Commonly used dental sealants and restorative resins contain substances that break down into the controversial chemical BPA, but dentists can use the product safely on children if they take care to wipe or rinse off the residue after treatment, a new study finds. Pregnant women, however, would be better off waiting until after delivery.
The benefits of sealants in preventing children’s tooth decay outweighed the risks associated with bisphenol A, or BPA, the chemical linked to a range of health problems and banned by many plastic bottle makers, researchers find in the report published in the latest issue of the journal Pediatrics. .
“People shouldn’t be afraid of this,” said Dr. Burton Edelstein, chair of social and behavioral sciences at Columbia University College of Dentistry and co-author of the study. “The size of the exposure is extremely low. And the layer containing BPA can be wiped with a cotton swab or rinsed with a stream of water which can then be aspirated by the dentist.”
Poll: Should dentists tell parents that dental sealants contain BPA?
BPA caused alarm after several studies linked the chemical to health problems, prompting many manufacturers of plastic bottles, particularly those used by children, to change their formulations to exclude the substance. In January, Federal Food and Drug Administration officials called for more research into the chemical, explaining that the agency had “some concern about the potential effects of BPA on the brain, behavior, and prostate glands of fetuses, infants, and children ».
The team of toxicologists and dentists who reviewed the scientific literature on the report concluded that the benefit of ensuring children’s teeth are protected from tooth decay outweighed the risk of brief exposure to BPA. In the US, depending on age, between 20 percent and 40 percent of children were treated with fillings between 1999 and 2004, and the rate is likely higher now because of aggressive efforts to improve dental hygiene.
Caution for pregnant women
But the article also warned that pregnant women should wait whenever possible for dental procedures involving BPA-related resins until after their babies are born.
“If the woman is in serious need of dental work during pregnancy, she should go ahead and have her teeth fixed,” said Dr. Philip J. Landrigan, study co-author and director of the Center for Children’s Environmental Health at Mount Sinai. School of Medicine and. “If it’s something she can wait, in the spirit of precaution, we would encourage the woman to wait until her baby is born.”
BPA derivatives are increasingly used in dental resins and sealants, which have gained popularity since the mid-1960s, the report notes. They are used for all dental patients, but children, pregnant women and their developing babies are particularly sensitive to the effects of the chemicals.
Edelstein and other dentists interviewed by msnbc.com argued that there are ways to protect even pregnant women from BPA, including using rubber “barriers” that isolate the tooth being repaired from the rest of the mouth. BPA is only released when certain chemicals in the resins come into contact with saliva, he said.
“Honestly, I think the article goes a little beyond the current level of evidence for pregnant women,” said Dr. Jim Krall, professor of pediatric dentistry at the University of California, Los Angeles. “And it’s maybe a bit too much. The science around it is still pretty sketchy in terms of dental exposure.”
Both dentists said they are concerned that women will get the wrong message from the article and skip dental care altogether. Edelstein emphasized the importance of dental hygiene and the potential health impact of untreated gingivitis on the developing fetus.
Critics urge avoidance of BPA
Some toxicologists, however, suggested that the article’s recommendations did not go far enough. Fred von Saal, a leading expert on BPA, believes that children should only receive sealants if they have a clear tendency to develop cavities.
“This chemical is one that should not be exposed to at any level,” said von Saal, a professor of biology at the University of Missouri in Columbia. “There are many sources of BPA, and you want to avoid anything that puts a strain on your body. And the younger you are, the more sensitive you are to this chemical.”
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National surveys conducted by the federal Centers for Disease Control and Prevention have revealed measurable levels of BPA metabolites in the urine of more than 95 percent of US residents, even though the compound has a short half-life and must be quickly eliminated from the body. This indicates that people are repeatedly and frequently exposed to BPA, experts say.
The solution, Von Saal and others said, is for resin manufacturers to find a dental product that doesn’t lead to BPA exposure.
