Monday, July 23, 2012

BPA and Toxic Plastics in Dentistry--Current Information

BPA, also known as Bisphenol-A, is a chemical that may be found in some plastics. BPA is also a component of select dental filling materials used to repair tooth decay. BPA has come under scrutiny in the past several years because of its potential to leach out of plastics and cause harmful physical effects.
A study from a pediatric medicine journal, Pediatrics, was released last week.  It links the presence of BPA-containing dental fillings to an increased risk for behavioral problems in kids.

An article was released yesterday on the Science News site that I applaud, because it offers a well-thought-out perspective regarding the research and its outcomes, and how the public should consider digesting the Pediatrics article.

BPA may not be going away anytime soon, but the exposure can be reduced for you and your family if you are willing to thoughtfully plan what you buy and/or consume.  Same goes for dentistry. There are alternatives to BPA-containing materials.

Any of the articles released recently recognize the best solution for any tooth is to prevent decay before it happens. I absolutely agree. There is a MASSIVE potential for improvement in how parents and kids can prevent decay in kids' teeth. Four things to do: 1) Use a mechanical brush, and supervise or participate in brushing. 2) Make teeth resistant with periodic exposure to TOPICAL fluoride. 3) Be thoughtful about your kids' diets. Sugars and sodas are frowned upon with good reason. I feel there is no reason to include soda or sugar in regular life for kids. Disneyland, Christmas, and Halloween don't happen very often, and that's about the same for sugars and sodas. 4) Medical health and dental health are connected, so you need to consult a dentist with a sound knowledge of the connections for your kids, and keep your kids going to that dentist no less than twice a year for review and prevention. And if you recall the name of my blog, you'll know I am one of these dentists.

As a dentist, it is tough to offer a perfect solution for any patients' maladies. Tooth decay happens, and I have to treat decay thoughtfully.  Dental professionals and researchers have not created the perfect material that is effective at replacing decayed tooth structure, look like real teeth, and can withstand rigorous daily chewing without chemical or physical breakdown.

There are,  however, a couple of materials that I offer to my patients that get close to a perfect solution.

Amalgam, or silver filling, is the least expensive material available for decay. Amalgam works well to repair small to large decay defects, has appealing longevity in pediatric teeth, has excellent wear and tear resistance. Decades of research has failed to prove harmful physical effects of any of the components in amalgam. But there are countless anecdotal pieces that describe autoimmune diseases linked to amalgam, mercury poisoning, the list goes on. And the majority of families and patients that I talk to don't want that material used for health reasons as well as esthetic reasons in their kids. But it does look like crap, and requires a liberal amount of cutting away tooth in many cases, because I can't predictably bond amalgam to tooth, unlike composite or other tooth-colored materials. And I do not use this material in adult teeth, as amalgam increases the chances of cracked or fractured teeth.

Compomers are a relatively new type of tooth-colored filler that doesn't contain BPA. It is moderately wear-resistant. But it it not meant for long-term use in areas of heavy function and not meant for long-term use in adult teeth. In my experience, as well as the various literature reviews, compomers work well in pediatric teeth with small to moderately sized decay lesions. I can be more conservative about the cutting I do on teeth when I use compomers--I remove decay, and bond them to the tooth. They also release low levels of fluoride when in contact with saliva, and that can be a helpful feature in kids who are at high risk for repeated decay problems.

Come talk to my team, and we will help you navigate BPA issues, or the thousands of other dental questions you may have to keep your kids in great health. Make your visit today!

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