Tag Archives: dental amalgam

Making Sense of Mercury

…with a much needed dose of humor, to boot!

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The Persistent Defense of Mercury Fillings

It’s kind of a weird passage to find on a site that promises to “improve your world” by covering “the broadest scope of environmental and social responsibility issues on the internet.” (Then again, the corporate-sponsored site – Mother Nature Network – gets funding from the likes of environmental polluter Georgia-Pacific, so maybe some cognitive dissonance is to be expected.)

From “6 Signs You Need a New Dentist,” originally published in Woman’s Day:

If your dentist recommends that you replace all of your silver fillings with tooth-colored versions, you may want to get a second opinion. While there are some theories that the mercury content in silver fillings can be harmful to your health, none of them has been proven to be true, says Dr. Gross. According to Shelley Seidel, DDS, MD, who practices at Oral and Maxillofacial Surgeons of Houston and is the director of the Institute for Dental Implant Awareness, as long as you don’t have cavities below your fillings — which can be detected by examination or x-ray — or the fillings aren’t broken or fractured, there is no need to replace them. “If your dentist wants to take them out simply because silver fillings are passé, you’re asking for trouble because you don’t know how your teeth will react,” explains Dr. Gross. “They may react in an unfavorable way, becoming more sensitive or in need of a root canal or crown.” (emphasis added)

Amalgam being “passé” is hardly the issue.

As regular readers know, “silver” describes only the color of these fillings, which mostly consist of mercury, a potent neurotoxin. Though more and more dentists have quit using mercury amalgam, US dentists alone place about 70 million of these fillings every year, using 34 tons of mercury. But not all that mercury goes into patients’ mouths. Tons of it are released into the water system each year, as well. As Dr. Bicuspid has reported,

Approximately 50% of mercury entering local waste treatment plants comes from dental amalgam waste – about 3.7 tons of mercury annually, according to the EPA. Once deposited, certain microorganisms can change elemental mercury into methylmercury, a highly toxic form that builds up in fish, shellfish, and animals that eat fish. Fish and shellfish are the main sources of methylmercury exposure to humans, and the EPA is concerned that methylmercury can damage children’s developing brains and nervous systems even before they are born.

And it doesn’t even take that much mercury to cause contamination: As little as one teaspoonful (PDF) can render a 22 acre lake toxic.

Yet it’s considered okay to put mercury in a person’s mouth, mere inches from the brain?

Contrary to Dr. Gross’s claim, there is a substantial scientific record of amalgam’s power to harm human health. (For a sample, see this and this and this.) There has also been work along the lines of a study published just this month in the Journal of Oral Rehabilitation which demonstrated long-lasting reduction of health complaints after mercury removal.

That said, no conscientious dentist would make a the kind of generalizing statement like the one used in the MNN/Woman’s Day article: “You need to replace all of your silver fillings with white ones.” You can’t just assume that if a person has amalgams, they must be removed. Our bodies have excretory mechanisms to remove any toxins that enter. Some people have healthier, more robust systems than others. Some carry a heavier toxic load due to multiple and/or ongoing exposures, not just mercury.

You have to ask, Is the person experiencing symptoms? Are amalgams the primary cause?

Always, you need to look at each individual’s health situation and do the appropriate exams and evaluations to determine the presence and impact of any oral obstacles to systemic health. If you find any – mercury fillings or otherwise (e.g., infected root canal teeth or cavitations) – you then map out a systematic, patient-specific plan for treatment and healing. And if amalgam removal is involved, it must be done safely (PDF). You also need to be sure that the new restorations are biocompatible, which is determined beforehand through blood serum analysis and other tests.

So, yes: The caution against rushing into amalgam removal (or any other treatment) is sound. You just don’t need to justify it by insisting against evidence that amalgam is risk-free.

Note: There’ll be no post next week, due to the Veteran’s Day holiday.

Mouth image by brillenschlange, via Flickr

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World Health Organization Urges Move Away from Dental Amalgam

There’s been plenty of good news lately on the effort to end the Age of Toxic Dentistry, such as the Malibu City Council’s resolution supporting the global phase-out of dental mercury, which was unanimously approved just last week.

