Dentsply/Caulk,a major manufacturer of dental amalgam, has placed the following warning for its amalgam products Dispersalloy, Megalloy, and Unison on their internet site. The URL's for the various products are:http://www.caulk.com/ MSDSDFU/DispersDFU.html,www.caulk.com/ MSDSDFU/UnisonDFU.html, and www.caulk. com/MSDSDFU/MegalloyDFU.html.

Contraindication

The use of amalgam is contraindicated:

In proximal or occlusal contact to dissimilar metal restorations.

In patients with severe renal deficiency.

In patients with known allergies to amalgam.

For retrograde or endodontic filling.

As a filling material for cast crown.

In children 6 and under.

In expectant mothers.

Side Effects/Warning:Prior to use, read the MSDS information and product instructions for this item.

Exposure to mercury may cause irritation to skin, eyes, respiratory tract and mucous membrane. In individual cases, hypersensitivity reactions, allergies, or electrochemically caused local reactions have been observed. Due to electrochemical processes, the lichen planus of the mucosa may develop.

Mercury may also be a skin sensitizer, pulmonary sensitizer, nephrotoxin and neurotoxin.

After placement or removal of amalgam restorations, there is a temporary increase of the mercury concentration in the blood and urine.

Mercury expressed during condensation and unset amalgam may cause amalgamation or galvanic effect if in contact with other metal restorations. If symptoms persist, the amalgam should be replaced by a different material.

Removal of clinically acceptable amalgam restorations should be avoided to minimize mercury exposure, especially in expectant mothers.

Precautions:

The number of amalgam restorations for one patient should be kept to a minimum.

Inhalation of mercury vapor by dental staff may be avoided by proper handling of the amalgam, the use of masks, along with adequate ventilation.

Avoid contact with skin and wear safety glasses and gloves.

Store amalgam scrap in well sealed containers. Regulations for disposal must be observed.

Dentsply/Caulk has also placed the MSDS for mercury on another page [www. caulk. com/MSDSDFU/DispersalloyMSDS.html#MERC]. Of particular importance, are some statements made in Section VIII - Control Measures, Inhalation, Chronic: Inhalation of mercury vapor over a long period may cause mercurialism, which is characterized by fine tremors and erethism. Tremors may affect the hands first, but may also become evident in the face, arms, and legs. Erethism may be manifested by abnormal shyness, blushing, self-consciousness, depression or despondency, resentment of criticism, irritability or excitability, headache, fatigue, and insomnia. In severe cases, hallucinations, loss of memory, and mental deterioration may occur. Concentrations as low and (sic "as") 0.03 mg/m3 have induced psychiatric symptoms in humans. Renal involvement may be indicated by proteinuria, albuminuria, enzymuria, and anuria. Other effects may include salivation, gingivitis, stomatitis, loosening of the teeth, blue lines on the gums, diarrhea, chronic pneumonitis and mild anemia. Repeated exposure to mercury and its compounds may result in sensitization. Intrauterine exposure may result in tremors and involuntary movements in the infants. Mercury is excreted in breast milk. Paternal reproductive effects and effects on fertility have been reported in male rats following repeated inhalation exposures. The fact that Dentsply/Caulk has placed this information on the Internet, available to the public and professionals alike, has a vital impact on various aspects of the current controversy over the safety of mercury/silver amalgam dental fillings.