In 1993, the United States Public Health Service (USPHS) formally embraced a multifaceted and interrelated plan to address the complex issue of the safety of dental amalgam and, more specifically, the effects of human exposure to mercury vapor emanating from dental amalgam fillings. In doing so, the USPHS committed to resolutely strive for answers to the question of whether dental amalgam poses a serious health threat to those who are treated with this material. The USPHS also committed itself to a number of educational and regulatory initiatives predicated on the best quality science and availability of resources.

Although the issue of dental amalgam safety does not appear to rival other public health problems that threaten the health and well-being of the American public, the exposure of the population to this material is very broad, and thus the issue merits serious study by the USPHS. USPHS leaders, scientists, and regulators are investigating whether dental amalgam is in any way injurious to human health, and what steps may be necessary to reduce any public health risks without compromising the well-established benefits of this dental product. This report documents the steps being taken, the initiatives underway and the inroads that have been made. It also describes what other experts in the world are thinking and doing about this issue and the relationships the USPHS has forged with them.

What this report does not do is provide any startling new revelations with respect to dental amalgam safety. Scientific research, while continuing to yield important clues, has still to definitively resolve the exact nature and degree of public health risk, if one exists at all, associated with dental amalgam. The report should in no way be construed as an end or diminution of the USPHS' original commitment, but rather as an indication of the directions the USPHS believes will be the most promising and which it intends to pursue.

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