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Dental materials — what is really in our mouths?

Sources: 13 · Article: 15 358 characters

Igor Dogocki points out that ingredients in dental resins can be released into the mouth, and studies described by the author found that HEMA, TEGDMA, and BisGMA were absorbed in animals.

  • Mercury was listed in amalgams, and cadmium in materials used to fill root canal-treated teeth.
  • The presence of metal does not automatically mean there is a problem; existing fillings, crowns, bridges, and implants can be assessed before treatment, and items are not removed without a clinical reason just because they contain metal.
  • Among the metal-free options, the author lists ceramic implants and crowns.

What the authors write

Igor Dogocki

The mouth may contain old amalgam fillings, crowns, bridges, inlays, prosthetic components, and titanium implants.

„For years, many people have had various metal materials in their mouths: old amalgam fillings, crowns, bridges, inlays, prosthetic components, or titanium implants. They often come from different periods of treatment and may contain different metal alloys.”Wiele osób przez lata ma w jamie ustnej różne materiały metalowe: stare wypełnienia amalgamatowe, korony, mosty, wkłady, elementy protetyczne czy implanty tytanowe. Często pochodzą one z różnych okresów leczenia i mogą zawierać odmienne stopy metali.
Igor Dogocki

Metal components may contain different metal alloys.

„They often come from different periods of treatment and may contain different metal alloys. For most patients, this does not automatically mean there is a problem. Some people may, however, experience local reactions, sensitivity, an unpleasant metallic taste, irritation of the oral mucosa, or a confirmed allergy to certain alloy components.”Często pochodzą one z różnych okresów leczenia i mogą zawierać odmienne stopy metali. Dla większości pacjentów nie oznacza to automatycznie problemu. U części osób mogą jednak występować miejscowe reakcje, nadwrażliwość, nieprzyjemny metaliczny smak, podrażnienia błony śluzowej lub potwierdzona alergia na określone składniki stopów.
Igor Dogocki

Mercury was listed in amalgams, and cadmium in materials used to fill root canal-treated teeth.

„Exposure to dental metals: mercury from amalgam fillings Periodontitis and gingivitis – infection caused by specific bacteria Herpes simplex – cold sores on the lips, in the mouth, or around the face Root canal-treated teeth filled with materials containing a heavy metal – cadmium Virulent bacteria in the oral microbiome entering the bloodstream and causing inflammation in the body To prove the theory that Alzheimer’s disease is caused by neuroinflammation, scientists isolated tissue from human brains and tested it for the presence of specific bacterial strains.”Ekspozycja na metale stomatologiczne : rtęć z wypełnień amalgamatowych Zapalenie przyzębia i dziąseł – infekcja wywołana przez specyficzne bakterie Herpes simplex – opryszczka umiejscowiona na ustach, w jamie ustnej lub okolicach twarzy Leczone kanałowo zęby wypełnione materiałami zawierającymi metal ciężki – kadm Zjadliwe bakterie w mikrobiomie jamy ustnej, przedostające się do krwioobiegu i wywołujące stany zapalne w organizmie W celu udowodnienia tezy neurozapalnej przyczyny choroby Alzheimera naukowcy wyizolowali tkanki z ludzkich mózgów i przetestowali na obecność określonych szczepów bakterii.
Igor Dogocki

Resin-based materials can release ingredients into the oral environment.

„It has been found that every resin-based material (that is, most materials used today) releases several ingredients into the oral environment. In particular, the comonomer triethylene glycol dimethacrylate (TEGDMA) and the “hydrophilic” monomer 2-hydroxyethyl methacrylate (HEMA) leach from various composite resins and “bonding” materials (e.g.”Stwierdzono, że każdy materiał na bazie żywicy ( czyli większość teraz używanych) uwalnia kilka składników do środowiska jamy ustnej. W szczególności komonomer, dimetakrylan glikolu trietylenowego (TEGDMA) i monomer „hydrofilowy”, metakrylan 2-hydroksyetylu (HEMA), są wypłukiwane z różnych żywic kompozytowych i materiałów „sklejających” (np.
Igor Dogocki

The compounds released can enter the body, and studies described by the author found that HEMA, TEGDMA, and BisGMA were absorbed in animals.

