FDA Advisory Panel to Review Dental Amalgam

Agency to consider risks to vulnerable populations

The U.S. Food and Drug Administration today announced plans to hold an advisory panel on Dec. 14-15, 2010, to discuss several scientific issues that may affect the regulation of dental amalgam, used for direct filling of carious lesions or structural defects in teeth. The panel meeting will focus particularly on the potential risk to vulnerable populations, such as pregnant women, fetuses, and young children.

Used to treat tooth decay, dental amalgam is a mixture of metals, composed of liquid mercury and a powdered amalgam alloy, composed primarily of silver, tin, and copper.

On July 28, 2009, the FDA issued a final rule that reclassified dental mercury from a class I device to class II, classified dental amalgam as a class II device, and designated special controls for dental amalgam, mercury and amalgam alloy. The special control for the devices is a guidance titled, “Class II Special Controls Guidance Document: Dental Amalgam, Mercury and Amalgam Alloy.”

Since that time, the agency has received several petitions raising various issues relating to the final rule and special controls.

The concerns raised include the adequacy of the risk assessment method used by the FDA in classifying dental amalgam, the bioaccumulative effect of mercury, the exposure of pediatric populations to mercury vapor, and the adequacy of the clinical studies on dental amalgam. In addition, a recent report on risk assessments issued by the National Academy of Sciences, titled “Science and Decisions: Advancing Risk Assessment, NAP 2009,” proposes new approaches to conducting risk assessments. These may be some of the issues the agency asks the advisory committee to review.

Details about the advisory panel meeting will be published in the Federal Register on June 11, 2010 and is available for advanced viewing today only.

For more information:

Advanced viewing - details about the advisory panel meeting

FDA website on dental amalgam

Petitions on dental amalgam:

International Academy of Oral Medicine et al (Titus Hillis Reynolds Love, Dickman & McCalmon) - Citizen Petition

Citizens for Health, et al (Swankin & Turner) - Petition for Reconsideration

Richard F. Edlich, M.D., Ph.D., et al - Citizen Petition

Moms Against Mercury, et al. - Petition for Reconsideration