Last update: July 12, 2016

Dental Filling

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

The materials most frequently used for direct dental restoration are amalgam, composite resin (plastic and glass), the glass ionomer (glass + organic acid) and the cement ionomer resin (resin + glass + organic acid).
Those used for indirect dental restoration (inlays, crowns, bridges and frames) mostly are porcelain pottery, porcelain fused to metal, gold alloys and copper and nickel alloys, cobalt and chromium.

Resins are biocompatible and safe. Glass cements and other dental materials (porcelains, gold alloys, nickel, cobalt and chromium) are nontoxic and safe.

Amalgams contain mercury (Hg), silver, tin and copper. Hg vapors are continually shed from fillings, mostly when chewing (especially chewing-gum) and drinking very hot liquids, increasing Hg concentrations in plasma and milk of nursing mothers.

There is controversy about how much mercury from amalgams actually passes into blood and breast milk (Roberts 2009).
For some authors it would be excessive with a daily intake of Hg higher than recommended by FAO / WHO (Norouzi 2012, da Costa 2005).
For others, it would be very small, even much smaller than that passing through eating fish and far below than that occurring through placenta during pregnancy, so that the levels of mercury found in cord blood which drop gradually in infants, whether breastfed or not, during the first weeks after birth (Drexler 1998 Drasch 1998).

Wearing of amalgam dental fillings does not contraindicate breastfeeding (Drasch 1998).
It is not convenient to place or remove amalgam fillings during pregnancy and lactation, otherwise, do so with proper precautions, because mercury vapors are released (FDA 2015, Ekstrand 1998) and may pass through inhalation into blood and breast milk.

Mercury exposure, both chronic and excessive, may have adverse health effects, but there is much controversy about the effects of minimum exposures such as amalgam fillings. In some countries of northern Europe and the USA an informed consent is required about the material to be used for dental filling procedures (Edlich 2007).

Despite the alarmism originated by some, there is no scientific basis for pointing out to such fillings as a cause of any disease (Mitchell 2005, Brownawell 2005, Ekstrand 1998), however, it is a goal of WHO the reduction and elimination of mercury exposure worldwide.
Dental amalgams fall within that policy of progressively mercury elimination: those amalgam fillings that are still in good shape must be left in place, whenever a replacement is needed, a resin or cement must be used.

The benefits of breastfeeding outweigh the risk that would be presented in low levels of environmental contaminants in human milk, which in many cases are lower than those appearing in cow's milk based formulas and other foods (WHO).