Malibu now joins Costa Mesa and Santa Ana as California cities opposed to dental amalgam.

And now more good news: The World Health Organization has finally released its 2009 report on the “Future Use of Materials for Dental Restorations,” which likewise urges a global “phase down” of toxic mercury amalgam.

The report has been released in preparation for the third of five Intergovernmental Committee deliberations that are expected to lead to the adoption of a legally binding treaty on mercury by 2013.

Here’s more on the report from Charlie Brown of Consumers for Dental Choice – and how he’d like YOU to get involved on this issue:

In a clear sign that dentistry’s amalgam era is fading, the World Health Organization (WHO) just released its long-awaited report on dental amalgam. In Future Use of Materials for Dental Restoration, WHO urges “a switch in use of dental materials” away from amalgam.

“[F]or many reasons,” WHO explains, “restorative materials alternative to dental amalgam are desirable.” The report describes three of these reasons in detail:

  • WHO determines that amalgam releases a “significant amount of mercury”: WHO concludes that amalgam poses a serious environmental health problem because amalgam releases a “significant amount of mercury” into the environment, including the atmosphere, surface water, groundwater, and soil. WHO says “When released from dental amalgam use into the environment through these pathways, mercury is transported globally and deposited. Mercury releases may then enter the human food chain especially via fish consumption.”
  • WHO determines that amalgam raises “general health concerns”: While the report acknowledges that a few dental trade groups still believe amalgam is safe for all, the WHO report reaches a very different conclusion: “Amalgam has been associated with general health concerns.” The report observes, “According to the Norwegian Dental Biomaterials Adverse Reaction Unit, the majority of cases of side-effects of dental filling materials are linked with dental amalgam.”
  • WHO determines that “materials alternative to dental amalgam are available”: WHO concludes that “Materials alternative to dental amalgam are available” – and cites many studies indicating that they are superior to amalgam. For example, WHO says “recent data suggest that RBCs [resin-based composites] perform equally well” as amalgam. And compomers have a higher survival rate, says WHO, citing a study finding that 95% of compomers and 92% of amalgams survive after 4 years. Perhaps more important than the survival of the filling, WHO asserts that “Adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself.”

We have come a long way. Less than a year ago, dental trade groups were circulating an unedited and unreviewed draft of this report to government officials, implying that it was WHO’s final position. But the draft was riddled with factual errors and scientifically unsupported claims. Consumers for Dental Choice – working with non-governmental organizations, scientists, and environmentalists from around the globe – organized a letter-writing campaign to insist that the draft be immediately withdrawn, accurately rewritten, and properly reviewed.

And it worked! Now WHO has removed all claims of amalgam’s safety. Now WHO has committed itself to “work for reduction of mercury and the development of a healthy environment.” Now “WHO will facilitate the work for a switch in use of dental materials.”

Thank you to everybody who urged WHO to take this important step to protect future generations from dental mercury.

It’s time for the U.S. FDA to catch up with the world – and we need your help. FDA’s support for amalgam is radically inconsistent with WHO’s new position. Please contact Dr. Jeff Shuren, Director of the FDA Center for Devices, at

jeff.shuren@fda.hhs.gov
Fax: 301-847-8149 & 301-847-8109
Telephone: 301-796-5900
Mail: 10903 New Hampshire Ave., WO66-5431, Room 5442, Silver Spring MD 20993-0002

Here is a sample letter:

Dear Dr. Shuren:

In its recent report, the World Health Organization concludes that dental amalgam releases a “significant amount of mercury” and raises “general health concerns.” In light of these serious problems, WHO calls on health authorities like FDA to take action now: “Health authorities can play an active role in advocacy for use of dental materials alternative to amalgam…Directives can be set up for provision of dental care incorporating concerns for oral health and the environment.”

The WHO report says “Materials alternative to dental amalgam are available.” In particular, “Alternative restorative materials of sufficient quality are available for use in the deciduous [baby] dentition of children” – the population whose developing neurological systems are most susceptible to the neurotoxic effects of dental mercury according to FDA. So there is no excuse for subjecting children to the risks associated with dental mercury exposure.

