Fear of amalgam: dentists' experiences in the Nordic countries

The purpose of the present investigation was to study Nordic dentists' experiences with patients concerned about the possible adverse effects of dental restorations, their perceived ability to deal with this problem and their views as to the suitability of amalgam as a filling material. A random sample of practising dentists in Denmark, Finland, Norway and Sweden were sent a questionnaire in spring 1990. Responses were received from 1732 dentists (65 per cent). In 1989, virtually every dentist had seen patients concerned about possible adverse effects of their dental restorations. The reported mean number of such patients per dentist per year was 80.5 (SD = 128.1) in Denmark, 39.3 (SD = 68.4) in Finland, 83.3 (SD = 194.1) in Norway, and 124.4 (SD = 210.3) in Sweden. Ninety-two per cent of the patients' questions concerned amalgam fillings. About 70 per cent of the dentists believed that inexplicable symptoms associated with amalgam fillings had a psychosomatic background. Only about a fifth of the respondents felt able to examine such patients without seeking medical expertise. In the absence of oral or medical indications, 65 per cent of the respondents in Sweden and 77 per cent in the other countries considered that dentists should advise patients against having their amalgam fillings replaced. About 5 per cent of the respondents were ready to stop using amalgam in the near future.