Tooth-coloured polymer-based dental filling materials are currently the first choice for dental restorative treatment in many countries. However, there are some concerns about their safety. It has been shown that substances known as endocrine disrupters, which might pass through the placental barrier, are released from these materials within the first hours after curing. Thus, the placement of polymer-based dental fillings in pregnant women may put the vulnerable foetus at risk. Large epidemiological studies exploring the risk of having polymer-based dental materials placed during pregnancy are lacking. The aim of this study was to investigate the association between the placement of polymer-based dental fillings during pregnancy and adverse birth outcomes.
This study is based on data from the large Norwegian Mother and Child Cohort Study (MoBa). The information about dental treatment during pregnancy was obtained from questionnaires sent to the participating women during weeks 17 and 30 of pregnancy. Reported placement of “white fillings” was used as exposure marker for having received polymer-based dental filling materials. Only singleton births were included in the present study. Data were linked to the Medical Birth Registry of Norway. Logistic regression models that included the mother’s age, level of education, body mass index, parity, and smoking and alcohol consumption during pregnancy were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Different adverse birth outcomes were of interest in the present study.
Valid data were available from 90,886 pregnancies. Dentist consultation during pregnancy was reported by 33,727 women, 10,972 of whom had white fillings placed. The adjusted logistic regression models showed no statistically significant association between having white dental fillings placed during pregnancy and stillbirth, malformations, preterm births, and low or high birth weight.
In this study, women who reported white fillings placed during pregnancy had no increased risk for adverse birth outcomes compared with women who did not consult a dentist during pregnancy. Thus, our findings do not support the hypothesis of an association between placement of polymer-based fillings during pregnancy and adverse birth outcomes.
Eklund SA. Trends in dental treatment, 1992 to 2007. J Am Dent Assoc. 2010;141:391–9. https://www.ncbi.nlm.nih.gov/pubmed/20354088 CrossRefPubMed
SCENIHR (Scientific Committee on Emerging and Newly-Identified Health Risks). Opinion on the safety of dental amalgam and alternative dental restoration materials for patients and users (update), 29 April. European commission. DG Health and Food Safety. 2015:2015. http://ec.europa.eu/health/sites/health/files/scientific_committees/emerging/docs/scenihr_o_046.pdf. Accessed 14 Dec 2017
Kingman A, Hyman J, Masten SA, Jayaram B, Smith C, Eichmiller F, et al. Bisphenol A and other compounds in human saliva and urine associated with the placement of composite restorations. J Am Dent Assoc. 2012;143:1292–302. http://www.ncbi.nlm.nih.gov/pubmed/23204083 CrossRefPubMed
Michelsen VB, Kopperud HB, Lygre GB, Bjorkman L, Jensen E, Kleven IS, et al. Detection and quantification of monomers in unstimulated whole saliva after treatment with resin-based composite fillings in vivo. Eur J Oral Sci. 2012;120:89–95. https://doi.org/10.1111/j.1600-0722.2011.00897.x. CrossRefPubMed
Sevkusic M, Schuster L, Rothmund L, Dettinger K, Maier M, Hickel R, et al. The elution and breakdown behavior of constituents from various light-cured composites. Dent Mater. 2014;30:619–31. https://doi.org/10.1016/j.dental.2014.02.022. CrossRefPubMed
Maserejian NN, Trachtenberg FL, Wheaton OB, Calafat AM, Ranganathan G, Kim HY, et al. Changes in urinary bisphenol a concentrations associated with placement of dental composite restorations in children and adolescents. J Am Dent Assoc. 2016; https://doi.org/10.1016/j.adaj.2016.02.020.
