Talk:Dental amalgam controversy

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[edit] Proposed infobox

Without prejudice to the issue itself, would it be useful for Wikipedia contributors to have a list of articles related to mercury and health? How about an infobox?

Add your links above. --Uncle Ed 22:24, 23 January 2007 (UTC)

Seems like a very good idea to me. Mercury is notoriously volatile, and has so many forms, that an infobox as you suggested above would help readers navigate between the various related pages that have something to do with health and mercury in one of its many forms. Simon K 16:07, 12 February 2007 (UTC)
At first I thought this was a good idea but i'm wondering now whether it is. The info box doesn't seem to have much to do with amalgams, and probably would be as relevant as an info box about scientific bodies that have reached conclusions but still have strong opponents, say global warming etc. However I do like the idea of having a link to mercury which i think should have that info box on the mercury page.(Bouncingmolar 15:42, 13 February 2007 (UTC))

[edit] The Scientific Case Against Amalgam

A summary of 97 scientific studies:
http://iaomt.org/articles/files/files210/The%20Case%20Against%20Amalgam.pdf
Drichw 22:35, 27 February 2007 (UTC)
Thanks for posting that. I could not read it all the way through due to my dental mercury related emotional instability. (It made me angry as hell.) Rumiton (talk) 13:26, 27 March 2008 (UTC)

[edit] Proposed statement to be added as a third paragraph in the intro

I proposed this 9 months ago (back in Feb), and received positive responses from others, but so far I'm still awaiting a consensus/conclusion on whether we can go ahead and add this statement to the intro or not? Is there anything about this statement which anyone would object to?

If not, would anyone like to add it to the article or should I (I don't want to add it not knowing if the consensus is in agreement)? Or, if it isn't ready yet, how would you propose it be altered? It has been written to (i) increase the article's readability; (ii) clearly, concisely and accurately summarise the most up-to-date concrete examples of both sides as discussed in the rest of the article; (ii) reflect primarily the current mainstream status on this controversy, and summarise this in one single introductory paragraph with 8 citations. With NPOV, space is given to both sides of the controversy, including several prominent dental and health organisations, plus the most credible and recent opposing view (conclusion of the recent FDA hearings). However, more space is devoted to the mainstream accepted views and practices in order to reflect that they currently represent the majority view, which is also made clear:

  • "The majority view in the dental amalgam controversy is that dental amalgams are safe, a belief generally accepted by many dental associations such as the American Dental Association [citation #1], British Dental Association [citation #2] and Irish Dental Association [citation #3], as well as governmental institutions such as the Food and Drug Administration [citation #4] in the USA, and by most national governments in most countries. In opposition, the minority view in the dental amalgam controversy is that dental amalgams are unsafe, a concern notably raised in 2006 by the Food and Drug Administration in the USA at a review panel [citation #5] which sought to demonstrate their safety, but at which 13 out of 20 independent scientists voted it was "unreasonable" to conclude dental amalgams are safe [citations #6,#7,#8]."
  • Citation #1: “Dental amalgam (silver filling) is considered a safe, affordable and durable material that has been used to restore the teeth of more than 100 million Americans.” ADA Statement on Dental Amalgam. American Dental Association, USA. Revised January 8, 2002. http://www.ada.org/prof/resources/positions/statements/amalgam.asp
  • Citation #2: “To date no epidemiological links have been established anywhere in the world between amalgam use and general ill-health. It is never possible to say categorically that anything is safe in all circumstances. With amalgam, as with all bio-materials, there are risks and benefits to be balanced. Whether amalgam can be called ‘safe’ is a matter for manufacturers of amalgam and for the Department of Health, and for the toxicologists and other scientists who advise them.” Dental Amalgam Safety, British Dental Association Fact File. British Dental Association, UK. November, 1996. http://www.bda.org
  • Citation #3: “All available world-wide research indicates that amalgam is not harmful to health. No Government or reputable scientific, medical or dental body anywhere in the world accepts, on any published evidence, that dental amalgam is a hazard to health.” Frequently Asked Questions. Irish Dental Association, Ireland. February, 2007. http://dentist.ie/resources/faqs/prostho/index.jsp#amalgam
  • Citation #4: "Since the 1990s, FDA and other government agencies (CDC, NIH) have reviewed the scientific literature looking for links between dental amalgams and health problems. To date, the agencies have found no scientific studies that demonstrate dental amalgams harm children or adults. But we continue to review the literature and ask experts their opinions on the safety of dental amalgam.” CDRH Consumer Information. Food and Drug Administration, USA. Updated October 31, 2006. http://www.fda.gov/cdrh/consumer/amalgams.html
  • Citation #6: “The draft FDA White Paper argued that mercury fillings are safe. By two votes of 13 to 7, this panel rejected the FDA staff position. It is highly unusual for a panel to disagree with staff. The questions presented: Q1. “Does the draft FDA White Paper objectively and clearly present the current state of knowledge about the exposure and health effects related to dental amalgam?” Yes 7, No 13. Q2. “Given the amount and quality of Information available for the draft FDA White Paper, are the conclusions reasonable?” Yes 7, No 13.” Joint Meeting of the Dental Products Panel (CDRH) and the Peripheral and Central Nervous System Drugs Advisory Committee (CDER) - September 6-7, 2006 (Summary). Food and Drug Administration, USA. Updated September 8, 2006. http://www.fda.gov/cdrh/meetings/090606-summary.html

