Side-effects of amalgam and its alternatives: local, systemic and environmental

It is clearly established that dental restorative materials, like all other foreign materials introduced into the human body, may cause pathological changes both local and general in type. However, in a proper evaluation of the side-effects occurring, their type, severity and frequency have to be considered. Local side-effects of dental restorative materials on oral mucosa are of either irritative or allergic nature while systemic effects are mainly due to allergic and other kinds of hypersensitivity reactions. Most side-effects of dental restorative materials seem to be insignificant and of short duration, although systemic hypersensitivity reactions may be most harmful to those affected. Although the frequency of side-effects seems to be low in comparison with the vast number of restorations that are placed, it is reasonable to assume that the more complex and diverse application of an increasing number of dental materials will increase the frequency. Study of a group of patients, referred for investigation of possible side-effects of dental materials, revealed that several of these patients showed allergic reactions to constituents of their dental restorations. Environmental problems associated with the handling of waste amalgam are discussed.