Plastics Chemical in Dental Fillings Might Affect Children’s Behavior: Study

MONDAY, July 16 (HealthDay News) — Children who receive dental
fillings made from the controversial plastics chemical bisphenol-A (BPA)
could undergo small but long-term changes in their behavior, a new study
suggests.

Researchers looked at 534 children who had fillings for at least two
cavities and examined their social skills before and five years after
getting fillings.

The fillings were made of either a silver blend called amalgam, which
has been phased out because it contains mercury, or plastic composites,
some of which are based on bisGMA, a material made from BPA.

The children who got the highest number of bisGMA-based fillings had
more emotional problems five years later than the children who got fewer
of these fillings. But no such change occurred with other types of
fillings.

The study appeared online July 16 and will be published in the August
print issue of Pediatrics.

“It was actually kind of a surprise that instead of seeing any possible
adverse associations with amalgam, that the trends seem to go the other
way and the children in the composite group seemed to have more problems,”
said study author Nancy Maserejian, an epidemiologist at New England
Research Institutes in Watertown, Mass.

“On average, the difference in social behavior scores were very small
and would probably not be noticed for each individual child,” Maserejian
said. “But imagine a huge group of children around the country; you’d
probably notice a difference.”

Although it remains controversial whether BPA affects human health,
previous research has linked BPA exposure to hyperactivity and aggressive
behavior in young children.

Composite fillings, including the kind made from BPA, became the
mainstay for treating children’s cavities in the mid-90s because they were
thought to be safer than mercury-containing amalgam fillings and they
looked more natural, said Dr. Burton Edelstein, a pediatric dentist and
professor of dentistry at Columbia University, in New York City.

“This study raises enough concern about the alternative of amalgam to
revisit the value of amalgam,” Edelstein said. There is no reason at this
point to be concerned about the health effects of amalgam, or the
stainless steel crowns that are sometimes placed on top of a tooth with a
cavity, he added.

The study included 543 children between the ages of 6 and 10 who
received two or more fillings in their back teeth made of amalgam or a
composite based on either bisGMA or urethane. The data were part of a New
England-based study that was designed to look at the long-term effects of
amalgam fillings on psychological scores and kidney function.

Children who had the most bisGMA-based fillings were more likely four
or five years later to score poorly on tests that asked the children and
their parents questions like whether they had trouble making friends or
felt anxious or depressed.

Overall, the researchers found that 16 percent of the children in the
top third for their number of bisGMA-based fillings were at risk for
having a behavior problem, based on a combination of children’s
self-reports and parents’ descriptions, compared with only 6 percent of
children in the bottom two-thirds.

But no difference existed in emotional problems when looking at
children who had more vs. fewer amalgam or urethane-based composite
fillings.

“This study is a call for more research,” said Dr. Mary Hayes, a
pediatric dentist in Chicago and a spokeswoman for the American Dental
Association.

Hayes chooses between composite fillings or amalgams depending on the
tooth and where it is in the mouth and if parents want a white-colored
composite filling for their children instead of a silver filling. “Most
composites that I am aware of have BPA,” she said.

Study author Maserejian said, “We are really not sure if BPA or another
material released from the resin could be causing these effects.” She and
her colleagues are currently measuring BPA levels in children’s
systems.

Children could be exposed to materials in their fillings both when the
dentist applies them and over time, because the fillings wear down and
release chemicals that children swallow, Columbia’s Edelstein said.

“If you’ve got to have a filling, you’re better to go with one that
does not have BPA, but that is not a panacea,” Edelstein said. Parents can
also reduce exposure by making sure their dentist takes standard steps,
like vacuuming around the tooth after applying the filling, he added.

“The only real solution is to realize that no material is better than
the material that Mother Nature gave us and to do a better job of [cavity]
prevention,” Edelstein said.

Parents can help prevent cavities by helping their children brush their
teeth, giving them water instead of sugary drinks and visiting the dentist
twice a year.

If your child does have a cavity, “talk to the dentist about where the
cavity came from and how to prevent the next one,” Edelstein said. “This
study was clear that [higher] doses of fillings were associated with a
health impact.”

The study also made it explicitly clear that you should not have your
amalgam fillings replaced with composites, which some dental practices
will do, Edelstein said. “If you’ve got a sound filling, leave it in
place.”

While the study found an association between materials in fillings and
behavior, it did not prove a cause-and-effect relationship.

More information

You can learn more about preventing cavities in children by visiting
the American Academy of Pediatric Dentistry.

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