Following updated recommendations from the U.S. Food and Drug Administration (FDA), Boston University Henry M. Goldman School of Dental Medicine (GSDM) eliminated the use of dental amalgam in patient care, effective October 14, 2020.
“By eliminating dental amalgam from our Patient Treatment Centers, we are prioritizing the health and safety of our patients and fully embracing the future of dental restorations – while simultaneously doing our part to protect the environment,” said Dean Jeffrey W. Hutter. “GSDM has a well-deserved reputation for innovation, and I believe this decision is yet another example of the Henry M. Goldman School of Dental Medicine being ahead of the curve when it comes to trends in dentistry and oral healthcare.”
In September, the FDA issued a recommendation that non-mercury restorations be used, when possible and appropriate, in place of dental amalgams in people who may be at higher risk for adverse health effects from mercury exposure. The groups of people who the FDA has designated as higher risk – which include pregnant women and women who are planning to become pregnant, nursing women, children, people with pre-existing neurological disease, people with impaired kidney function, and people with known sensitivity to mercury or other components of dental amalgam – account for a significant percentage of the general public.
Additionally, according to the U.S. Environmental Protection Agency, dental offices contribute the largest source of mercury into sewage treatment plants.
“Nationally, dentists discharge about 5.1 tons of mercury into publicly owned treatment works, and most of this mercury will end up in the environment,” said Dr. Hesham Nouh, associate chair and director of predoctoral prosthodontics and restorative dentistry in the Department of General Dentistry. “Environmentally, it’s the right thing to do.”
Over the last five years, GSDM has moved away from the use of dental amalgams in the patient treatment centers, with the number of amalgams completed dropping from 1,730 in fiscal year 2017 to 746 in fiscal year 2019—in fiscal year 2020, the school completed just 391 amalgams prior to the suspension of patient care in the Patient Treatment Centers in March 2020 after the start of the COVID-19 pandemic. Prior to finalizing the elimination of amalgam, Dean Hutter consulted with a number of the school’s faculty, representing different departments and perspectives; these faculty universally endorsed the decision.
“The shift from amalgam dominance in practice to composite has been remarkable,” Nouh said. “Patients prefer esthetic restorations (tooth-colored material).”
Students will continue to learn how to use dental amalgam in the Simulation Learning Center, so they will know how to work with the material if they encounter it while on externship or post-graduation.