- 期刊
牙材與健康：以銀粉補牙的健康風險為例
Dental Materials and Health Risks: A Case of the Health Risks of Using Amalgam Fillings
摘要
牙齒不僅只是咬合、咀嚼的工具，也跟整體身體健康、生活品質有關，可以說口腔健康是全身健康之本，因此當牙齒需要治療時，對於置入的牙材成份和安全性，是需要仔細考量。以銀粉補牙為例，由於「銀粉」是一種含有大約50%的「汞」，而汞是有毒金屬中，毒性最強的一種化學物質，因此以銀粉做為補牙用的填料，雖已經超過一百八十年，但是使用上仍一直有爭議。近年來，歐洲國家中，像是挪威、瑞典、丹麥等禁止使用銀粉，顯然銀粉做為補牙的材料並非是絕對安全，也不是不可取代。台灣目前並未禁用銀粉，但是近年來受到媒體報導、相關研究、以及健保給付等影響，許多牙醫師和民眾也逐漸減少使用銀粉補牙。由於金屬是牙材中最常用到的物質，因此本文以銀粉補牙為例，分成兩個部分，首先回顧銀粉使用歷史的健康風險爭議，接著描述銀粉對於人體健康與環境的影響，透過銀粉使用的討論，使牙醫界能更重視牙材、牙科職業場所的安全性，以促進民眾和牙科工作人員的健康，進而提昇牙醫照護的醫療品質。
並列摘要
Teeth are not merely biting and chewing tools-they are also related to overall health and life quality. Therefore, dental health can be considered a crucial foundation for human health. Hence, when dental treatments are required, serious considerations should be given to the safety of implant and filling materials. For example, in terms of teeth filling materials, amalgam is filling material that consists of approximately 50% mercury, and mercury is one the most toxic chemical elements. Although it has been 180 years since amalgam was first used as a filling material, the controversies surrounding its use have never subsided. In recent years, European countries such as Norway, Sweden, and Denmark had banned the use of amalgam as a filling material. This ban indicates that amalgam is not completely safe as a dental filling material and it is not an irreplaceable. Currently, the use of amalgam is not banned in Taiwan. However, due to media coverage, relevant research, and changes in the National Health Insurance benefit package, dentists (and therefore the general public) have gradually reduced the use of amalgam as dental fillings. As metals are the most common dental materials, this paper provides a discussion on this topic by using amalgam fillings as a specific example. This paper is divided into two parts. In the first part, the author reviews the history of amalgam as well as the health risks and controversies surrounding its use. The second part of the paper focuses on the effects of amalgam on human health and the environment. Through such a discussion, it is hoped that the medical community will pay more attention to the safety of dental materials and the dental working environment. This may in turn improve the health of dental professionals and the public, and ultimately elevate the quality of dental care services.