Democrat and Chronicle
Published March 6, 2006
Chances are that you have mercury amalgam in your mouth.
Most American adults have at least one of the silvery fillings, an alloy composed of mercury and other metals. While some controversy remains, it is generally accepted that the fillings themselves do not release significant amounts of mercury into the human body.
The environment is another story. And so new regulations were approved last week by a state board in hopes of keeping dental mercury out of New York's air and water.
The issue is drawing particular focus in Monroe County because mercury levels in the water are already slightly elevated as a result of other forms of pollution, and ongoing efforts are aimed at improving water quality in the Great Lakes.
Even the small amounts of mercury amalgam from shavings off the tops of new tooth fillings can be problematic if they are mixed in with other waste. Medical waste tends to be incinerated — a great approach for destroying bacteria, but the worst possible means of dealing with mercury.
Incinerating a chunk of mercury amalgam releases the elemental mercury in the alloy, polluting the air and eventually the land and water.
"Mercury finds a way of getting into the environment," said Alexis Cain of the federal Environmental Protection Agency.
Small amounts of mercury waste can also be flushed down drains and into sewer systems. Dental wastewater can contain 10 billion times the concentration of mercury that is permitted by federal water standards, according to the state Department of Environmental Conservation.
To address the problem, state law now requires that dentists use only pre-mixed amalgam, rather than keeping a store of elemental mercury on hand and mixing their own alloy. Because it's simpler and safer, most dentists switched to the pre-mixed capsules years ago, said Roy Lasky, executive director of the New York State Dental Association.
New York dentists will also be required to recycle waste mercury amalgam and to install a device known as an amalgam separator on their office plumbing, which is capable of removing 99 percent of mercury from wastewater. The cost of the equipment can range from $500 to more than $1,200.
The state dental association doesn't have good figures on how many offices already use amalgam separators, but Lori Bauerman of the Monroe County Dental Authority said that many local offices have been proactive, despite the fact that they need not comply for two years. A Pittsford dental practice did not want to comment on the new law but said it is moving forward with purchasing a separator.
Dentistry is believed to contribute less than 1 percent of mercury released into the environment, according to the American Dental Association. Compared to major sources of environmental mercury pollution, such as coal-fired power plants, this figure is minuscule, Lasky said, calling the new regulations "a placebo."
But most reports don't count indirect sources of dental mercury, such as the incineration of sewage sludge or the cremation of bodies containing fillings, said Amanda Garong of Consumers for Dental Choice, a group based in Washington, D.C., that seeks to eliminate the use of mercury amalgam fillings.
In New York state, sewage sludge incineration alone emits more than 600 pounds of mercury into the air each year — 20 percent of the state total.
And when all the avenues are considered, dental mercury is the major contributor to mercury pollution at municipal wastewater treatment plants, resulting in millions of dollars in water filtration costs each year, according to several recent studies cited both by Garong and the New York DEC.
Regardless of the ongoing debate over its impact, dental amalgam is one of the few sources of mercury that's easy to contain, said Steve Peletz of the Monroe County Department of Environmental Services.
At least 45 states have passed some legislation addressing mercury amalgam, according to the EPA, and Lasky said control measures such as those outlined in the bill have a very good cost-to-benefit ratio.
"The more we can reduce, obviously, the better it is for the environment," Peletz said.