FDA needs to stop amalgam use in children immediately and join WHO in working for a switch to the many mercury-free alternatives to amalgam.

Sincerely,
Your name

Thank you for working with us to protect everyone worldwide from mercury fillings!

Charlie
18 October 2011

Charles G. Brown
National Counsel, Consumers for Dental Choice
President, World Alliance for Mercury-Free Dentistry
316 F St. NE, Suite 210, Washington DC 20002
Telephone: 202-544-6333
Fax: 202-544-6331

The full WHO report is available here (PDF).

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30+ Years of Mercury-Free Dentistry

There’s a lot of high-quality, detailed and well-documented information out there about the health hazards of dental mercury. Many who contact my office about their dental needs are already quite familiar with it. In fact, their research is often what brought them to my office in the first place. Still, they have specific questions about me, my practice and what they can expect in terms of treatment.

So I created a FAQ to address the most common questions and concerns. Here’s an excerpt to round out Mercury-Free Dentistry Week:

  • How long have you been a mercury-free dentist?
    I have been a mercury-free dentist since the mid-1970s.
  • What qualifies you to diagnose and safely treat dental mercury poisoning?
    I have taken hundreds of hours of postgraduate training in order to learn the proper techniques of and science supporting this dental treatment. This study is in addition to my general qualifications as a dentist and related continuing education, which you can read about here.
  • How do you know if mercury amalgam fillings are causing a problem?
    I begin by gathering as much information as possible. The first visit involves a comprehensive, oral, head and neck examination, in which we fully chart your current dental, periodontal (gum) and oral conditions. We evaluate the state of your occlusion (bite), TM joint function and musculoskeletal condition, and perform galvanic, pulp vitality and allergy tests. We get further documentation of conditions via intra- and extra-oral photos, x-rays and diagnostic cast models. Unfortunately, there is still no single test that can prove without a doubt that dental mercury is causing a particular health problem. However, there are several tests that can help confirm diagnosis. These include hair analysis, fecal mercury analysis, blood chemistry, heavy metals urine challenge and electrodermal screening.
  • Which mercury-removal protocols do you follow?
    Standards of care for safe removal (PDF) have been established and are maintained by the International Academy of Oral Medicine and Toxicology (IAOMT).

     

     

    These standards help ensure that the mercury is removed safely and that the patient, dentist and staff are not exposed to the poisonous mercury vapor that is released during the process. My staff and I are trained in and have followed this protocol since its inception. Before that, we followed the widely-accepted Huggins Protocol, which continues to guide our work in this area, as well.

  • What will you replace the mercury fillings with?
    There are hundreds of different dental restoration materials and cements that can be combined in literally millions of ways. Our rule of thumb is to use the most practical and least toxic. We’ll look to what’s most compatible with your specific biochemistry and what’s most suited to the specific dental conditions we need to recreate in your mouth.
  • How do you know if a material is biocompatible?
    The suitability of materials can be accurately assessed via serum compatibility testing, electrodermal screening (EAV) or applied kinesiology. Of these, serum compatibility is the surest and most thorough, and we strongly recommend it for those with autoimmune disorders, multiple chemical sensitivities or other environmentally-aggravated illness. We prefer the serum testing provided by Clifford Consulting and Research, for which samples of your blood are specially prepared and mixed with hundreds of dental chemicals that are used in several thousand dental products. The antibodies produced provide an immunological record of offensive chemical families, and this information is cross-referenced with over 2000 dental products. With this info at hand, we can find the materials most suited to your unique biochemistry, double-checking their suitability via electrical testing and applied kinesiology, both of which we provide in our office. We want to be absolutely sure that we never replace one poison with another.
  • How fast can I expect to feel better after removing the mercury?
    While you may have read some accounts of people feeling physical relief within hours of having old mercury amalgams removed, it’s unrealistic to expect instant results. Nor is it possible to say how quickly you will experience relief. Results can never be predicted. Each affected person carries a different toxic burden. This alone varies the time it takes to rid the body of mercury completely. Some people may show improvement within months. Those with heavier toxic burdens or more compromised immune systems may need years to recover.
  • I feel fine. Should I have the mercury removed anyway?
    Eliminating any toxin from the body is an undeniable good. While there may not be an immediate effect, you pave the way for greater health, quality of life and longevity. Taking preventive measures is to be properly concerned with the long-term impact of the health choices you make today. Obviously, I recommend removing any potential source of illness or dysfunction. But it is not my role to make your choices for you. You must consider your own needs, desires, values and goals. You must consider the whole of your knowledge of your health and how to maintain good health. You must educate yourself about your options. It is my role to help you do this – and make the most informed choices possible.

