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State Legislatures Pass Bills Placing Restrictions or Warnings on Use of Amalgam Dental Fillings- More States Plan to Consider Bills in the Next Legislative Session

The California Legislature passed a bill, SB134, to implement Proposition 65

which was passed earlier and requires all dentists who use amalgam dental fillings

to issue the following warning:"This office uses amalgam filling materials which contain and expose you to a chemical known to the State of California to cause birth defects and other reproductive harm". (mercury)

Governor Davis signed S.B. 134 yesterday (Oct. 5). Thus, on Dec. 31, 2001, the California Dental Board ceases to exist. The existing Dental Board was abolished due to its refusal over several years to carry out the provisions of Prop 65 regarding the issuance of a warning by dentists of the dangers of mercury. A brand new Board will be appointed. The law also requires that the Fact Sheet must be given to the patient; the dentist has a duty to ensure patients read it before placing any toxins into their mouths. Finally, the Board executive director must be approved by Director Hamilton of the Dept of Consumers Affairs, a step to ensure more consumer accountability.

The Maine Legislature passed a bill this year, LD1409, placing restrictions on amalgam

use by requiring a warning regarding possible mercury related adverse health effects

be given to all patients if amalgam use is considered. They also passed LD 697, "An Act to Require Installation of Dental Amalgam Separators in Dental Offices" in 2003. The Florida Legislature passed a bill, SB1324, removing restrictions on the replacement of amalgam fillings by alternatives and encouraging discussion of pros and cons of alternative treatments. Bills are being prepared for consideration in the next session in the majority of states.

The New Hampshire Legislature passed one of the strongest bills so far, HB 1251 AN ACT relative to the use of mercury amalgam fillings by dentists. This bill requires dentists and the department of health and human services to provide health information on restorative dental materials, and requires the department of environmental services to adopt rules for the disposal of mercury amalgam waste in dental offices in an environmentally-appropriate manner.

Rhode Island's Mercury Reduction and Education Act( S661Aaa) which passed in 2001 contained this language in the state procurement section: "(c) State dental insurance contracts negotiated after January 1, 2003, shall provide equal coverage for non-mercury fillings at no additional expense to the state employee."

Rhode Island also requires amalgam separators in dental offices.

Current Legislation



HB 2647 would prohibit the use of mercury amalgam fillings in certain situations, including children under 18, nursing mothers or pregnant women. In addition, dentists would need to provide information to their patients on the advantages and disadvantages of mercury fillings. Assigned to Human Services Committee and Rules Committee.


HB 495. This bill would prohibit the use of a device that is a mercury alloy intended for use as a dental amalgam if the device contains approximately 50 percent mercury on children less than 18 years of age, pregnant women, or lactating women. The bill would provide that the device could not be administered to any consumer without a warning that the product contains mercury. Assigned to the Health Committee.

AB 611 would require the installation of dental amalgam separators by January 1, 2004, along with training of staff in each office to maintain the equipment. Referred to Committee on Health and to Committee on Environmental Safety & Toxic Materials, where it was amended, to eliminate the requirement for amalgam separators and instead require Best Management Practices (BMP). It was recommended for adoption and referred to Appropriations.


AB 999 would require dental insurers to provide insurance for alternatives to mercury amalgam fillings. Referred to Committee on Health, where it was amended, recommended for adoption and referred to Appropriations.



HB 442 would prohibit the use of mercury amalgam fillings in women younger than 45 years old and men younger than 18 and require that dentists provide patients information on the use of amalgam fillings. Had a second reading on February 26, 2003. In the Committee on Health and Human Services.


SB 455 would prohibit the use of mercury amalgams in dental procedures for pregnant women and for children under 8 years in age. Re-referred to the Rules Committee on March 14, 2003.



LD 134 would require that by January 1, 2004 the Department of Environmental Protection shall establish rules for dental offices and other places where mercury amalgam fillings are prepared, used, removed, replaced or repaired relative to the use of environmentally appropriate disposal equipment for amalgam waste to trap and dispose of mercury.


New York

A05932 Enacts The Mercury-Free Water Resources and Mercury Reduction Management Strategy Act of 2003 provides for: disclosure of mercury content, phase-out of mercury-added products, disposal prohibition, labeling, source separation, collection, requirements for sewage treatment plants, point source release containment traps, ban on sale or distribution of certain mercury products, replacement of manometers and gas pressure regulators (agriculture dept. to handle for dairy industry), regulates dental use and bans health insurance discrimination therein, requires lamp recycling; adds all mercury-added products to state universal waste rules; provides for a state advisory committee on mercury pollution; provides for penalties for violations. Referred to Environmental Conservation


SB 681 Requires written informed consent prior to procedure or treatment that uses dental materials containing mercury. Prohibits use of dental materials containing mercury in women of child-bearing age or in children. Prohibits use of dental materials containing mercury in people with metal orthodontic devices in their mouths. Prohibits use of dental materials containing mercury after July 1, 2007. Referred to Human Resources Committee.

SB 695 directs the Department of Human Services to conduct a study of mercury amalgam fillings in human teeth and environmental sources of mercury ingestion. Directs Oregon Health and Science University to assist department in conducting study. Referred to Human Resources Committee, then to Way and Means Committee.



The Governor of Oregon has recently signed into law SB 704, which requires dentist to have amalgam separator installed in wastewater drain if materials containing mercury pass through drain. Establishes requirements regarding proof of installation and maintaining amalgam separator maintenance log. Exempts from specified requirements, until January 1, 2011, dentist who follows guidelines for best management of dental wastes recommended by Oregon Dental Association and who is certified by special district that manages wastewater treatment as following guidelines. It has been signed into law as Chapter 517, 2007 Laws.



