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Dental Resins linked to mental dysfunction in children

Robin Wulffson MD's picture
dental resins, amalgam, mental dysfunction, pediatric dentistry. BPA

Dental resins are substances used to restore damaged teeth back to almost their original appearance. Amalgam is a substance that can fill cavities and defects in teeth; however, the metallic substance lacks a normal appearance.

Nancy N. Maserejian, ScD, an epidemiologist from the New England Research Institutes in Watertown, Massachusetts, and colleagues noted that the New England Children’s Amalgam Trial found that children randomized to receive amalgam had better psychosocial outcomes than those assigned to resins for posterior tooth (back teeth) restorations. Therefore, they designed a study to examine whether greater exposure to dental composites is associated with psychosocial problems in children.

They published the results of their study online on July 16 in the journal Pediatrics as well as in the August print edition.

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The researcher noted that resin-based dental materials may release their chemical components and bisphenol A (BPA) into the mouth. Many commercial products contain this compound, and previous research has implicated it in neurological damage, particularly in children. They analyzed treatment-level data from the New England Children’s Amalgam Trial, which was a 2-group randomized safety trial comparing amalgam with the treatment plan of bisphenol A-glycidyl methacrylate (bisGMA)-based composite and urethane dimethacrylate–based polyacid-modified composite (compomer). The reviewed data from 534 children aged 6 to 10 years at baseline. Psychosocial function at follow-up (434 children) was measured by using the self-reported Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL).

The study authors found that children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on three of four BASC-SR global scales: Emotional Symptoms, Clinical Maladjustment, and Personal Adjustment. Associations were stronger with posterior-occlusal (chewing) surfaces where degradation of composite was more likely. At-risk or clinically significant scores were more common among children with greater bisGMA-based composite exposure for CBCL Total Problem Behaviors (16.3% vs. 11.2%) and numerous BASC-SR syndromes (i.e., Interpersonal Relations 13.7% vs. 4.8%). No associations were found with either compomer or with amalgam exposure levels among children randomized to amalgam.

The authors concluded that increased exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function in children; however, no adverse psychosocial outcomes were observed with greater urethane dimethacrylate–based compomer or amalgam treatment levels. They note that further research is indicated before a final decision can be made as to whether these substances are harmful.

Take home message:

While the final verdict is not out, this study notes that resins that have excellent cosmetic results may be detrimental to a child’s health. Furthermore, the behavioral problems manifesting in the children may lead to further mental impairment in adulthood. Thus, it would be prudent to using the aforementioned resins for teeth restoration in children. These substances might be less hazardous on the front teeth (incisors and canines) where appearance is more important. Children without cavities have no need of resins or amalgam. Discuss oral hygiene and preventive care with your dentist. Most are anxious to discuss preventive measures to prevent cavity formation.

Reference: Pediatrics

See also:
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Six tips to keep your kid's teeth healthy
Ultrasonic toothbrush might revolutionize dental hygiene