“A patient approached me today regarding an article she read in the local newspaper about mercury fillings. Since this is a topical (pardon the pun) subject, how would you suggest I answer?”

Recently it was reported that a federally funded study concluded that dental fillings containing mercury-laden amalgam were unsafe. However, a joint panel of Food and Drug Administration health advisors rejected the findings of this report by a 13 to 7 vote after reviewing 34 recent research studies contained in the federal report. The advisors said that the federal report didn't clearly and objectively present the current state of knowledge about the "silver" fillings. In addition the panel stated that the report's conclusion about safety weren't reasonable, given the quality and quantity of information available. The panelists recommended further study regarding the mercury-based fillings, with emphasis on risk groups such as young children and pregnant women. And so the beat goes on.

The fate regarding the safety of mercury-based amalgam continues, and the debate of these fillings will too. In the meantime there are millions of patients whose mouths are full of “silver” fillings. What is a dentist to do?

Practicing dentists have differing opinions about how mercury based silver fillings affect one’s health and well-being. No matter what side of the track you are on regarding the safety issues of these fillings, you most likely will come across patients with questions. This article is intended not to sway anyone to one side of thinking; rather, it is designed to help the dentist and staff handle these questions or concerns should they come up.

Research and find the facts

Take the time to find pertinent information from reputable sources regarding your position on the matter. Assemble this information in a way that is easy to disseminate to people who may have questions about amalgam. Make legible copies or request reprints from periodicals, newsletters, or internet sites that provide the information.

Educate the team!

In order to make sure that everyone in the practice is on the same page, spend time discussing the issue with the relevant facts. Be open to questions from the team and create an environment that allows people to discuss the topic freely. Make certain that any questions regarding the topic are answered with fact based material, not opinions.

Objective vs. Subjective

Be aware that some may not have the same belief about amalgam restorations. In this case, if the beliefs of a team member don’t mirror that of the doctor, I’d recommend providing the team member enough time to research the subject and allow the person to arrive at an objective conclusion based on the facts, rather than a subjective opinion. If the person’s stance still varies from the doctor’s, then request the team member defer all answers to the doctor and not provide an opinion on the matter.

If there is a team member that has strong convictions and aren’t able to follow these simple instructions, ask the team member to leave the practice and find an office that agrees with his/her philosophy.

Inform before you perform!

One of the most frustrating experiences a patient has is when something happens by surprise. In other aspects of the dental office, “…wow, I didn’t know it would be that much!” happens when we don’t make specific financial arrangements with the patient prior to treatment. In the case relating to restoration materials, make sure the patient is aware of the material used in the restoration prior to starting treatment. That way there won’t be any surprises. Try something like, “Mrs. Smith, we’ll use {name of material of choice} to restore your tooth. In our (doctor, staff) experience, this has served our patients very well.”

If a question arises regarding restoration material, then you’ll have information handy to explain why the practice has selected the material of choice. Further, the entire team will present a united front regarding the issue. Without this approach, patients may become confused as to what may be best for them and won’t be reassured they are receiving the best care.

It is important to be aware that people are receiving information in the public circle and are going to have questions. They may or may not ask them openly in the dental office. When they do, it’s important to be prepared to provide an answer that is consistent across the board – from the doctor to the dental assistant to the hygienist to the front office coordinator. Backing up your position with material from reputable sources makes your position that much more respectable to patients.

The trust and confidence you have with patients goes back to how well you communicate with them. It carries even further when good factual information comes alongside. Be proactive in your approach to this customer/patient relations issue and other sensitive issues to retain patients’ trust.