Simon K 16:17, 11 November 2007 (UTC)

Simon, I appreciate the fact that you're willing to wait so patiently for consensus. The problem with your citations is that they appeal to authority; when possible, we should actually cite facts rather than opinions. No matter what the ADA, FDA, or panel scientists say, there are objective facts associated with dental amalgam. We can say how much, in micrograms, is put into the mouth, and we can look at the same benchmarks that scientists look at. Sometimes we may cite scientists, but in those cases we try to cite actual researchers than biased organizations such as the ADA. I have filled in those facts; many of them were present in the article but just needed to be brought to prominence. OptimistBen (talk) 04:51, 17 April 2008 (UTC)
Ben, that's not the way Wikipedia works. We cite V & RS for facts and opinions. You can't leave out such a source because you (in contrast to others) believe it's biased. So what if it's biased. We use biased sources all the time. We document POV here, all significant POV, and they are by definition biased. Read WP:NPOV again. -- Fyslee / talk 06:04, 17 April 2008 (UTC)
We add what's appropriate. I think you're misreading me, anyway. When writing an introduction, you want it to be clean, succinct, and if possible enlightening as to the actual truth. Appeals to authority are the weakest information you can use in an argument, and they really aren't that informative. That's why we should cite science rather than opinions -- because opinions can be misleading. The fact that the ADA believes amalgam is safe is in the introduction to the article. It doesn't need to be repeated; Simon has 3 citations from different dental organizations saying the same exact thing. OptimistBen (talk) 07:37, 17 April 2008 (UTC)
As an example, I've been contributing to organic farming quite a bit. There's a supposed expert, Alex Avery, who believes that organic yields are terribly low. When writing my section on organic yields, I can report his opinion, although he's never cited scientific data to back it up, or I can note consistent results from the numerous empirical studies of organic fields vrs conventional fields. Given that I don't want to waste my reader's time, I opted for the latter. I'm not going to note every scientist who claims that organic yields suck contrary to evidence. I believe that we're faced with this dilemma often, and we can go straight to the science rather than report the opinions. When the science is presented well, opinions may supplement it, but they shouldn't be the core of your article's claims unless you really can't find data. And I would argue that you can always find data; if you haven't found it, you're not looking hard enough. It's unfortunate that most Wikipedians are not truly interested in creating quality articles, however, so they don't dig for the data. Further, I would argue that you can always make data intelligible to a lay audience. OptimistBen (talk) 07:48, 17 April 2008 (UTC)

[edit] Regulation and governmental involvement

I updated the description pertaining to the regulations in Norway and used links directly to the goverment agency effecting the decicion. (And removed Norway from the "maybe list".) I moved the paragraph describing Nations with regulations closer to the headline "Regulation and governmental involvement". A beneficial sideeffect is that the paragraph about the mandated notice in some offices (> 9 employees) and the could have been notice and later regulation, follows naturally. Both characterize USA at the beginning of the millennium.