„Animal studies showed that the (co)monomers hydroxyethyl methacrylate (HEMA), triethylene glycol dimethacrylate (TEGDMA), and bisphenol glycidyl methacrylate (BisGMA), released from dental materials and swallowed, are completely absorbed and broken down in the body into CO2.”Badania na zwierzętach wykazały, że (ko) monomery metakrylan hydroksyetylu (HEMA), glikol trietylenowy dimetakrylan (TEGDMA) i metakrylan glicydylu bisfenolu (BisGMA) uwalniane z materiałów stomatologicznych i połknięte są całkowicie wchłaniane i rozkładane w organizmie do CO2.
Igor Dogocki

The author lists reactions such as asthma, eczema, and lichenoid reactions following dental restorations, and identifies HEMA and TEGDMA as triggers.

„Over the past 10 years, a growing number of patients have reported increased symptoms of adverse reactions (e.g. lichenoid reactions, asthma, eczema) after dental restorations. The triggers of these reactions have now been clearly identified as the methacrylates HEMA and TEGDMA, which are widely used in dental materials.”W ciągu ostatnich 10 lat rosnąca liczba pacjentów wykazała zwiększone objawy działań niepożądanych (np. reakcja lichenoidalna, astma, wyprysk) po odbudowie zębów. Wyzwalacze takich reakcji zostały obecnie jednoznacznie zidentyfikowane jako metakrylany HEMA i TEGDMA, które są powszechnie stosowane w materiałach stomatologicznych.
Igor Dogocki

The author says that the presence of metal does not automatically mean there is a problem, although some people may experience local reactions or an allergy.

„For most patients, this does not automatically mean there is a problem. Some people may, however, experience local reactions, sensitivity, an unpleasant metallic taste, irritation of the oral mucosa, or a confirmed allergy to certain alloy components. That is why at Bio Clinic® we do not start from the assumption that “all metal must be removed.””Dla większości pacjentów nie oznacza to automatycznie problemu. U części osób mogą jednak występować miejscowe reakcje, nadwrażliwość, nieprzyjemny metaliczny smak, podrażnienia błony śluzowej lub potwierdzona alergia na określone składniki stopów. Dlatego w Bio Clinic® nie zaczynamy od założenia, że „każdy metal trzeba usunąć”.
Igor Dogocki

Symptoms in the mouth should not automatically be attributed to metals, as they can have various causes.

„Patients who come to us often mention: a metallic taste in the mouth, recurring irritation or redness of the oral mucosa, a burning sensation or discomfort in the mouth, skin reactions around the mouth, a confirmed allergy to nickel or other metals, the presence of many different metal alloys in the mouth, old amalgam fillings, a desire to switch to metal-free dentistry, a need to replace metal crowns, bridges, or implants with ceramic materials. These symptoms can have various causes, so they require proper assessment rather than being automatically attributed to the presence of metal.”Pacjenci zgłaszający się do nas często zwracają uwagę na: metaliczny smak w ustach, nawracające podrażnienia lub zaczerwienienia błony śluzowej, uczucie pieczenia lub dyskomfortu w jamie ustnej, reakcje skórne w okolicy ust, potwierdzoną alergię na nikiel lub inne metale, obecność wielu różnych stopów metali w jamie ustnej, stare wypełnienia amalgamatowe, chęć przejścia na stomatologię bezmetalową, potrzebę zastąpienia metalowych koron, mostów lub implantów materiałami ceramicznymi. Takie objawy mogą mieć różne przyczyny, dlatego wymagają właściwej oceny, a nie automatycznego przypisywania ich obecności metalu.
Igor Dogocki

Existing fillings, crowns, bridges, and implants can be assessed before treatment, and materials are not removed without a clinical reason just because they contain metal.

„Before starting treatment, we assess existing fillings, crowns, bridges, implants, and other components in the mouth. We do not remove materials without a clinical reason just because they contain metal.”Przed rozpoczęciem leczenia analizujemy istniejące wypełnienia, korony, mosty, implanty i inne elementy znajdujące się w jamie ustnej. Nie usuwamy materiałów bez wskazania tylko dlatego, że zawierają metal.
Igor Dogocki

Among the proposed metal-free options are ceramic implants and crowns.

