The risk of arsenic from the dental paste leaking into the general circulation and the tissues surrounding the teeth cannot be excluded. In addition, epidemiology studies have shown an association between arsenic and spontaneous abortions and stillbirths. In vitro studies with Caustinerf arsenical and Yranicid arsenical have confirmed a clastogenic/aneugenic potential and there are published data showing that arsenic compounds have a toxic effect on reproduction in animals. The EMA recommendations are based on a review of data indicating a potential genotoxic effect of the products due to the presence of arsenic trioxide (arsenous anhydride). Dentists should use other alternative methods available for removing dental pulp. The EMA has concluded that the benefits of Caustinerf arsenical, Yranicid arsenical and associated names do not outweigh their risks and has recommended that their marketing authorisations in the EU be revoked.

If you have any questions or concerns, speak to your dentist.

If you require such treatment, your dentist will use other methods available which do not contain arsenic.

Caustinerf arsenical and Yranicid arsenical dental pastes will no longer be used for removing damaged nerves in teeth, because they may pose a risk of genotoxic effects (which can cause cancers) and cell death in tissues around the teeth which may be difficult to treat.

The CHMP recommendation will now be sent to the European Commission for a legally binding decision that will be valid throughout the EU 1. The review was initiated at the request of the French medicines agency (ANSM) after new data became available that raised concerns about the safety of these products. Therefore, in the light of current standard of care available, the Committee concluded that the benefits of Caustinerf arsenical and Yranicid arsenical do not outweigh their risks and recommended that their marketing authorisations be revoked. In addition, there have been a small number of cases where arsenic is thought to have leaked into the areas around the teeth, causing parts of the tissue to die, including bone (osteonecrosis).Дuring the review, the CHMP considered measures to minimise the risks identified with these products but concluded that restrictions and additional guidance to dentists would not reduce the risks to an acceptable level.

In a review of the benefits and risks of these dental products, analyses of data from laboratory and population studies indicate that the arsenic contained in them may pose a risk of genotoxic effects that could increase the risk of cancer. The dental pastes, which contain an arsenic-based compound, arsenic trioxide, have been used to remove the damaged nerves in the dental pulp (the inside of the tooth). We didn't believe it was affecting more than a tiny fraction of OCSP requests - so few that it didn't reach our threshold to declare an incident - but our initial troubleshooting efforts assumed that it was related.The European Medicines Agency's Committee for Medicinal Products for Human Use ( CHMP) has recommended that the marketing authorisations for the dental pastes Caustinerf arsenical, Yranicid arsenical and associated names be revoked in the EU due to concerns over the risk of genotoxic effects (damage to the genetic material in cells) and cell death in tissues around the teeth. The start of the incident (that is, the previous CRL's expiration) coincided with our troubleshooting a database performance problem.

The JRE's exception messages can identify the wrong type of validation failure entirely.

OCSP is always served over HTTP, so a mismatched TLS certificate at the edge CDN won't cause any failures.

SSL Labs does tend to incorrectly report OCSP failures.To summarize and confirm some ways troubleshooting in this thread was tricky:

The short version is that although our OCSP responder was working correctly, there was another validation problem for some clients: the CRL. We just identified and fixed the problem, and created a retroactive status report. Thanks for posting about this, and we're sorry about the trouble.

Has it leaked revocation