HealthCare Without Harm
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This report was funded primarily through the generous support of the Garfield Foundation. Additional support was provided by the John Merck Fund, the Mitchell Kapor Foundation and the Tamarind Foundation.

June 2000

Executive Summary

While there has been considerable public debate about the potential health effects of mercury fillings, little attention has been focused thus far on the disposal of waste dental mercury. Dental clinics remain largely unregulated for mercury disposal and extracted amalgam materials are often rinsed down the drain, usually to a municipal wastewater system (or septic system), deposited in biomedical waste con-tainers destined for waste incineration, or placed in
trash disposed in a municipal waste landfill or incin-erator.

By far, the largest single contributor of mercury to wastewater is from dental offices. While most other anthropogenic mercury uses—and their subsequent releases—have declined by 80 percent or more since the 1980s, this has not been the case in the dental sector. Today, dentists are the third largest user of mercury in the United States, consuming over 20 percent of the estimated 200 metric tons used in 2001—or over 40 metric tons of mercury— with most eventually released into the environment.

Another significant factor is that the influential American Dental Association (ADA), as well as many state dental associations, has refrained from promoting, and even opposed mercury reduction efforts.

Clearly, the time has come for U.S. dental associations— as other health care industry associations are already doing—to embrace the fundamental credo of “first do no harm,” by taking responsibility to reduce amalgam use and mercury pollution.

ADA’s Lack of Support for
Reducing Dental Mercury Releases

Despite overwhelming evidence to the contrary, the ADA presents conflicting and often contradictory statements about the nature of amalgams, at times claiming that their members make only a “small contribution to mercury in dental wastewater,” but other times remaining completely silent on the question of environmental impacts, such as in its Statement on Dental Amalgam.

In its most recent statement on the issue, the ADA pledged support for a Food & Drug Administration initiative to preempt or override any and all state laws intended to regulate the dental industry and reduce its use of mercury.

The ADA goes so far as to argue that amalgamated mercury waste poses no environmental risk, asserting that it is a “scientific fact that mercury in dental amalgam chemically combines with other ingredients, including silver, to form a biologically inactive substance.”

Finally, ADA, state dental associations and their members consistently refer to amalgams as “silver fillings” even though, on average, the silver actually only comprises 25 percent of an amalgam filling.

All of these contentions, arguments, and positions by the ADA and state dental associations are designed to undermine and discourage legislative and regulatory efforts to control mercury discharge limits for the dental industry, even though scientifically the positions are largely unfounded.

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