„thorough and comprehensive diagnostics instead of a typical oral examination ceramic implants instead of titanium implants ceramic crowns instead of crowns with metal substructures composite materials for restoring teeth without plasticizers (including Bisphenol A).”dokładna i szeroka diagnostyka zamiast typowego przeglądu jamy ustnej implanty ceramiczne zamiast implantów tytanowych korony ceramiczne zamiast koron na podbudowach metalowych materiały kompozytowe do odbudowy zębów bez plastyfikatorów (m.in. Bisfenol A).

Research from PubMed · Europe PMC

We selected 5 studies with the best, positive results. This is a selection, not a full review of all research.

Total number of studies on this topic in PubMed: 55 630.

The review found that heating resin materials may improve their mechanical and physical properties, although clinical confirmation is lacking.

Aim of the study: To perform a review on the influence of preheating and/or heating of resinous and ionomeric materials on their physical and mechanical properties and to discuss the benefits and methods of preheating/heating that have been used.

Results: At the end of reading the search titles and abstracts, 74 articles were selected. Preheating of composite resins reduces viscosity, facilitates adaptation to cavity preparation walls, increases the degree of conversion, and decreases the polymerization shrinkage. Preheating of resin cements improves strength, adhesion, and degree of conversion. Dental adhesives showed good results such as higher bond strength to dentin. However, unlike resinous materials, ionomeric materials have an increase in viscosity upon heating. Preheating improves the mechanical and physical properties. However, there is a lack of clinical studies to confirm the advantages of preheating technique.

Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyreview of many studies

“Not stated” does not mean nobody paid — the database does not always record it.

The review found that immediate dentin sealing was associated with less postoperative sensitivity.

Aim of the study: The purpose of this systematic review and meta-analysis was to find and collect evidence on the clinical complication, success, and survival rates of indirect restorations delivered with immediate dentin sealing.

Results: A total of 11 studies were included in this review. The clinical complication rate was lower for immediately sealed dentin than for protocols without dentin sealing. The survival rate of restorations luted with the immediate dentin sealing protocol was higher (96.4% to 100%) than that of immediate dentin sealing (81.8% to 96.7%), negatively correlated with the observation time. The intensity and incidence of postoperative sensitivity were statistically significantly lower for restorations with immediate dentin sealing than for those without dentin sealing or conventionally cemented (P<.05). Immediate dentin-sealed indirect restorations had fewer clinical complications and higher success and survival rates than those delivered without dentin sealing. To avoid postoperative sensitivity or reduce its intensity, dentin surfaces should be sealed immediately after preparation. More long-term randomized clinical trials are recommended to confirm these evidence-based conclusions.

Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studycombined analysis of many studies (meta-analysis)

“Not stated” does not mean nobody paid — the database does not always record it.

In primary teeth with deep decay, calcium silicate cements used for pulpotomy had greater success than several other methods.

Aim of the study: Purpose: The purpose of this study was to present an evidence-based guideline for primary teeth with deep caries or trauma requiring vital pulp therapies (VPT). Methods: A systematic review/meta-analysis on vital primary teeth resulting from trauma or caries was conducted using GRADE to assess the certainty of evidence for clinical recommendations.

Results: For vital primary incisors with deep caries, pulpotomy was significantly better statistically than pulpectomy. Teeth diagnosed with/without reversible pulpitis pain showed comparable success after 12 months of treatment by IPT or calcium silicate cement pulpotomy. The following had little or no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; anterior or posterior teeth. Conclusions: Indirect pulp treatment or calcium silicate cement pulpotomy is likely to increase vital pulp therapy success over other VPTs such as direct pulp capping and other pulpotomies after 24 months (moderate certainty).

Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studycombined analysis of many studies (meta-analysis)

“Not stated” does not mean nobody paid — the database does not always record it.

After 15 years, glass-fiber posts showed a favorable survival trend, while root fractures occurred more often with metal posts.

