Dental amalgam: few proven harmful effects but many ongoing concerns.

(1) Dental amalgam is one of the main sources of exposure to mercury in industrialised countries; (2) At high doses, mercury is both neurotoxic and nephrotoxic. A suspected link exists between chronic exposure to low doses of mercury derived from dental amalgam and renal, neurodegenerative or neurobehavioural disorders, but it has not been established; (3) Some individual cases are troubling, but epidemiological studies show no major effects in the general population. Various hypotheses have been proposed to explain why some people may be more sensitive than others to the effects of low-dose mercury; (4) More and more countries, especially Sweden, recommend that the use of amalgam should be restricted, particularly in pregnant women and children; (5) As part of a global strategy to eliminate mercury, the European Parliament has asked the Commission to draft legislation limiting the use of mercury in dental amalgam; (6) Evaluation of the risk-benefit balances of alternatives to dental amalgam does not provide sufficient data on which to base an informed choice between available options.