Dear Patient,
The California State Legislature passed a new law (SB 134) requiring all dentist to Inform their
patients of the Dental Material Fact Sheet (DMFS). This is required of every new and returning
patient that received dental restorative treatment. Each patient, including children, must sign
the acknowledgement form below and have this form retained in their patient records.
This law was created to encourage doctor-patient discussions about the dental materials used
In restorative procedures, including the risk and benefits of these materials. This requirement
came about primarily because of an increased attention on all products containing mercury. In
this dental office we do not use amalgam (silver filling material which contains mercury) for
restorations, but this discussion of materials is appropriate and this acknowledgement will need
to be completed.
The American Dental Association and the California Dental Association have provided
documentation regarding the safety and efficacy of amalgam and current scientific literature
continues to support its use.
