ALERT:
 MERCURY RELEASES TO THE ENVIRONMENT
CAUSED BY DENTAL AMALGAM FILLINGS

A Report by David Warwick, DDS, IAOMT

Executive Summary

Dentistry uses an estimated 350 tons of mercury per year for dental amalgams.

Dental amalgam consists of 50% mercury.

The mercury in dental amalgam continually vaporizes out of the material at a rate that is dependent on temperature, pH, surface area, and physical stimulation.

Mercury that comes off silver amalgam fillings is known to be the single largest source of human exposure, exceeding all other sources combined, including fish and seafood.

Countries banning or limiting practices involving dental mercury have made specific recommendations on the use of amalgam because of concerns for environmental impact.

There are no effective universal environmental systems in place to account for the dispersion of all dental mercury into the environment. 

The use of amalgam creates a significant occupational risk of mercury exposure from both vapor and amalgam particulate.

The use of amalgam creates a significant source of mercury to all facets of the environment, including humans.

For every 1 kg of mercury used for dentistry
	•	Up to 10% may be diverted for artisanal gold mining
	•	Up to 1% may be lost in manufacturing and transportation spills
	•	Up to 54% is waste not placed in the tooth
Of this, most is large particulate that is required to be retrieved and placed in sealed storage short term and sent for recycling long term.  There are currently no tracking systems to determine how much of this mercury is actually entering recycling programs.

There is also waste from contaminated capsules.  If all mercury for dentistry were delivered via capsules, this would result in 700,000,000 capsules annually.  There are currently no tracking systems to determine the fate of this mercury tainted waste.

This amount also includes unrecoverable mercury that is embedded in dental sundries such as bibs, gloves etc.  Presently, most of this waste makes it way into the landfills or into incineration facilities where the mercury enters the atmosphere:
	•	Up to 43% is placed in the teeth of humans
Through exhalation, excretion via urine or the feces, replacement and removal, cremation, burial, breast feeding, and fetal development, a very large percentage of this mercury makes its way into the environment.
	
The evaluation of how mercury from amalgam may impact the environment in the future requires a brief analysis of the populations of the world.

There are 3 distinct groups on the globe:
1) Developed Populations
The developed countries make up 20% of the world population and have up until now been the population that has required the most dental restorations.  Therefore, these populations have required using the most mercury in dental amalgam.  The developed countries of today hit their peak of decay several decades ago.  Because of this, and their choices away from amalgam, their demand for mercury is decreasing.  

The developed countries are still deficient in many aspects of protocols and programs to reduce environmental exposure of mercury from the use of amalgam.  This deficiency includes the failure to track the ultimate fate of this material.

An awareness that mercury based fillings have an significant impact on the environment has only occurred in the past 15-20 years.  Since the approximate lifespan of amalgam is 15 years, it can be hypothesized that most of the mercury from the first 150 years of service is functionally in the environment.  An educated estimate of this quantity would be several thousand tons.

2) Developing Populations
The developing countries make up 60% of the world population.  As this group moves from undeveloped to developing, the exposure to sugar increases, and consequently, the decay rates and the need for dental restoration is increased.  This phenomenon is occurring globally right now.

The presence of protective measures restricting mercury releases to the environment from amalgam use in these populations is essentially non-existent.  If the use of amalgam continues in these populations, the developed countries should commit to technical and financial aid, as they themselves improve their own initiatives of environmentally-conscientious techniques and tracking of mercury in amalgam.  

It should be noted that if each person in the developing populations was to have one amalgam filling next year, the global demand for mercury could grow over 500% to an estimated 2251 tons.

3) Undeveloped Populations
Because this group has virtually no access to sugar, their decay rates are extremely low.  There is therefore very little need for tooth restoration, and furthermore, there are materials available now that are affordable and less hazardous to the environment.

There are also techniques such as ART, endorsed by Dr. Peter Cooney, Canada’s chief dental officer, which can be implemented to restore decayed teeth in developing areas that do not require any special equipment or intensive training and have predictable longevity for patients and no ill-effects on the environment.

Currently there are affordable, long lasting, cost effective and environmentally friendly alternatives to amalgam. 
 
Although amalgam separators are an essential strategy to reduce mercury from entering the environment from dental amalgam use, they only collect a fraction of the potential mercury that can enter the environment.

International organizations such as the International Academy of Oral Medicine and Toxicology (IAOMT) are capable of helping to make a transition to delivering safe, effective, and environmentally-friendly dental treatment without using amalgam.

"Mercury is among the most dangerous environmental toxins.  Satisfactory alternatives to mercury in products are available, and it is therefore fitting to introduce a ban."

--Erik Solheim, Norway’s Minister of Environment and Development, 2007

“For medical reasons, amalgam should be eliminated in dental care as soon as possible. As a result, one of our largest sources of mercury in the environment can be eliminated.”

--Dr. Maths Berlin, the Dental Material Commission of Sweden, 2003