Apr 162012

For Michael Bender to Present

Today’s report is focused on the costs and impacts of dental mercury release to the environment.  The dental economic study was conducted by consultant Concorde East/West out of Brussels who has done indepth research for the US EPA, UNEP, and the European Commission, among others.

The main report findings indicate that when  the costs to society are factored in, the report calculates that amalgam costs at least $41 more than a mercury-free alternate composite filling material.

Dental amalgam, by weight, is comprised of 50% and EPA estimates that amalgam is the largest source of mercury to municipal wastewater, contributing 50%.  While EPA has stated that it will be proposing a rule in 2010 to control dental clinics, they have yet to do so.  Amalgam is one
of the largest sources of mercury reservoir, with the study estimating over 500 tons of mercury walking around in American’s mouths today.

The report’s methodology:   The study identifies release dental mercury pathways to air, water and land and conducts a mass balance analysis of mercury flows from dental offices to the environment.   It uses ADA data on numbers of fillings, types of fillings, costs and trends in the US.  It also uses USEPA (and international) publications on waste pathways, quantities of dental mercury waste and releases following different pathways and trends.

The study then utilizes US and international published data and estimates of the cost of end-of-pipe control of mercury releases and estimates of the value of societal and environmental benefits of eliminating dental related mercury emissions.  In order to get a handle on the full cost of using amalgam, the study develops two scenarios:

  1. The first scenario calculates the additional cost required (to reduce by 90% – using end-of-pipe techniques – the amount of dental mercury now being released to the environment. Since this scenario does not consider the environmental and other benefits of such a reduction as well, it may be seen as an extremely conservative estimate of the “external” cost of dealing with dental mercury releases.
  2. The second scenario quantifies the benefits for society and the environment that would result from a phase-out of mercury use in dentistry,
    including such benefits as reduced (indirect) health costs, reduced environmental impacts, additional jobs created, etc. This may be seen as a
    somewhat less conservative estimate of the “external” costs of using amalgam, but of course the result depends heavily on the scope of health and environmental impacts included in the calculation.

It’s important to note that this study includes only broadly accepted health and environmental impacts of mercury releases.

Main FIndings:   Based on ADA data, the report estimates that some 32 tons of dental mercury were used in the US in 2009 – about twice that of recent reporting by the amalgam manufacturers to the Interstate Mercury Reduction Clearinghouse, as they are required to do so every three years by state laws.

While some of the 32 tons of releases are controlled, society pays for the uncontrolled releases of mercury from amalgam use through additional pollution control costs, the loss of common publicly-owned resources, and the health effects associated with mercury contamination. For example, according to EPA, dental mercury contaminates fish, which in turn presents a neurological exposure risk especially to pregnant women and children, with impacts on cognitive thinking, memory, attention, language, and fine motor and visual spatial skills.

The basic commercial cost of an “equivalent” mercury amalgam filling in the rear teeth in the US is $144 compared to $188 for an “equivalent” composite filling. However, even when using conservative assumptions, the report shows that when the real cost to society and the environment is accounted for, amalgam turns out to be significantly more costly than composite as a filling material, by at least $41 and up to $87 more per filling.

In summary, the environmental concerns and indirect health risks, not to mention the still debated direct health effects from amalgams, all support the need for an amalgam phase-out. Yet now another clear reason has been provided: on a full-cost basis amalgam is also significantly more costly than composite.

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