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. All she did was ask me if I was allergic to amalgam and then proceeded to fill the tooth with what I thought was some alternative material.

Since I already carried a number of 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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