"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 materi
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