Bisphenol A in contemporary dentistry: from material chemistry and exposure pathways to potential clinical relevance—a comprehensive narrative review

Introduction Resin-based dental materials have substantially improved contemporary dental care while raising interest in their long-term biological safety. Attention has focused on bisphenol A (BPA), which may be associated with dental materials through BPA-derived monomers, residual impurities, or degradation processes. This narrative review critically synthesizes current evidence regarding BPA in dentistry, focusing on its origin and availability, biological implications, clinical relevance, and regulatory perspectives. Methods A comprehensive narrative review was conducted through a structured search of PubMed/MEDLINE, Scopus, and Web of Science from database inception to 15 July 2026. Experimental, clinical, human biomonitoring, review, and relevant regulatory evidence published in English was integrated across defined thematic domains. Results BPA availability from resin-based dental materials may reflect distinct processes, including elution of pre-existing impurities and BPA formation through chemical or biologically mediated degradation of susceptible BPA-derived monomers. Incomplete polymerization may increase the availability of residual resin constituents but does not itself generate free BPA, while ageing and wear may facilitate constituent release without necessarily producing BPA. Reported BPA concentrations vary according to material composition, experimental conditions, analytical methods, and sampling strategies. Human biomonitoring studies indicate that the largest post-treatment changes generally occur during early sampling periods, although their magnitude and temporal pattern vary with the procedure, treatment burden, biological matrix, sampling interval, and background environmental exposure. Available human evidence remains insufficient to establish a causal relationship between BPA exposure specifically attributable to dental materials and clinically relevant systemic adverse health outcomes. However, the absence of demonstrated long-term adverse outcomes should not be interpreted as definitive evidence of long-term safety, because longitudinal studies evaluating clinically relevant systemic outcomes remain limited. Conclusions Current evidence supports a balanced and precautionary interpretation of BPA in dentistry. Clinical decision-making should consider the overall biological and clinical performance of dental materials while minimizing avoidable exposure whenever reasonably achievable. Analytical detection or experimental biological activity should not, in isolation, be interpreted as evidence of clinically meaningful harm; conversely, the absence of demonstrated adverse outcomes does not establish definitive long-term safety. Further longitudinal studies are required, particularly under repeated or cumulative exposure conditions and in potentially susceptible populations.