Another of the mentioned Nations on the "maybe list", Sweeden, have not yet banned amalgam. They claim they will do so, soon, and no later than during 2008, according to SVT (Sweedish national television). Both Norway and Sweeden is in Scandinavia (North Europa). I have _not_ updated this information as it is about to change. PolarNight (talk) 02:20, 12 January 2008 (UTC)


[edit] SCENIHR

The acronym stands for the Scientific Committee on Emerging and Newly Identified Health Risks, which is an independent scientific committee managed by the Directorate-General of Health and Consumer Protection of the European Commission. The committee released a preliminary report that may serve as a good reference. - Dozenist talk 19:50, 23 February 2008 (UTC)

[edit] Globalization tag

I have removed the globalization tag because it is unexplained. If you think that it's deserved, then please explain your concerns in detail right here on the talk page. This will help other editors figure out how to address your concerns. Thanks, WhatamIdoing (talk) 20:32, 4 March 2008 (UTC)

[edit] Some Unanswered Issues of Importance

The article does not *seem* to address the following issues which may be relevant :

1)Whether the exposure to elemental (and possible organic) mercury increases or varies dependent upon pH alterations within the mouth (for example, do very acidic environments within the mouth cause greater degradation of amalgam – or is it very chemically inert?).

2)The temperature range over which amalgam is stable.

3)Some information concerning how alloying of mercury affects its various mechanical properties would seem wise (this does not seem to appear on the alloys index of wikipedia, nor on the amalgam wikipedia link – the mechanical properties of interest would include : density, reactivity, Young's modulus, and electrical and thermal conductivity, tensile strength and shear strength. These would provide an indication of the types of pressure under which amalgam starts to mechanically decompose, etc...). An important item of information would include the alloying procedure (how many dentists alloy in-house when making amalgam?), together with homogeneity information (inhomogeneous alloying processes might make less mechanically tough amalgam). Also, knowing HOW amalgam breaks would be interesting (if the amalgam has to fit arbitrary geometries, then it will break in arbitrary ways – but can it ever fracture in a friably/glass-like way?).

4)In one of the references, the following is stated : “The true exposure measure is the level of mercury at critical brain sites but cannot be determined at this time.”

Would it be feasible modify MRI scanners to detect the exact location of mercury within the body? What significance might it be that the concentration of mercury within the brain is not necessarily a constant, but variable (so that it may be substantially higher in some parts of the brain than in others). What do regulations state about allowable concentrations of mercury WITHIN the brain rather than just the body as a whole?

P.S - Point (3) relates to the "Alloy vs. Mixture" remark above - how homogeneous does a mix have to be before being an alloy, etc...?

MrASMafmo (talk) 00:39, 14 March 2008 (UTC)

[edit] Messy Page

This page is rather disorganized and redundant. I'm going to do some real cutting here sometime soon. Background and history are largely redundant; regulation and government involvement could probably go under the broad background/history section as well.

Anyone have any preferences on how they want it organized? If nobody speaks, I'm just gonna go in there and start cutting and pasting so that this thing is halfway intelligible. The points of contention stuff is better organized, but the content inside of it is way too wordy. OptimistBen (talk) 03:21, 13 April 2008 (UTC)

I've done my work. I'd like to archive much of this Talk page. Anyone have objections? I will keep things which I find to be substantive. Also, I will probably use the permanent method. OptimistBen (talk) 04:44, 15 April 2008 (UTC)
Please don't use that method. The normal method is already in use and is easy to do. I'll make the link and you can just move content to it. Give me a couple minutes. -- Fyslee / talk 04:57, 15 April 2008 (UTC)
Go for it. It's probably safe to archive stuff before this year. -- Fyslee / talk 05:11, 15 April 2008 (UTC)