Van Landuyt KL, Nawrot T, Geebelen B, De Munck J, Snauwaert J, Yoshihara K, et al. How much do resin-based dental materials release? A meta-analytical approach. Dent Mater. 2011;27:723–47. https://doi.org/10.1016/j.dental.2011.05.001. CrossRefPubMed
Durner J, Obermaier J, Draenert M, Ilie N. Correlation of the degree of conversion with the amount of elutable substances in nano-hybrid dental composites. Dent Mater. 2012;28:1146–53. https://doi.org/10.1016/j.dental.2012.08.006. CrossRefPubMed
Ferracane JL. Elution of leachable components from composites. J Oral Rehabil. 1994;21:441–52. https://www.ncbi.nlm.nih.gov/pubmed/7965355 CrossRefPubMed
American Dental Association Council on Scientific Affairs. Determination of bisphenol a released from resin-based composite dental restoratives. American Dental Association Professional Product Review. 2014;9(3). http://www.ada.org/en/publications/ada-professional-product-review-ppr. Accessed 5 Sept 2014.
Schmalz G, Preiss A, Arenholt-Bindslev D. Bisphenol-A content of resin monomers and related degradation products. Clin Oral Investig. 1999;3:114–9. https://www.ncbi.nlm.nih.gov/pubmed/10803121 CrossRefPubMed
Schedle A, Ortengren U, Eidler N, Gabauer M, Hensten A. Do adverse effects of dental materials exist? What are the consequences, and how can they be diagnosed and treated? Clin Oral Implants Res. 2007;18(Suppl 3):232–56. https://doi.org/10.1111/j.1600-0501.2007.01481.x. CrossRefPubMed
Rochester JR. Bisphenol a and human health: a review of the literature. Reprod Toxicol. 2013;42:132–55. https://doi.org/10.1016/j.reprotox.2013.08.008. CrossRefPubMed
Schug TT, Janesick A, Blumberg B, Heindel JJ. Endocrine disrupting chemicals and disease susceptibility. J Steroid Biochem Mol Biol. 2011;127:204–15. https://doi.org/10.1016/j.jsbmb.2011.08.007. CrossRefPubMedPubMedCentral
Crain DA, Eriksen M, Iguchi T, Jobling S, Laufer H, LeBlanc GA, et al. An ecological assessment of bisphenol-a: evidence from comparative biology. Reprod Toxicol. 2007;24:225–39. https://doi.org/10.1016/j.reprotox.2007.05.008. CrossRefPubMed
Soderholm KJ, Mariotti A. BIS-GMA--based resins in dentistry: are they safe? J Am Dent Assoc. 1999;130:201–9. https://www.ncbi.nlm.nih.gov/pubmed/10036843 CrossRefPubMed
Imai Y, Watanabe M, Ohsaki A. Analysis of major components and bisphenol a in commercial Bis-GMA and Bis-GMA-based resins using high performance liquid chromatography. Dent Mater J. 2000;19:263–9. https://www.ncbi.nlm.nih.gov/pubmed/11218846 CrossRefPubMed
Atkinson JC, Diamond F, Eichmiller F, Selwitz R, Jones G. Stability of bisphenol a, triethylene-glycol dimethacrylate, and bisphenol a dimethacrylate in whole saliva. Dent Mater. 2002;18:128–35. http://www.ncbi.nlm.nih.gov/pubmed/11755591 CrossRefPubMed
Richter CA, Birnbaum LS, Farabollini F, Newbold RR, Rubin BS, Talsness CE, et al. In vivo effects of bisphenol a in laboratory rodent studies. Reprod Toxicol. 2007;24:199–224. https://doi.org/10.1016/j.reprotox.2007.06.004. CrossRefPubMedPubMedCentral
Miyakoda HT, Masako T, Onodera SO, Takeda K. Passage of bisphenol a into the fetus of pregnant rat. J Health Sci. 1999;45:318–23. CrossRef
Magnus P, Birke C, Vejrup K, Haugan A, Alsaker E, Daltveit AK, et al. Cohort profile update: the Norwegian mother and child cohort study (MoBa). Int J Epidemiol. 2016; https://doi.org/10.1093/ije/dyw029.
Norwegian Institute of Public Health. Questionnaires from MoBa. 2005 [updated 15 September 2016]. https://www.fhi.no/en/studies/moba/for-forskere-artikler/questionnaires-from-moba/. Accessed 15 Dec 2017.