Read the full version of the Mercury FAQ.

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One Mercury Filling Is Too Many

Every so often, the Wealthy Dentist surveys dentists on their use of mercury amalgam. In their latest poll, 67% of dentists said they place amalgam fillings at least some of the time: 40% regularly, 27% “in only [sic] special circumstances.” This is quite a change from past results, in which 53% of dentists said they don’t place amalgam – though the difference may be due to there being no “sometimes” option in past polls, and that dentists decide if they want to participate or not. These are hardly scientific polls.

But research published earlier this year in JADA suggests that higher rates of use are more accurate. Amalgam is still more common than composite (tooth-colored filling material) and especially favored by younger dentists and those who work in large group practices:

Dentists who graduated in the past 5 years placed amalgam on 61% of the lesions they treated. One explanation may be that younger dentists are more likely to be in large group practices where they work on salary, rather than fee-for-service, said [study author] Dr. Sonia K. Makhija. The type of material might be dictated by managers of the group practice. In large group practices (4 dentists or more), 79% of the restorations were amalgam (P < .001). "It's quicker, it's easier and it's cheaper to use amalgam," Dr. Makhija said. [emphasis added]

And that, as they say, is the gist and sum of it.

However many are being placed, the simple fact of the matter is that one mercury filling is too many. We know now that there is no longer a place for mercury amalgam in dentistry. While the FDA has flip-flopped and currently holds that mercury fillings are safe, just this year, one of its own scientific panels said otherwise:

According to the panel, FDA’s amalgam risk assessments were not adequate to protect hypersensitive adults, children and unborn babies. Repeatedly, panel members expressed their concern about amalgam use in children. Pediatric neurologist Dr. Suresh Kotagal of the Mayo Clinic summed it up for the entire panel: “There is really no place for mercury in children.” Other panelists went on to explain that dental mercury is like lead. The panel urged FDA to quickly contraindicate amalgam for these vulnerable populations and insisted that FDA provide consumers with labeling containing clear warnings.

Dental amalgam is more than 50% mercury, a known neurotoxin. There is no safe level of exposure. It is considered “toxic waste” outside the mouth but somehow magically inert and harmless when packed into living human teeth.

Mercury fillings have been linked to neurological, autoimmune and cardiovascular disorders, as well as enigmatic chronic illnesses such as CFS, fibromyalgia and MCS. It is continually released from the fillings into the general circulation just under the normal pressures of chewing and swallowing. Indeed, up to 95% of the mercury may be “lost” over time. But it doesn’t just disappear. That which isn’t excreted turns up in other tissues, including the brain. And while videos such as “Smoking Teeth = Poison Gas” have brought a lot of attention to the reality of “outgassing,” this isn’t the only way mercury may enter the general circulation. Some research has shown that mercury may travel through the teeth themselves.

There are many nontoxic alternatives that are strong and durable, less prone to fail and certainly more aesthetic. Placing composite is also a less invasive procedure than placing amalgam, letting you retain more natural tooth structure. All things considered, there just is no good reason for a dentist to place mercury fillings.

