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Dental fillings linked to kids' behavior problems
July 16th, 2012
12:01 AM ET

Dental fillings linked to kids' behavior problems

Tooth decay is the most common chronic disease in the U.S. for kids. In fact, more than half of elementary school students will have cavities by the time they're in second grade, according to the National Institutes of Health. 

Since the 1970s, dentists have been using tooth-colored fillings that contain derivatives of the controversial chemical bisphenol A (BPA), in favor of the metal amalgam fillings.

Now a new analysis on dental fillings in children suggests these non-metal fillings may contribute to behavioral problems.  The study authors caution that their results only point to an association; they say their analysis does not prove that BPA causes any behavior changes.

Researchers looked at data from a previous study called The New England Children's Amalgam Trial, which was designed to examine the overall health effects of metal fillings in children, but also included children with composite or tooth-colored fillings. This study in particular was analyzed because it's really the only one looking at dental composites and behavioral problems, according to lead author Nancy N. Maserejian.

The scientists found that young people who got tooth-colored fillings made with BPA derivatives reported higher rates of anxiety, depression and social stress, compared to children whose fillings were made with metals or other materials. The more fillings a child had, the greater the incidence of behavioral problems, according to the data.

But the researchers are quick to point out that the levels of BPA were not measured in more than 400 children who participated in the study.

"There is a strong suggestion that the associations may be causal, but we can't be certain," says Maserejian, an epidemiologist with the New England Research Institutes. "More research is needed."

BPA is an industrial chemical that's been used in hard plastic products and in the linings of metal and aluminum cans since the 1960s.  Concerns about the effects of this chemical were raised as recently as 2008. That's when a report released by the  National Toxicology Program expressed “some concern for effects on the brain, behavior, and prostate gland in fetuses, infants, and children at current human exposures to bisphenol A.”

BPA has come under scrutiny for possible associations with a variety of health problems including developmental problems in young children and heart disease in adults.

This chemical is an endocrine disruptor, which means it interferes with how hormones work in the body.

In 2010 the U.S. Food and Drug Administration expressed the same concerns as the 2008 report.  Earlier this year, the FDA decided not to ban BPA in products made in the United States, cautioning that this announcement was not a final determination.  The FDA says it continues to support research examining the safety of BPA.

Experts speculate that dental patients may be exposed to BPA in two ways - when cavities are filled and various chemicals interact with our saliva, and/or over time as it leaches out due to wear and tear. 

When asked about the safety concerns due to BPA raised in this study, Michele Mummert, a spokesperson for Dentsply (a manufacturer of dental cavity composites) said: "Dental composites are one of several safe and effective options to treat tooth decay," and referred CNN to the American Dental Association's website for more information about dental treatment option.

Dr. Joel Berg is the president of the American Academy of Pediatric Dentistry. He supports the use of tooth-colored fillings because he says he knows they help children with cavities.

"Both amalgams and composites [tooth-colored fillings] are safe materials. They are both effective, they have been shown to be effective for years and years," explains Berg. "This is one study that has an early finding in the context of a larger group of studies looking at BPA, in a wide variety of materials where it's much more prevalent than in dental materials."

He also points out that the chemicals used in fillings are constantly improving and that what was used during the time of the original study (1997 to 2005) may be less safe than what we have today.

Frederick vom Saal, a biologist at the University of Missouri and a well-known critic of BPA, sees it differently. "This study provides evidence that the use of BPA-based composites should be re-evaluated."

Despite the lack of agreement on the safety of BPA, neglecting to treat cavities is dangerous and can lead to serious health issues for children, particularly from untreated infections.  Which is why Berg says getting children in the habit of brushing and taking care of their teeth is essential.

"Preventing cavities is the message I like to get out to children and parents," says Berg. 

He urges parents to discuss any concerns about their child's filling with the pediatric dentist.


soundoff (194 Responses)
  1. Road Runner Sports Coupon codes

    To author, you did a great job writing this!

