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Philadelphia Ordinance Requires Information Sheet on Restorative Option

In December 2007, Philadelphia City Council unanimously passed Bill No. 040904, The Use of Mercury in Dentistry. Councilwoman Blondell Reynolds Brown, an at-large member, introduced this ordinance.

The ordinance requires the following:
  • The Philadelphia Board of Health is instructed to promulgate an information sheet for patients “that explains the potential advantages and disadvantages to oral health, overall human health and the environment of using mercury or mercury amalgam in dental procedures, describes what alternatives are available to mercury amalgam in various dental procedures and what potential advantages and disadvantages are posed by the use of those alternatives, and includes such other information the Department believes will contribute to a patient’s ability to make an informed decision when choosing between the use of mercury amalgam or an alternative material in a dental procedure, including, but not limited to, information on the durability, cost, aesthetic quality or other characteristics of the mercury amalgam and alternative materials.”
  • The Board of Health is instructed to consult on the text of the information sheet with PDA,  New Era Dental Society and Consumers for Dental Choice. The information sheet will be published on the City’s website for downloading.
  • Any dentist in Philadelphia County who places or removes dental amalgam must provide each patient, one time only, with a copy of the information sheet and obtain the patient’s signed receipt of the information sheet.
  • Dental practices limited to oral and maxillofacial surgery, oral medicine, oral pathology, orthodontics, periodontics or radiology are exempted from the above requirements.
PDA’s lobbying efforts succeeded in amending the bill in several areas. In its original form, the ordinance would have required the installation of amalgam separators in every dental office in Philadelphia. It also would have required dentists to display a poster warning of the hazards of mercury in dental amalgam. PDA convinced Councilwoman Brown to remove these requirements. PDA also persuaded the sponsor to exempt the specialty practices listed above from the information sheet requirement.

PDA and Philadelphia County Dental Society (PCDS), along with the New Era Dental Society, continued advocating for all dentists before the Philadelphia Board of Health to ensure its adoption of an information sheet based on sound science. The Board of Health adopted an information sheet that, while not perfect, is based largely on the information PDA provided, despite strong opposition from anti-amalgam groups. While the Board of Health generally based the information sheet on science, PDA and PCDS does not agree with every statement in the document. For example, the information sheet mistakenly refers to amalgam as a hazardous waste. In fact, the federal Environmental Protection Agency does not list amalgam as a hazardous waste. PDA and PCDS will work with the Board of Health to correct the definition in any future updates to the information sheet. View more information about PDA and PCDS's advocacy efforts.

All dental patients who receive amalgam restorations must receive the sheet only once. Dentists and patients (or the patient’s representative) must provide signatures at the bottom acknowledging receipt. Dentists should retain the original copy of the signed form in their patients’ records. Download a PDF of the information sheet.

This law became effective on May 18, 2009, and Philadelphia dentists have 120 days to comply. PDA encourages dentists to begin using the information sheet and obtaining signatures immediately.