Sample material safety data sheet for amalgam

The use of amalgam is contraindicated in

  • contact to dissimilar metal restorations;
  • patients with severe renal deficiency;
  • patients with known allergy to amalgam;
  • for retrograde or endodontic fillings (root fillings or root canals);
  • under a cast crown (metal crown or metal-ceramic crown);
  • in children under 6 and;
  • in expectant mothers.

Side effects

  • This product contains mercury that is known to cause birth defects.
  • Lichen planus may form on the mucous membrane which is in contact with amalgam (lichen planus can be a pre-cancerous condition).
  • Inhalation of a high concentration of mercury va­pour can cause almost immediate dyspnea, cough, fever, nausea and vomiting, diarrhoea, stomatitis, salivation, metallic taste, gingivitis, and cardiac abnormalities.
  • Respiratory irritation may occur with chest pain and tightness. Symptoms may resolve or may progress to necrotising bronchiolitis, pneumonia, pulmo­nary oedema, pneumothorax, interstitial fibrosis and death.
  • Acidosis and renal damage may also occur.
  • Allergy reactions that may occur in previously ex­posed persons include dermatitis, encephalitis and death.
  • Metal fume fever, an influenza-like illness, may oc­cur due to inhalation of freshly formed metal oxide particles. Symptoms may be delayed 4 to 12 hours and begin with sudden onset of thirst, a metallic taste in the mouth, dryness of mucous membranes, lassitude and a general feeling of malaise. Also, fe­ver, chills, muscular pain, mild to severe headaches, nausea, profuse sweating, excessive urination, diar­rhoea and prostration can occur.
  • Chronic inhalation is characterised by fine tremors and erethism. Tremors first affect the hand, then become evident in the face, arms and legs. Ere­thism is manifested by abnormal shyness, blush­ing, self-consciousness, depression or despondency, resentment of criticism, irritability or excitability, headache, fatigue and insomnia. In severe cases, hallucinations, loss of memory, and mental deterio­ration may occur. Concentrations as low as 0.03mg/ m3 (30ppm) have induced psychiatric symptoms in humans. (All amalgam carriers inhale mercury on a daily basis, see On the dangers of dental amalgam (mercury) "silver" fillings.)
  • Other effects may include salivation, gingivitis, sto­matitis, loosening of teeth, blue lines of the gums, diarrhoea, chronic pneumonitis and mild anaemia.
  • Tremors and involuntary movements can occur in babies still in the womb.
  • Mercury is excreted in breast milk.
  • Paternal reproductive effects and effects on fertility have been reported in male rats following repeated inhalation exposures.

When placing or removing amalgam fillings

  • protective gloves must be worn;
  • safety goggles must be worn;
  • appropriate protective clothing must be worn and;
  • exhaust or general dilution ventilation must be em­ployed to meet permissible exposure limits.

PS

Personally, I once had an amalgam placed by a dentist after I had asked her expressly not to use amalgam. Since I already carried gold fillings, at home I immediately got unpleasant electrogalvanic effects in my mouth (this is how I discovered what she had done). She replaced the amalgam filling when I returned the following day - without an apology and any protection whatsoever, glaring at me...

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