Aim of the study: This randomized controlled trial compared the 15-year clinical success and survival rate of endodontically treated teeth restored with glass-fiber or metal posts.

Results: The mean follow-up time was 179.6 ± 7 months, and the recall rate was 91.6 %. Success rate was 48.0 % for metal posts, 59.2 % for prefabricated glass-fiber posts and 49.5 % for custom glass-fiber posts. Survival rate was 53.6 % for metal posts, 68.5 % for prefab glass-fiber posts and 55.3 % for custom glass-fiber posts. No statistically significant effect of post material was observed. There was, however, a trend towards better success/survival for teeth with prefabricated glass-fiber posts. Teeth with metal posts failed more frequently due to root fracture than teeth with glass-fiber posts. There was a trend towards better clinical success and survival rate for teeth restored with glass-fiber posts, even though post material had no statistically significant effect on the clinical outcome.

Money for the studyuniversity or foundation · KU Leuven
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studystudy with random allocation to groups (RCT)
Participants131

“Not stated” does not mean nobody paid — the database does not always record it.

The review indicates that gold, silver, and palladium alloys showed the best biocompatibility and antibacterial properties and limited biofilm accumulation.

Aim of the study: Introduction: One of the fundamental principles of modern medicine, including dentistry, is prevention. However, if treatment is not initiated, tooth loss can occur, necessitating the use of dental prostheses to restore the function and aesthetics of the stomatognathic system.

Results: In contrast, base metal alloys (cobalt-chromium and nickel-chromium) are highly susceptible to biocorrosion in acidic environments, which can encourage the growth of bacteria that cause tooth decay and inflammation, potentially exacerbating oral dysbiosis. Conclusions: The selection of materials plays a critical role in maintaining oral microbial homeostasis and preventing plaque-related diseases. High-noble alloys and titanium are more biocompatible than base metal alloys. However, further long-term clinical trials and multi-species biofilm models are needed to fully understand these interactions between materials and microbes.

Money for the studyuniversity or foundation · Gdańsk Medical University
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studydiscussion of other studies

“Not stated” does not mean nobody paid — the database does not always record it.

Perspectives and opinion materials

The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.

Orthomolecular Medicine News Service Opinion material
„Without exception, seriously ill patients, often with such diseases as Parkinson's, ALS, Alzheimer's, MS, and atherosclerosis, almost always had extensive dental toxicity in the form of root canal-treated teeth, infected dental implants, mercury amalgams, extensive cavitational osteonecrosis, and/or advanced periodontal disease.”Without exception, seriously ill patients, often with such diseases as Parkinson's, ALS, Alzheimer's, MS, and atherosclerosis, almost always had extensive dental toxicity in the form of root canal-treated teeth, infected dental implants, mercury amalgams, extensive cavitational osteonecrosis, and/or advanced periodontal disease.
Orthomolecular Medicine News Service Opinion material
„[37] Any excess of hydrogen peroxide in the oral cavity and oropharynx would therefore be detoxified by these enzymes in saliva. Accidental swallowing of 3% hydrogen peroxide, however, is known to cause gastric irritation in some individuals. In the two-year period of study of hydrogen peroxide use to prevent COVID-19, our attention has not been drawn to any such deleterious effect in those using the hydrogen peroxide solution.”[37] Any excess of hydrogen peroxide in the oral cavity and oropharynx would therefore be detoxified by these enzymes in saliva. Accidental swallowing of 3% hydrogen peroxide, however, is known to cause gastric irritation in some individuals. In the two-year period of study of hydrogen peroxide use to prevent COVID-19, our attention has not been drawn to any such deleterious effect in those using the hydrogen peroxide solution.
Orthomolecular Medicine News Service Opinion material
„Too often, dental checkups focus on the visible aspects of oral hygiene—plaque removal, teeth cleaning, and cavity checks—while overlooking the much deeper issue of hidden oral infections. These infections can be silent and asymptomatic, making them easy to miss in routine dental visits.”Too often, dental checkups focus on the visible aspects of oral hygiene-plaque removal, teeth cleaning, and cavity checks-while overlooking the much deeper issue of hidden oral infections. These infections can be silent and asymptomatic, making them easy to miss in routine dental visits.

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