Dental Sealants Containing BPA Should be Used Carefully

Dental sealants containing a variety of bisphenol A (BPA) derivatives can still be used to prevent dental cavities in children and adolescents, provided there is strict adherence to precautionary application techniques, according to a report from the American Academy of Pediatrics.

Although there is evidence that dental sealants and composite filling materials containing BPA derivatives can pose health risks attributable to their endocrine-disrupting, estrogenic properties, the products have proven to be effective in preventing the most common dental cavities.

Dental materials present a much smaller and infrequent exposure to BPA—a material commonly found in plastic food-storage containers, some water bottles, and linings of metal food cans—than more common sources, according to Abby F. Fleisch, MD, of Children’s Hospital Boston, and colleagues. They found that BPA is released from dental resins through enzymes in saliva, and is detectable in saliva for up to 3 hours after resin placement. How much is absorbed, however, is not known.

In the article, “Bisphenol A and Related Compounds in Dental Materials: A Critical Review,” published in Pediatrics, Fleisch and colleagues point out that dental products that contain the bisphenol A derivative glycidyl dimethacrylate (bis-GMA) are less likely to be converted to BPA and have less estrogenic properties than those containing bisphenol A dimethacrylate (bis-DMA). Therefore, the “more commonly used bis-GMA resins should be the preferred choice.”

The most significant window of exposure to BPA occurs during and immediately after the material is placed in the mouth. To reduce exposure, the authors suggest rubbing the material with pumice to remove the top liquefied layer of sealants. Rinsing the surface with water for 30 seconds immediately after application also has been shown to decrease salivary BPA levels to nearly baseline.

“Because of the substantial benefit resin-based dental sealants provide, and the brevity of exposure to BPA,” Fleisch and colleages recommend they continue to be used in pediatric dentistry. They suggest that “use of these materials should be minimized during pregnancy when possible,” and they urge manufacturers to develop materials with less estrogenic potential.