Status of scrap (recyclable) dental amalgams as environmental health hazards or toxic substances

Article Abstract:

Disposal of scrap dental amalgam (mercury mixed with other substances) is the focus of an Environmental Protection Agency (EPA) investigation begun in 1987. This issue is presented, along with the results of interviews, a summary of EPA and OSHA (Occupational Safety and Health Administration) material, and a review of the scientific literature from 1977 to 1987. 'Health hazard' was defined using OSHA criteria, and is defined as acute or chronic health effects in employees, as documented by at least one study. Scrap dental amalgam was defined as set amalgam stored by dentists in a closed, sedentary container, usually covered with liquid. It may be excess amounts prepared for fillings, or old material removed from patients' extracted or deteriorated teeth. The results of interviews with toxicologists and operating personnel indicated that they were unaware of the refining and salvaging of amalgam, or about the EPA investigation. Amalgam has no set definition, since the materials with which mercury is blended change according to dental practice. The EPA lists some substances commonly blended with mercury in amalgam as hazardous, such as copper or silver, but the compounds amalgams form as they harden are not listed as hazardous. OSHA Material safety data sheets do not exist for amalgam. The American Dental Association Council on Dental Materials, Instruments, and Equipment, and the Council on Dental Therapeutics, consider amalgam safe for patients. They have provided guidelines to avoid direct handling of mercury and to ensure adequate ventilation of offices. A thorough review of the relevant literature is provided, including articles discussing the toxicity of amalgam emissions, dissolved material, ingestion of amalgams, ingestion of methylmercury (amalgams contain elemental mercury), direct contact, skin absorption, and allergic skin reactions. Amalgam may be saved because of its silver content, which is about 25 percent by weight. More than 40 percent of the silver refined in the United States for one month in 1988 came from the recycling of 'old scrap', and dentists are constantly approached by recyclers. Dental equipment is manufactured for the economic recovery of scrap. Overall, there is no evidence that scrap dental amalgam is harmful or toxic, according to the standard criteria. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Laws, regulations and rules, Environmental aspects, Dental amalgams, Dentistry, United States. Environmental Protection Agency, Waste management, Recycling (Waste, etc.), Recycling, Medical wastes

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Dentistry and hypertension

Article Abstract:

Blood pressure (BP) measurements taken at the beginning of dental procedures are often elevated, and may inappropriately indicate hypertension. Hypertension, or high blood pressure, damages blood vessels and can seriously injure the heart, brain, kidneys and other organs. Eighty-nine dental patients had their BP measured each minute during dental treatment and oral surgery. The first five measurements were consistently higher than the final five. Dentists should retest BP at the end of procedures before referring patients to a physician for assessment of high readings.

Hypertension, Diagnosis, Measurement, Medical examination, Patients, Blood pressure, Blood pressure measurement

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