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

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References

  1. OMS. El mercurio y la salud. Centro de prensa. Nota descriptiva N°361. 2016 Full text (link to original source) Full text (in our servers)
  2. WHO. Mercury and health. Media centre. Fact sheet 361. 2016 Full text (link to original source) Full text (in our servers)
  3. U.S. Food and Drug Administration. About Dental Amalgam Fillings 2015 Full text (in our servers)
  4. U.S. Food and Drug Administration. Appendix I : Summary of Changes to the Classification of Dental Amalgam and Mercury. 2015 Full text (in our servers)
  5. Vieira SM, de Almeida R, Holanda IB, Mussy MH, Galvão RC, Crispim PT, Dórea JG, Bastos WR. Total and methyl-mercury in hair and milk of mothers living in the city of Porto Velho and in villages along the Rio Madeira, Amazon, Brazil. Int J Hyg Environ Health. 2013 Abstract
  6. Jiménez L. Empastes de amalgama de mercurio ¿Son tóxicos y peligrosos? ¿Tienes que preocuparte por tu salud? El Blog de Centinel. 2013 Full text (link to original source) Full text (in our servers)
  7. Norouzi E, Bahramifar N, Ghasempouri SM. Effect of teeth amalgam on mercury levels in the colostrums human milk in Lenjan. Environ Monit Assess. 2012 Abstract
  8. Barghi M, Behrooz RD, Esmaili-Sari A, Ghasempouri SM. Mercury exposure assessment in Iranian pregnant women's hair with respect to diet, amalgam filling, and lactation. Biol Trace Elem Res. 2012 Abstract
  9. Orün E, Yalçin SS, Aykut O, Orhan G, Koç-Morgil G, Yurdakök K, Uzun R. Mercury exposure via breast-milk in infants from a suburban area of Ankara, Turkey. Turk J Pediatr. 2012 Abstract Full text (link to original source) Full text (in our servers)
  10. Richardson GM, Wilson R, Allard D, Purtill C, Douma S, Gravière J. Mercury exposure and risks from dental amalgam in the US population, post-2000. Sci Total Environ. 2011 Abstract
  11. Roberts HW, Charlton DG. The release of mercury from amalgam restorations and its health effects: a review. Oper Dent. 2009 Abstract Full text (link to original source) Full text (in our servers)
  12. U.S. Food and Drug Administration. White Paper: FDA Update/Review of Potential Adverse Health Risks Associated with Exposure to Mercury in Dental Amalgam. 2009 Full text (link to original source) Full text (in our servers)
  13. Edlich RF, Greene JA, Cochran AA, Kelley AR, Gubler KD, Olson BM, Hudson MA, Woode DR, Long WB 3rd, McGregor W, Yoder C, Hopkins DB, Saepoff JP. Need for informed consent for dentists who use mercury amalgam restorative material as well as technical considerations in removal of dental amalgam restorations. J Environ Pathol Toxicol Oncol. 2007 Abstract
  14. Ursinyova M, Masanova V. Cadmium, lead and mercury in human milk from Slovakia. Food Addit Contam. 2005 Abstract
  15. Brownawell AM, Berent S, Brent RL, Bruckner JV, Doull J, Gershwin EM, Hood RD, Matanoski GM, Rubin R, Weiss B, Karol MH. The potential adverse health effects of dental amalgam. Toxicol Rev. 2005 Abstract
  16. da Costa SL, Malm O, Dórea JG. Breast-milk mercury concentrations and amalgam surface in mothers from Brasília, Brazil. Biol Trace Elem Res. 2005 Abstract
  17. Mitchell RJ, Osborne PB, Haubenreich JE. Dental amalgam restorations: daily mercury dose and biocompatibility. J Long Term Eff Med Implants. 2005 Abstract
  18. Dental Board of California. The Facts about Fillings. 2005 Full text (in our servers)
  19. Junta Dental de California. Datos sobre los empastes. 2005 Full text (in our servers)
  20. The Trans-agency Working Group on the Health Effects of Dental Amalgam. Review and analysis of the literature on the Health effects of Dental Amalgam. Life Sciences Research Office. 2005 Full text (link to original source) Full text (in our servers)
  21. Ekstrand J, Björkman L, Edlund C, Sandborgh-Englund G. Toxicological aspects on the release and systemic uptake of mercury from dental amalgam. Eur J Oral Sci. 1998 Abstract
  22. Drexler H, Schaller KH. The mercury concentration in breast milk resulting from amalgam fillings and dietary habits. Environ Res. 1998 Abstract
  23. Drasch G, Aigner S, Roider G, Staiger F, Lipowsky G. Mercury in human colostrum and early breast milk. Its dependence on dental amalgam and other factors. J Trace Elem Med Biol. 1998 Abstract
  24. Oskarsson A, Schültz A, Skerfving S, Hallén IP, Ohlin B, Lagerkvist BJ. Total and inorganic mercury in breast milk in relation to fish consumption and amalgam in lactating women. Arch Environ Health. 1996 Abstract
  25. Klemann D, Weinhold J, Strubelt O, Pentz R, Jungblut JR, Klink F. [Effects of amalgam fillings on the mercury concentrations in amniotic fluid and breast milk]. Dtsch Zahnarztl Z. 1990 Abstract

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