HB 1235, SB 5403 and substitute SB 5403 provide for state supplemental operating appropriations and include a provision for the Department of Ecology to develop plans for the reduction in the use of mercury and its discharge to the environment. Dental amalgam is the largest source of mercury in sewers and a major source in the environment. The House bill is in Appropriations, while the Senate substitute has passed the Senate 29-20.


HB 1273 would require informed consent prior to using mercury amalgam dental restorative material. Introduced on January 22, 2003, in Health Care. Also see SB 5066.


SB 5066 is similar to HB 1273 and would require informed consent prior to using mercury amalgam dental restorative material. Introduced on January 14, 2003; referred to Health & Long-Term Care.

****************************Details:CaliforniaSB-134 AUTHORED BY SEN. LIZ FIGUEROA, to DE-FUND THE CALIFORNIA DENTALBOARD. This bill will de-fund the state dental board and transfer responsibilities for dental regulation to Dept of Consumer Affairs for 6 months, and then re-create the Dental Board effective January 1, 2002, with an enforcement monitor to assure the Board Is acting in theconsumer interest.BACKGROUND:For the last nine years, the California Dental Board has refused toimplement the 1992 law passed by the California Legislature implementingProposition 65, which requires a "fact sheet" on the risks of dentalamalgam fillings (which are half mercury ) . The law requires thatdentists warn that:"This office uses amalgam filling materials which contain and expose youto a chemical known to the State of California to cause birth defectsand other reproductive harm". (mercury)The effort to have the law implemented has been lead by Consumers for Dental Choice

and DAMS. The Dental Board has again broken its promise to the legislature's Sunset Committee to complete the Fact Sheet by the end of this fiscal year (June 30, 2001). As

the last straw, the Dental Board abruptly canceled its June 14th meeting in L.A., where

it had promised hundreds of concerned consumers that it would finally, after 9 years

of stalling, provide the required fact sheet. This is what led to SB134.Amalgam, which many dentists call "silver fillings" contains 50% mercury which is

known to be the most toxic non-radioactive element. Mercury is documented to be toxic

to the nervous system, the immune system, the reproductive system, and the hormonal

system. Some amalgam manufacturers and regulatory agencies in Canada and Europe

advise all pregnant women, children, people with kidney problems, or with braces orother metalwork in the mouth to avoid Mercury- Amalgam dental fillings. Most dentists

have not heeded these warnings or passed them on to patients, even though there is

evidence that amalgam fillings are the biggest source of mercury in most with amalgam

fillings, cause significant adverse health effects to many, are classified as beinghazardous waste when removed from the mouth, and are a significant source of mercury

in home and city sewers as well as in fish and wildlife throughout the U.S. Over 7% of

all U.S. river miles as well as many lakes that sewers empty into have warnings to limit

fish consumption due to mercury levels. (for documentation on exposure, health effects,

and environmental effects from amalgam fillings see:******************************************************************************MaineMaine Governor Angus King had the distinction of signing the first bill in the U. S.

passed by a Legislature that requires dentists to notify their patients regarding the use of amalgam fillings. California has a similar provision which was passed by voters as Proposition 65. After July 1, 2002, dentists in Maine will be required to display a poster

in the public waiting area of the dental office and must provide each patient a copy of a

brochure that explains the potential advantages and disadvantages to oral health, overall

human health and the environment of using mercury or mercury amalgam in dental

procedures. The Director of the Bureau of Health, together with the Department of the Environmental Protection will develop the poster and brochure. The Mercury Pollution Prevention Committee has the job of developing a strategy to reduce mercury in the

environment from industrial sources, including dental offices and home sewers.

Documentation of the significant levels of mercury contributed to waterways by dentaloffices, homes, and businesses related to amalgam fillings can be found fought long and hard for the passage of Bill LD 1409, and while the bill as

passed is not as strong as desired they still considered this a major triumph for the citizens

of Maine. They indicate that stronger measures including limits on amalgam use will bepursued again in future sessions.**************************************************************************FloridaThe Florida Legislature passed SB1324 this year dealing with consumer and consumer

right to know issues related to dental and medical treatment. In the past, dentists have

been strongly discouraged from replacing amalgam fillings with alternatives by the ADA

and the State Dental Board as well as from openly discussing possible adverse healtheffects from amalgam or pros and cons of amalgam versus alternatives.SB 1324 allows dentists to replace amalgam fillings due to concerns over mercury toxicity

and health concerns, and encourages discussion of the pros and cons of alternative treatments.Measures similar to A.4209 are being considered in Connecticut, Maine, Florida,

Maryland, Massachusetts, Maine, Nebraska, New Hampshire, New Jersey, Oregon

and Rhode Island, and indeed, the bill is modeled on a law Vermont passed in 1998.

Federal agencies and the National Academy of Sciences have a priority to reduce

mercury in people and the environment due to high levels of mercury being found

in fish throughout the U.S. and in tests on women of child bearing age by the

U.S. Centers for Disease Control. Since many consumer and environmental groups

are also concerned and actively support the bills, this likely means that the issue

of regulating mercury will be on the front burner of dentistry's legislative agenda

as for other sources of mercury in people and the environment.*****************************************************Technical Contact: Bernie Windham 850-878-9024Local Contact:Documentation with over 2500 medical study references on exposure levelsand adverse health effects of mercury from amalgam fillings, as well as 60,000 clinical cases documented by doctors of recovery from over 30chronic conditions after amalgam replacement can be found at