 

 

So why do so many dentists keep using it? Here’s a sample of responses to that Wealthy Dentist poll:

  • “I don’t understand what the big hoopla is about banning it entirely. Health concerns? Unproven. Mercury in environment? Don’t blame the dentists.” [Fact: Dentistry is the largest source of wastewater mercury pollution.]
  • “The greatest posterior restoration ever!”
  • “They are the most technically forgiving, economical workable restorative still.”
  • “There is nothing wrong with amalgam restorations — they are efficient and cost effective for the patient!”
  • “They last much longer, less sensitivity and there is no credible evidence they have killed anyone. [A straw man. The issue is harm, for which there is certainly evidence. (PDF)] Remember composites contain Bis-Phenol and I still place many more composites, GI’s, then amalgams. [Fact: Not all composites contain BPA. All amalgams, however, do contain mercury.] Because of their proven longevity, it is unethical to not offer amalgam to your dental patients.” [Fact: This “longevity” claim is a canard. Many new generation restorative materials are reported to be as strong and durable as metal.]
  • “I still love amalgams. I am also tired of all the amalgam-bashing. I believe most of it is profit-driven. I had great gold and amalgams placed years ago in my mouth. No one ever notices.”[Fact: Placing different metals next to each other in the mouth can create galvanic currents, which can also contribute to illness.]

This coming week, September 4 – 9, Consumers for Dental Choice will be teaming up with Dr. Mercola to promote Mercury-Free Dentistry Week. Each day, Dr. Mercola will run an article in honor of mercury-free dentistry – and the people who have worked so hard to stop this toxin from contaminating our bodies, our planet and our workplaces.

I’ll be posting mercury-related content on my office’s Facebook page all week, as well. So be sure to connect with me there so you can stay up to date – not only on the mercury issue but all aspects of holistic, biological dental health and wellness.

Image by foshydog, via Flickr

Updated 9/9/11

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US Calls for a “Phase-out” of Dental Amalgam in World Mercury Treaty Negotiations

This week, we got another email from Charlie Brown, National Counsel of Consumers for Dental Choice and President of the World Alliance for Mercury-Free Dentistry, delivering some excellent news: the US Mercury Intergovernmental Negotiating Committee has called for the phase-out of dental amalgam.

The Committee is part of an international effort to prepare a global legally binding treaty on mercury.

Charlie explains what happened and what it means:

The United States government has announced that it supports a “phase down, with the goal of eventual phase out by all Parties, of mercury amalgam.” This statement – a radical reversal of its former position that “any change toward the use of dental amalgam is likely to result in positive public health outcomes” – is part of the U.S. government’s submission for the upcoming third round of negotiations for the world mercury treaty.

While couched in diplomatic hedging – remember it is still early in the negotiations – this new U.S. position makes three significant breakthroughs for the mercury-free dentistry movement:

  1. The U.S. calls for the phase-out of amalgam ultimately and recommends actions to “phase down” its use immediately….
  2. The U.S. speaks up for protecting children and the unborn from amalgam, recommending that the nations “educat[e] patients and parents in order to protect children and fetuses.”
  3. The U.S. stands up for the human right of every patient and parent to make educated decisions about amalgam.

What does this mean? Our position – advocating the phase-out of amalgam – is now the mainstream because the U.S. government supports it. Who is the outlier now? It’s the pro-mercury faction, represented by the World Dental Federation and the American Dental Association….

We applaud the U.S. government. But tough work lies ahead. For example, we must demonstrate to the world that the available alternatives – such as composites and the adhesive materials used in atraumatic restorative treatment (“ART”) – can cost less than amalgam and will increase access to dental care particularly in developing countries.

For now though, let’s mark this watershed in the mercury-free dentistry movement: the debate has shifted from “whether to end amalgam” to “how to end amalgam.”

You can read and download the full text of the US statement here (PDF).

The next session of negotiations is tentatively scheduled for October 31 – November 4 of this year.

