Bisphenol A and Related Compounds in Dental Materials

CONTEXT: Dental sealants and composite filling materials containing bisphenol A (BPA) derivatives are increasingly used in childhood dentistry. Evidence is accumulating that BPA and some BPA derivatives can pose health risks attributable to their endocrine-disrupting, estrogenic properties. OBJECTIVES: To systematically compile and critically evaluate the literature characterizing BPA content of dental materials; to assess BPA exposures from dental materials and potential health risks; and to develop evidence-based guidance for reducing BPA exposures while promoting oral health. METHODS: The extant toxicological literature and material safety data sheets were used as data sources. RESULTS: BPA is released from dental resins through salivary enzymatic hydrolysis of BPA derivatives, and BPA is detectable in saliva for up to 3 hours after resin placement. The quantity and duration of systemic BPA absorption is not clear from the available data. Dental products containing the bisphenol A derivative glycidyl dimethacrylate (bis-GMA) are less likely to be hydrolyzed to BPA and have less estrogenicity than those containing bisphenol A dimethacrylate (bis-DMA). Most other BPA derivatives used in dental materials have not been evaluated for estrogenicity. BPA exposure can be reduced by cleaning and rinsing surfaces of sealants and composites immediately after placement. CONCLUSIONS: On the basis of the proven benefits of resin-based dental materials and the brevity of BPA exposure, we recommend continued usewith strict adherence to precautionary application techniques. Use of these materials should be minimized during pregnancy whenever possible. Manufacturers should be required to report complete information on the chemical composition of dental products and encouraged to develop materials with less estrogenic potential. Pediatrics 2010;126:760–768 AUTHORS: Abby F. Fleisch, MD,a Perry E. Sheffield, MD,b Courtney Chinn, DDS, MPH,c Burton L. Edelstein, DDS, MPH,c and Philip J. Landrigan, MD, MScb aDepartment of Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts; bDepartments of Pediatrics and Preventive Medicine, Mount Sinai School of Medicine, New York, New York; and cSection of Social and Behavioral Sciences, Division of Community Health, Columbia University College of Dental Medicine, New York, New York