Is Formocresol Obsolete? A Fresh Look at the Evidence Concerning Safety Issues

Use of Formocresol by the Pediatric Dentists Across India - A Questionnaire Survey

“…Pediatric Dentists who wish to continue to use Formocresol should apply the lowest dose possible using a standardized size cotton or foam pellet for the least possible time to obtain the desired effect. When used judiciously, Formocresol is a safe medicament 5 . Hence, it would be wise to use diluted Formocresol to lower the formaldehyde exposure to the children.…”

“…Formocresol, though the center of much controversy, is still the most widely used medicament for primary teeth pulpotomy & an intracanal medicament which has undergone a lengthy evolution to shorten the Formocresol application time & reduce the concentration of Formocresol exposure to the pulp tissue 3,4 . The fact that only micrograms of formaldehyde is applied to pulp tissues during pulpotomy for mere minutes means pediatric pulp therapy should be considered as a "low exposure condition" 5 . The first reports recommending the dilution of Formocresol for use in pulpotomies came more than 42 years ago.…”

The obsolescence of formocresol

“…1 Yet, defence of formocresol use continues. 2 In 1981, this author published the original compendium of research dealing specifi cally with the use of the carcinogens formaldehyde, cresol and paraformaldehyde in endodontic procedures; aimed at all general practice clinicians and specialists. [3][4][5] The original two-year project started a debate that continues: why haven't we eliminated formaldehyde-containing medicaments like formocresol from the dental armamentarium?…”

“…Authors who defend the use of formocresol admit that the dose is clearly unknown and it remains an important area for future research. 19 Proponents of this type of methodology have never utilised reliable and reproducible studies, advantaged by a simple mean and standard deviation. 20 Much of the literature for the continuance of formocresol is supported by pharmaceutical chemists and argues that since formaldehyde is so prevalent in our daily lives, it matters little if we introduce a small uncalculated dose into the systems of children.…”

“…21 Milnes, in a minority perspective, has written that since antibiotics are used frequently and cause death, why should we be concerned about formaldehyde? 19 As clinicians we should be trying to reduce the amounts of potentially harmful medicaments delivered to our patients, particularly when so many alternatives exist.…”