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The Ongoing Fight Against Dental Mercury Amalgam

Late last month, the Second Session of the World Mercury Treaty negotiations was held in Chiba, Japan. The World Alliance for Mercury-Free Dentistry (WAMFD) – a coalition of consumer organizations from around the globe – was there to advocate for a provision to phase out mercury fillings. Charlie Brown, National Counsel of Consumers for Dental Choice and President of the WAMFD, recently sent this progress report:

  • Our meeting kicked off with the announcement that the World Health Organization has withdrawn the biased paper that the American Dental Association so heavily cited as “reinforc[ing] dental amalgam as a safe and effective restorative material.” The alleged WHO report had been passed off as the conclusions of the team of scientists, environmentalists, and dentists who met in November 2009 to discuss the future of amalgam. We exposed the paper as nothing more than a propaganda piece slapped together by a rogue dentist inside WHO who failed even to consult the other meeting participants before signing their names to his paper (needless to say they were furious; they did not remember ever declaring amalgam safe). Then, we organized the worldwide condemnation of this paper that led to its hurried retraction. You can learn how we accomplished this feat step-by-step by watching this video interview, courtesy of filmmaker Kelly Gallagher.
  • Because of our work, the first draft of the treaty lists amalgam as one of only five mercury products to be phased out. While the war is not won, we did succeed in keeping it on the list for now.
  • Thanks to the efforts of our regional vice presidents Dr. Naji Kodeih and Dominique Bally, both the Arab League and the African region announced that they support the phase-out of amalgam and the promotion of alternatives.
  • We gained a valuable new ally dedicated to ending dental mercury: Health Care Without Harm. We congratulate Health Care Without Harm for convincing the Mexico City Health Secretariat to deauthorize the purchase of amalgam in the city’s hospitals and obtaining a discussion paper from Argentina calling for a phase down of amalgam and use of alternatives.

Unfortunately, adds Charlie, “The delegates made no major decisions in this early round, not on amalgam, not on anything. Thus how amalgam will ultimately be addressed in this treaty will not be determined until the third negotiating session, to be held in an African city in October.”

Meanwhile, The Guardian reports that the “European commission is due to publish the findings of its review on dental amalgam fillings in March. In a preliminary report, published online in July, the company tasked with the study, Bio Intelligence Service, recommended phasing out mercury in dental care in Europe.”

Of course, it was just a few years ago when the EC’s Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) released its report (PDF) touting the safety of mercury fillings. “SCENIHR recognises that dental amalgam is an effective restorative material,” they wrote, “and may be considered the material of choice for some restorations….We conclude that dental health can be adequately ensured by both types of material [mercury amalgam and composite]. All the materials are considered safe to use and they are all associated with very low rates of local adverse effects with no evidence of systemic disease.”

That’s what they said. But their report was greatly flawed. Now, a paper by Dr. Joachim Mutter recently published in the Journal of Occupational Medicine and Toxicology casts a very bright light on those flaws. The main problem? According to Dr. Mutter,

SCENIHR disregarded the toxicology of mercury and did not include most important scientific studies in their review. But the real scientific data show that:

(a) Dental amalgam is by far the main source of human total mercury body burden. This is proven by autopsy studies which found 2-12 times more mercury in body tissues of individuals with dental amalgam. Autopsy studies are the most valuable and most important studies for examining the amalgam-caused mercury body burden.

(b) These autopsy studies have shown consistently that many individuals with amalgam have toxic levels of mercury in their brains or kidneys.

(c) There is no correlation between mercury levels in blood or urine, and the levels in body tissues or the severity of clinical symptoms. SCENIHR only relied on levels in urine or blood.

(d) The half-life of mercury in the brain can last from several years to decades, thus mercury accumulates over time of amalgam exposure in body tissues to toxic levels. However, SCENIHR state that the half-life of mercury in the body is only “20-90 days”.

(e) Mercury vapor is about ten times more toxic than lead on human neurons and with synergistic toxicity to other metals.

(f) Most studies cited by SCENIHR which conclude that amalgam fillings are safe have severe methodical flaws.

Dr. Mutter’s paper provides an excellent overview of the research record on mercury in dental amalgam and its links to a variety of illnesses, including ALS, MS and Alzheimer’s. It’s a must-read for anyone concerned about the dangers of “silver” fillings and is freely accessible here.

Will critiques such as this, coupled with the new recommendation against mercury be enough to get the EC to ban mercury in dentistry? Stay tuned…

Cross-posted

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