Irgens LM. The medical birth registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand. 2000;79:435–9. https://www.ncbi.nlm.nih.gov/pubmed/10857866 CrossRefPubMed
Fleischman AR, Oinuma M, Clark SL. Rethinking the definition of “term pregnancy”. Obstet Gynecol. 2010;116:136–9. https://doi.org/10.1097/AOG.0b013e3181e24f28. CrossRefPubMed
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379:2162–72. https://doi.org/10.1016/S0140-6736(12)60820-4. CrossRefPubMed
World Health Organization. WHO: recommended definitions, terminology and format for statistical tables related to the perinatal period and use of a new certificate for cause of perinatal deaths. Modifications recommended by FIGO as amended October 14, 1976. Acta Obstet Gynecol Scand. 1977;56:247–53. https://www.ncbi.nlm.nih.gov/pubmed/560099
World Health Organization. Global Database on Body Mass Index. BMI classification 2007. 2007. http://www.who.int/. Accessed 22.11.2017.
Skjaerven R, Gjessing HK, Bakketeig LS. Birthweight by gestational age in Norway. Acta Obstet Gynecol Scand. 2000;79:440–9. https://www.ncbi.nlm.nih.gov/pubmed/10857867 CrossRefPubMed
Michalowicz BS, DiAngelis AJ, Novak MJ, Buchanan W, Papapanou PN, Mitchell DA, et al. Examining the safety of dental treatment in pregnant women. J Am Dent Assoc. 2008;139:685–95. https://www.ncbi.nlm.nih.gov/pubmed/18519992 CrossRefPubMed
Nilsen RM, Vollset SE, Gjessing HK, Skjaerven R, Melve KK, Schreuder P, et al. Self-selection and bias in a large prospective pregnancy cohort in Norway. Paediatr Perinat Epidemiol. 2009;23:597–608. https://doi.org/10.1111/j.1365-3016.2009.01062.x. CrossRefPubMed
Berge TL, Lygre GB, Jonsson BA, Lindh CH, Bjorkman L. Bisphenol a concentration in human saliva related to dental polymer-based fillings. Clin Oral Investig. 2017; https://doi.org/10.1007/s00784-017-2055-9.
Wang NJ. Tannhelseutvikling og bruk av tannrestaureringsmaterialer. In: Bruk av tannrestaureringsmaterialer i Norge IK-2652. 98–8. Oslo: Statens helsetilsyn; 1998. p. 69–74.
Selevan SG, Kimmel CA, Mendola P. Identifying critical windows of exposure for children's health. Environ Health Perspect. 2000;108(Suppl 3):451–5. https://www.ncbi.nlm.nih.gov/pubmed/10852844 CrossRefPubMedPubMedCentral
Rogers JM, Kavlok RJ. Developmental toxicology. In: Klaassen CD, editor. Casarett and Doull's toxicology: the basic science of poisons. 7th ed. New York: McGraw-Hill; 2008. p. 417–8.
Gaffield ML, Gilbert BJ, Malvitz DM, Romaguera R. Oral health during pregnancy: An analysis of information collected by the pregnancy risk assessment monitoring system. J Am Dent Assoc. 2001;132:1009–16. https://www.ncbi.nlm.nih.gov/pubmed/11480627 CrossRefPubMed
Norwegian Institute of Public Health. Research and data access from the Norwegian Mother and Child Cohort Study. 2010 [updated 11 January 2018]. https://www.fhi.no/div/datatilgang/. Accessed 19 Jan 2018.
Norwegian Institute of Public Health. MoBa study protocol. 2010 [updated October 2012]. https://www.fhi.no/globalassets/dokumenterfiler/moba/dokumenter/moba-protokoll-norsk-versjon-oktober-2012-pdf.pdf. Accessed 19 Jan 2018.
- Polymer-based dental filling materials placed during pregnancy and risk to the foetus
Trine Lise Lundekvam Berge
Gunvor Bentung Lygre
Stein Atle Lie
- BioMed Central
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