Key words: amalgam, mercury, risk assessment, tech support
In response to three citizen's petitions, the Working Group on Dental Amalgam, a group under the PHS Environmental Health Policy Committee, was charged with evaluating 175 citations related to the potential adverse effects of dental amalgam mercury. OST scientists organized the review literature in order to determine if the science cited by the petitioners, in whole, or part, shed any new light on the safety of dental amalgam and past risk assessments performed by PHS and others. The citations represented an assortment of literature, including peer-reviewed publications, non-refereed publications, untranslated foreign documents, print media articles, and letters to the editor. Therefore, OST scientists first performed a triage of the citations in order to focus its evaluation on these studies that met a set of criteria established by the review group. This process resulted in 57 articles which were reviewed by scientific experts from FDA, CDC, and NIH representing disciplines of general toxicology, neurotoxicology, immunotoxicology, epidemiology, dental materials, and clinical dentistry. These experts commented on the strengths and weaknesses of each paper, the appropriateness of methodologies, control groups and statistics, and whether the conclusions were supported by the data. The conclusions drawn by these experts were overwhelmingly unanimous. None of the reviewers suggested that any study under review would indicate that individuals with dental amalgam restorations would experience adverse health effects. When the citations were considered in the aggregate, the data did not imply to the reviewers that adverse human health effects would occur as a result of exposure to dental amalgam.