Scientific research has clearly identified occupational risks for dentists and other dental staff members related to the use of dental amalgam mercury.  Mercury is a notoriously toxic substance, and dangerous levels of mercury can be generated in the dental workplace due to the presence of mercury in dental amalgam. In particular, mercury is known to be released during the placement, replacement, polishing, and removal of dental amalgam fillings.  Another occupational risk is the mercury exposure to dental staff that can occur during the opening and maintenance of suction traps in operatories or on the main suction unit.

Research articles have demonstrated occupational risks from amalgam fillings by linking exposure to dental mercury with adverse health conditions in dentists:

• Data from a series of research articles has shown that dental workers’ exposure to mercury can have behavioral, cognitive, and psychological impacts.
• Mercury is known for being toxic to the kidney, and dentists and dental assistants exposed to mercury have been reported to have a higher risk of kidney function disturbance than other industrial workers.
• A higher rate of the use of prescription medication (for neuropsychological, neurological, respiratory, and cardiovascular conditions) in dentists has been related to their occupational mercury exposure.
• Additionally, specific genetic traits have been associated with dental workers, their mercury levels, and memory recall, anxiety, and other neurobehavioral responses.
• Furthermore, dental workers and risks of mercury allergies have also been studied.  This is significant because exposure to dental amalgam correlates with a higher prevalence of mercury allergies.  Mercury allergies have been linked to autoimmune diseases such as amyotrophic lateral sclerosis (Lou Gehrig’s Disease) multiple sclerosis, and chronic fatigue syndrome, as well as other adverse health consequences.
• Another area that has received much attention is the possibility of reproductive hazards to female dental personnel.  It is known that mercury can have a damaging influence on the developing brain and neurological system, which impacts children, pregnant women, and women of childbearing age. Thus, the dangers of exposure to mercury for pregnant dental workers have been recognized, and fertility issues and menstrual cycle disorders have been reported in female dental workers as well.

In addition to the research about mercury exposure in the dental office and occupational risks to workers there, a variety of studies have called for protective measures to be taken with dental amalgam mercury.  For example, researchers of a 2013 study led by Robin Warwick stated: “To maximize safety, dental schools should train students to remove amalgam only while using water spray and high volume suction. Alternatively, students should use appropriate occupational hygiene personal protective equipment during amalgam removals.” This is an important consideration because unfortunately, dental schools oftentimes do not train dental students to comply with these work practices and engineering controls in their operative technique laboratories.

“Various countries are moving to limit the use of amalgam as a dental restorative material in order to protect dental patients from Hg [mercury] exposure. However, dentists’ occupational exposure should also be considered as a justification for reduced amalgam use.” – Richardson GM. Inhalation of mercury-contaminated particulate matter by dentists: an overlooked occupational risk. Human and Ecological Risk Assessment. 2003; 9(6):1519-1531.

Many factors contribute to increased incidences of disease and health conditions among dentists, but mercury poisoning is a threat that can be decreased by the use of current alternatives to amalgam filling materials.  Additionally, safety measures should be taken to mitigate mercury exposures to dentists, dental professionals, dental students, and other staff members, as well as patients, during removal of amalgam fillings.

Based on up-to-date science, the IAOMT has developed rigorous recommendations for amalgam removal known as the Safe Mercury Amalgam Removal Technique (SMART).  The recommendations build upon traditional safe amalgam removal techniques such as the use of masks, water irrigation, and high volume suction by supplementing these conventional strategies with a number of additional protective measures.  Specific aspects of SMART address occupational risks for dentists and other dental staff members related to the use of dental amalgam mercury.