Sir, a recent study examines associations between urinary Bisphenol A (BPA) concentrations and adult health status.1 The study concludes that higher BPA exposure, reflected in higher urinary concentrations of BPA, may lead to a higher incidence of disease in the adult population. The quarter of the population with the highest BPA levels were more than twice as likely to have heart disease and/or diabetes when compared to the quarter with the lowest levels. Also, higher BPA levels were associated with abnormal liver enzyme concentrations. This paper is discussed by Saal and Myer,2 concluding that 'decreasing exposure to BPA and developing alternatives to its use are the logical next steps to minimise risk to public health'.

BPA is in widespread use in dentistry, in adhesives as BIS-GMA (bisphenol A glycidyl methacrylate) and in composite filling materials.

There are very little data about adverse events relating to BPA in dentistry, the paper by Söderholm and Mariotti3 being one of the few, which looks at the potential of these agents to mimic or disrupt oestrogenic cell responses. The overall conclusion is that there is little to worry about, but longer term effects need to be studied, together with pharmacological evaluation of dental materials.

It would appear that this is an area where further research is needed, especially as we are gradually moving away from amalgam to other materials, composite resins being an important alternative in many instances.