of exposure, all dentists are indeed trained about mercury hygiene and the ADA���s best management practices. That training, however, deals mainly with precautions dentists must take in handling amalgam filling material before it goes into the mouth as well as dealing with scrap amalgam. Often, the missing piece of training is the actual procedure for removing an old amalgam filling���and the potential mercury exposure that may result. By weight, mercury makes up approximately half of amalgam fillings. Because the compound is unstable, low levels of mercury vapor are continually released at the surface. The release can increase dramatically with heat or friction, such as when you drink hot coffee, chew gum, or brush your teeth. Imagine what can occur when a dentist���s drill, spinning at upward of 300,000 rotations per minute, cuts into an old filling. Without adequate protective protocols, the amount of mercury vapor released can be enormous. Review options Without protective protocols, patients, dentists, and dental assistants may be exposed to hazardous levels of mercury vapor. A highly toxic substance, mercury is more poisonous than lead, cadmium or arsenic. Mercury release can increase with heat and friction. That means drinking coffee, chewing food, brushing your teeth, and having your teeth polished all may lead to increased release. Governmental agencies, including OSHA, have set safe exposure limits and have established a ceiling limit���100 micrograms per cubic meter of air (100 mcg/m3)���beyond which a worker should never be exposed. Incredibly, vapor levels have been measured above 1,000 micrograms per cubic meter of air during some amalgam removals.