Executive director of the Alabama Dental Association calls legislation 'inappropriate'
February 26, 2004
Alabama Mobile Register
A legislative committee killed a bill Wednesday that would have banned the use of mercury in dental fillings for children, pregnant women and nursing mothers.
The bill, which failed on an 11-0 vote of the House Health Committee, with one abstention, also would have required dentists to disclose the presence of mercury to adult patients who receive what are called amalgam fillings.
Proponents of the measure -- ranging from national activists, two Alabama dentists and a legislator who suffers from multiple sclerosis -- armed themselves with studies focusing on mercury's toxicity. They argued such a substance poses a serious health risk when placed in a patient's mouth.
Representatives of the dental industry argued that medical studies have shown no causal link between mercury fillings and medical problems such as multiple sclerosis, Lou Gehrig's disease, Parkinson's disease and chronic fatigue syndrome.
"I am encouraging you to consider the difference between association and causation," said Dr. Don Williamson, the state's public health officer.
Wayne McMahan, executive director of the Alabama Dental Association, said, "We believe this legislation is inappropriate. ... There is no current scientific evidence that supports the need for suspending the use of amalgam fillings."
Dismissing studies cited by the bill's supporters, McMahan said, "If you're looking for it in terms of a study, it's out there."
Amalgam fillings -- commonly called "silver fillings" -- have been used for about 150 years. Considered the most durable and inexpensive form of fillings, the amalgam typically is about 50 percent mercury and contains other metals such as silver and copper.
Mercury is an acute neurotoxin, meaning it can adversely affect the nervous system. Methylmercury absorbed into the food supply through fish is among the most common form of mercury contamination for humans, but the issue of dental amalgams has produced concern from some groups for at least three decades.
Amalgam restrictions have been proposed in statehouses around the country. No state, however, has passed any sort of ban. Arizona lawmakers are considering a bill this year similar to what the House Health Committee in Alabama blocked on Wednesday.
The members' vote followed two hours of impassioned testimony from both sides.
Rep. David Grimes, D-Montgomery, told his colleagues that he thought amalgam fillings played a role in his development of multiple sclerosis.
Dr. Ada Frazier, a Huntsville dentist, said she does not use mercury amalgams and is convinced that the metallic compound causes health problems.
Representatives of the American Dental Association, meanwhile, distributed copies of an October 2003 article published in the New England Journal of Medicine. The article acknowledged the dangers associated with inhaling mercury vapors over time, but said, "Patients who have questions about the potential relation between mercury and degenerative diseases can be assured that the available evidence shows no connection. ... There is no clear evidence supporting the removal of amalgams."
And still more dentists contradicted Frazier's testimony, telling lawmakers that they knew of no health problems in patients with amalgam fillings. Dentists testified that they already disclose the presence of mercury in the fillings.
Officials with the state Medicaid Agency said banning amalgam fillings could cost the cash-strapped agency about $2 million more per year, because the state could have to pay dentists greater reimbursement costs for using more expensive materials.
Frazier said money should not be an object. "I don't think there's any question about whether mercury is poisonous," she said. "If there is a possibility that this stuff could be toxic, then we should give the consumer every opportunity to opt out."
Sen. Vivian Davis Figures, D-Mobile, is sponsoring the Senate version
of the bill that failed Wednesday. Lobbyists supporting the measure said
they would rewrite the proposal and still push later this session for some
sort of increased disclosure requirements.
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