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Lynchburg dentist supports use of amalgam fillings

Wednesday, December 13, 2006 10:54 AM EST

Editor's note: On Nov. 21 the Bulletin began looking at the issue of the use of mercury in amalgam fillings, focusing on the testimony of a county woman's testimony before an FDA advisory panel on her experience with the fillings. This week's stories take a look at one area dentist's response, along with legislation dealing with the issue before Congress. A future story will look closer at the American Dental Association's stance on the claims by some that amalgam fillings are not safe.

Michael Davis says he's seen this all before. In fact, he states, he once thought there might be something to claims that amalgam fillings aren't safe.

But now he's convinced: "There's nothing wrong with them," he says emphatically.

Davis has been practicing dentistry for more than 30 years. "There are scientifically backed facts that proclaim it to be OK," said Davis of Lynchburg during a recent interview in response to claims made in a story featuring Marie Flowers. Flowers testified before an advisory panel of the FDA in September that amalgam fillings' use of mercury had created severe health problems for her. But Davis discounts such testimony.

"The whole issue has been laid to rest I don't know how many times," he said

The problem, according to Davis, is that every time it pops up patients get scared. "(Someone) stirs it up and puts doubt in all the minds of all the people who go to the dentist."

He said he has patients ask questions about amalgam fillings most every day.

"If this was a bad thing the dental schools wouldn't teach it as a procedure," he said.

Davis points to the stand of the American Dental Association on the issue: "While other dental filling materials are also available, dental amalgam remains a valued option due to its strength, durability, affordability and the fact that it can be used below the gum line, which is difficult to keep dry. Dental amalgam can be placed in a wet environment and hardens quickly, which can be critical when working with patients such as children or people with disabilities, who might have difficulty sitting still during treatment."

The ADA concludes: "The overwhelming weight of scientific evidence supports the safety and efficacy of dental amalgam, and it should continue to be made available to dentists and their patients."

That statement was made in response to the hearings held before a U.S. Food and Drug Administration advisory panel in September. That panel considered several questions on a paper presented on the safety of amalgam fillings. Among the panel's conclusions were that the paper had not fully explored the issue of amalgam filling safety, voting "no" that the paper's conclusions were "reasonable" because the evidence, according to the panel, was contradictory with conclusions based on a limited search.

Davis said the panel didn't reject the safety of amalgam fillings, but just asked for more study, something the ADA said it welcomes.

"The more well-designed studies that are considered, the better the pool of evidence for making treatment recommendations to patients," stated ADA Executive Director James B. Bramson. "First and foremost, we want scientific evidence to lead the way when it comes to health care treatment."

Davis has no problems stating that amalgam fillings are safe. He said they've been used for 150 years and have proven safe. He said much of the questioning of the fillings was raised on a news show years ago and now, at times, makes headlines.

"Everybody seems to try to keep this alive. We just can't let this go," Davis said. "

The alternative to amalgam fillings, Davis said, are substances that don't last as long and cost twice as much. He said it borders on unethical treatment to replace amalgam fillings with an inferior material, if the consequences are not fully explained to the patient.

He provides amalgam fillings as well as alternatives, stating that the patient should be able to have the choice, but that the patient should base that choice on full and accurate information.

"I don't think people want this," he said. "(They don't say) I want the more expensive thing that isn't going to last as long. Who wants to sit in the dentist's office any more than they have to.

"Do you really want something that's not going to last as long and is going to cost more."

He said if there are true health problems related to amalgam fillings, it comes from a very few patients with an allergic reaction to it. That was echoed in a statement by Milton V. Marshall, PhD, DABT, to the FDA panel, as he explained what other panels had concluded on amalgam safety: "The conclusion from these panels was that no adverse health effects were associated with amalgam use other than occasional allergic reactions."

Another doctor who testified at the hearings concurred. "The current scientific evidence does not support an association between dental amalgam and any adverse health effect, except for the very small number of documented cases involving individuals who were allergic to one of its components," stated Dr. Amid Ismail during the hearings.

Davis said early on he recognized the claims of amalgam fillings being unsafe as "bogus."

He said patients read a story on amalgam and get scared.

"I'm just trying to be a dentist, and they've read this somewhere and they think they know more than I do," he said.

And if changes are made to the laws concerning amalgam use, Davis states: "I can tell you, the (patients) are the ones that are going to suffer because of this."

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