    April 10, 2013 at 00:20 | Report abuse | Reply
  2. Tony

    Many people here have commented that there is no causal relationship because it could be poor diet that caused these bad behaviors. Also, certain drugs can lead to dry mouth which causes bad things to happen to teeth. I'm not sure if children this young might be on such medications, but if they have mental health issues that are not being properly corrected by medications which, however, *do* cause dry mouth, we have another possible reason why these kids have bad psychosocial results: because they have mental health issues in the first place.

    But there are people who will defend against these assertions because this study compared so-called BPA fillings to metal ones, and the BPA group had worse scores. But what were the percentages. In one category, the BPA to metal score for bad results was something like 16 to 10. In another it was 13 to 5. So BPA had higher percentages each time. But if 16 and 13 are going to be considered statistically significantly, tell me why the ten percent of amalgam recipients who scored bad *is not* statistically significant? Don't give me any convoluted, pretentious primer on statistics. If 13 % is a high number, then so should 10 percent be a high number. You can't have it both ways. This is just a hit piece on the current boogeyman: BPA. Ten years ago, these same so-called scientists would be bleating about how they've found some kind of link between the mercury in fillings and brain cancer.

    August 31, 2013 at 23:37 | Report abuse | Reply
    • Tony

      I'd also be very curious to see the results if 1,000 random kids were chosen and given this questionnaire. I'm pretty sure there would be at least 10 to 15 percent of kids scoring low on them. 450 is a low sample size. Also, next time, maybe these dummies should have collected blood and urine samples BEFORE and AFTER the fillings were placed, not to mention asking the same questions before the fillings were placed.

      August 31, 2013 at 23:40 | Report abuse |
  3. Tony

    I've just found some data regarding this flawed, useless study. There were 231 children who had 0 composite surfaces (or surface-years, however they called it). Of these 231,over 10 percent exhibited problem behaviors. The percentages of problem behaviors was LOWER for those with up to 5 surfaces and up to 13 surfaces. Interesting how this was not mentioned in the articles and even from the so-called researchers. Of the 48 or so children with more than 13 surfaces, over 16% had problem behaviors.

    If we reverse the groups and change the chart around, instead of showing 231 kids with no composite surfaces (just over 10%), we'd have 152 kids with no amalgam surfaces. And the total percentage of kids who have no amalgam surfaces (but have composites) who experience bad behaviors is 9.8%.

    Interesting. So maybe all the noise about how this really isn't due to bad diet and bad hygiene causing the issues is unfair after all. I'm curious to know, also, what is the most number of amalgams put into any kids' mouths. We know, from the stats, that the highest number for composites is greater than 13. How many amalgams were put into anyone's mouth. Even if there were fifty amalgams put into any kid's mouth, I've prved above that this study is garbage but I also doubt that any parent would agree to have her child full of ugly, silver fillings in every molar in the back of his mouth.

    This study doesn't fool me. I wish more people were less gullible. Composites are safe. Amalgams are safe. BPA is safe. The only thing that isn't safe are research scientists who are desperate for more grant money to discover what else might cause us harm.

    September 4, 2013 at 22:18 | Report abuse | Reply
  4. Tony

    I just want to make sure that my above point is clear. The stats that these so-called researchers have compiled have put ALL kids who received amalgam into one group for statistical measurement. Then they took the group with the MOST composites and compared their percentage to ALL of the kids in the amalgam group, whether they had just one filling or fifteen. Talk about skewed numbers. So, we are told that 16% of kids with composites (really the kids with the MOST filings) exhibited problem behaviors while "only" ten percent of those with no composite surfaces had issues. That's misleading. As I've said, ALL kids with composites had the same exact percentage of problem behaviors. In fact, the number was LESS.

    These researchers should be ashamed of themselves.

    September 4, 2013 at 22:29 | Report abuse | Reply
  5. Rachel Griffith

    A very interesting article on the link between dental fillings and kids' behavior. You can find out more at http://www.kidschoicedental.com/

    July 18, 2014 at 08:17 | Report abuse | Reply
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