Citing environmental concerns, the New York University College of Dentistry announced in a letter to students and faculty last week that it has decided to go “amalgam free”. According to a letter written by Dr. Mark Wolff, D.D.S., Ph.D., Chair of the Department of Cariology and Comprehensive Care and Associate Dean for Pre-doctoral Clinical Education:
All treatment plans should consider alternative restorative materials other than amalgam.
Existing amalgam restorations that are deemed clinically acceptable should NOT be replaced.
Amalgam will still be available at the supply area and will require justification by faculty for placement.
Students will still receive pre-clinical training in the use of amalgam with special attention to the indications and contra-indications
Strict mercury hygiene when using amalgam will be maintained in both the clinic and pre-clinical settings
The letter stressed that the changes were made out of concern about mercury pollution in the environment and that the evidence still supports the safety of amalgam for patients. ASDA’s position on amalgam restorations states:
I-6 Amalgam Restorations (1990)
It is the position of the American Student Dental Association that, based on available scientific data, the continued use of amalgam as a restorative material does not pose a health hazard to the nonallergic patient. The removal of clinically serviceable dental amalgam restorations solely to substitute a material that does not contain mercury is unwarranted, improper, unethical, and intentional misrepresentation to the patient.
While the change in policy does not appear to directly conflict with ASDA’s position, it is sure to generate discussion. Students at NYU were shocked and frustrated with the new policy.
The new policy has come under withering criticism from proponents of the use of amalgam. In an email obtained by ASDA, Dean Charles Bertolami tried to assuage the concerns of critics of the policy, saying:
The NYU College of Dentistry has not stopped teaching the use of amalgam nor does it intend to do so. Further, amalgam is now and will continue to be used in our clinics whenever indicated. …
Amalgam will still be available in our supply areas; students will still receive pre-clinical training in the use of amalgam; and amalgam will continue to be used whenever indicated.
While that may be technically true, the school is still putting significant barriers around the use of amalgam. Dr. Wolff hints at the underlying reasoning when he says in his letter, “Recently the United Nations Environmental Program, supported in part by the United States Department of State, has proposed a legally binding global treaty on mercury pollution and is recommending phasing out the use of mercury containing products including amalgam.” A strong case could be made that these moves are more along the lines of phasing out the use of amalgam than continuing to use amalgam whenever indicated.
A full copy of Dr. Wolff’s letter can be found here: Amalgam policy.pdf
~Michael Capp, Minnesota ’15, Washington D.C. Extern