[edit] Safe Concentrations in Air

This article is messy, but there is a lot of contention and all needs to be based on science. So i think people see things missing and want to add it. But who's to decide what gets deleted in a complex and contentious topic? As an former air toxicologist (by profession, but not by degree), I can say the WHO 2003 article [1] contains the most useful information, but makes terrible conclusions. They state 20 ug/m^3 was observed in several studies to have an effect in workers after "several" years. They then conclude (using a terrible method) that 0.2 ug/m^3 for the general population is safe. What they don't take into account is that a 40 hour work week is 4.2 times less than a 168 hour week of living with amalgams. Also, people live with amalgams for 20 times longer than "several years" of work. Standard U.S. toxicology work would conclude that 4.2 * 10 safety for constant exposure * 10 weak individuals = 420 times less is probably "OK" (but not "safe"). This results in 0.05 ug/m^3 for "probably OK". Everyone seems to agree that amalgams cause about 10 times more. Calculation: 0.417 ug/m^3 is the average breathed in from amalgams calculated from 5 ug/day at 15 m^3/day breathed in and 80% absorbed and small amount absorbed from swallowing. That's for the average amalgam person. This kind of standard approach is far more useful than the rest of the wiki article. OSHA and EPA regulations would never allow this kind of exposure for a toxic. The problem is that they can't regulate our mouths and FDA is well known to be in the pocket of industry. —Preceding unsigned comment added by 24.214.120.227 (talk) 13:07, 27 May 2008 (UTC)

[edit] FDA concedes that mercury fillings may cause harm to some

Here is a new RS reference that should be integrated in the article: Reuters: 'Mercury teeth fillings may harm some: U.S. FDA' [1] MaxPont (talk) 08:04, 6 June 2008 (UTC)

Avoid referencing the mass media, they're not really reliable on science. Cite the FDA if they put up a statement. Jefffire (talk) 08:22, 6 June 2008 (UTC)
This is not a scientific issue but a statement about policy. Reuters is a perfectly RS here. MaxPont (talk) 08:33, 6 June 2008 (UTC)
Agreed with MaxPont. This isn't an issue of understanding science. It's an issue of quoting the FDA. Reuters works fine. Although I would like to see the statement online, it seems to have been made mainly orally so far; hard to find on the website. ImpIn | (t - c) 08:54, 6 June 2008 (UTC)
FDA faq here, which is preferable to citing the news story. Jefffire (talk) 09:40, 6 June 2008 (UTC)
Could be the beginning of a major breakthrough in this subject (my own, highly POV opinion.) While we await the results of the July 28, 2008 survey, the preliminary statements made by the FDA above should surely go in the article. Rumiton (talk) 14:33, 6 June 2008 (UTC)
The reason why the source from Yahoo News is problematic on scientific matters is because the American Dental Association, a respected source for dental research and information, also has a response to the FDA settlement which says, "Contrary to some assertions, the FDA’s current reclassification proposal does not call for restrictions on the use of amalgam in any particular population group." Since the reclassification of amalgam will not change everyday dental treatment, most dentists and patients will not even notice a change. If the FDA really believes that mercury fillings can cause harm, then we should get an FDA statement. The FDA link provided above would be a good reference for citing a possible but not proven concern of amalgam in pregnant women and young children. - Dozenist talk 16:01, 6 June 2008 (UTC)

Both the FDA and the American Dental Association are policy and interest group organizations. If they make statements about scientific facts we should take into consideration that these statements most likely are influenced by various economic and professional interests. You can't claim that the FDA is unscientifc at the same time as you accept the American Dental Association as scientific. MaxPont (talk) 06:58, 7 June 2008 (UTC)

Nobody claimed that the FDA wasn't scientific, just that the ADA's statement clarifies the FDA's faq. Jefffire (talk) 08:09, 7 June 2008 (UTC)
Absolutely, if anything, I think the FDA is a very strong reliable source for comments on science and especially for its own policy. I would take statements on science by the FDA, the American Medical Association, and American Dental Association over mass media, such as Yahoo News, any day. - Dozenist talk 13:11, 7 June 2008 (UTC)
On the other hand, secondary sources provide context and establish notability. IMO the Reuter reference should be used in addition to the primary sources. MaxPont (talk) 07:35, 8 June 2008 (UTC)
I am not disputing the usefulness of secondary sources in some cases, but in this case the response of Yahoo News is quite different from that of the American Dental Association. (I realize the two are quite different: Yahoo News/Reuters being mass media and the ADA a reliable source for dental science.) As a result, the best way to reference the FDA's view of amalgam would be the FDA itself. - Dozenist talk 12:19, 8 June 2008 (UTC)