Polymer-based Dental Filling Materials Placed During Pregnancy and Risk to the Foetus

Trine Lise Lundekvam Berge; Gunvor Bentung Lygre; Stein Atle Lie; Lars Björkman

Disclosures

BMC Oral Health. 2018;18(144) 

In This Article

Background

Tooth-coloured polymer-based materials are the first choice for dental restorative treatment in many countries.[1,2] However, there are concerns about the safety of these materials.[3] Results of in vitro and in vivo studies have shown that substances that potentially could lead to adverse effects in the patient are released from these materials within 24 h after curing.[4–8] Elution may initially be due to incomplete polymerization[9,10] and contaminants.[11,12] The local adverse effects[13] caused by the leachable components are rare.[14] However, the possibility of systemic adverse effects could not be ruled out.[15]

The elution of bisphenol A (BPA) has been of particular concern.[16] BPA is a chemical known to be an endocrine disruptor, mimicking oestrogen.[17,18] Polymer-based dental filling materials may contain BPA as an impurity from the production process of bisphenol-A glycidyl dimethacrylate (Bis-GMA)[8,11,19,20] or, less probable, a degradation product of monomers.[12,21,22] Results from animal studies have indicated that BPA has reproductive, developmental and systemic toxic effects.[23,24] It has been shown that newly placed composite restorations in humans may be associated with short-term elevated BPA levels in both saliva and urine.[4,7]

The impact of exposure to BPA on human health remains uncertain. However, data from the literature indicate that exposure to BPA, even at relatively low doses, could potentially result in adverse health effects.[15] Moreover, studies suggest that BPA might pass through the placental barrier,[25] and thus, maternal exposure to BPA may offer a potential risk to the vulnerable foetus.

Even though substances with potential toxicity are released from dental polymer-based materials,[4,5] studies exploring the risk of having these materials placed during pregnancy are lacking.

The aim of the present study was to investigate whether the placement of polymer-based dental fillings during pregnancy is associated with adverse birth outcomes including stillbirth, preterm birth, malformations and low or high birth weight.

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