Mercury Exposure from your Amalgam Fillings?
By Dr. Paul Rubin & Cynthia Logan
You may not have been born with a silver spoon in your mouth, but chances are you have one or more "silver" fillings in there. It's not, however, a source of emergency wealth-each contains a miniscule amount of the precious metal, and it's mixed with copper, tin and zinc. Oh, and about 50% mercury. That's the blobby silvery stuff you see in old-fashioned thermometers, and it makes for great visual effects in movies like Terminator 2. It's also one of the earth's most dangerous substances-more toxic than lead, cadmium or arsenic. If you are one of less than 10% of American adults aware that his or her silver amalgam fillings contain mercury, no doubt your dentist assured you it was completely stable and absolutely safe. But is it?
The American Dental Association states: "Mercury in dental amalgam chemically combines with other ingredients, including silver, to form a biologically inactive substance,"1 but there is irrefutable scientific evidence that amalgam fillings leak mercury, mostly in the form of mercury vapor, and that it accumulates in body tissues. According to L.R. Goldman, writing in the American Academy of Pediatrics,(2001) "The developing fetus and young children are thought to be disproportionately affected by mercury exposure, because many aspects of development, particularly brain maturation, can be disturbed by the presence of mercury. Minimizing mercury exposure is, therefore, essential to optimal child health."
In 1991, a worldwide panel of leading experts in mercury toxicology was convened by the World Health Organization to assess various sources of human exposure to mercury. They concluded that the single greatest source of human exposure was amalgam fillings, greater than all other sources (food, fish, air, water) combined.2 Dr. Bruce Shelton, Medical Director of the Allergy Center in Phoenix, Arizona, concurs, and takes it a step further, saying, "Dental amalgams have set us up for most of the diseases we see today; I'm convinced that 80% of my patients are ill because of hidden dental problems." Though easily detectable when tested, the amount of mercury released is small. So-is it really a problem?
It was for Christine. A healthy child, she sported a mouthful of shiny silver fillings. Following her marriage, she began having old fillings replaced, again with silver amalgam. Within five years, her health had seriously deteriorated, and doctors were at a loss to help or explain. For nearly two decades, Christine was constantly exhausted, had difficulty breathing and experienced allergic reactions to foods and prescription drugs. Mental fogginess made her feel like she was doing things in slow motion. After being bedridden for six months, her chiropractor suspected a connection to mercury. Having been unaware that her dental fillings contained mercury, Christine researched mercury toxicity and decided to have the amalgam removed. By the time her last fillings were gone, her health had vastly improved.
Jill also experienced rapidly deteriorating health in her 30's, including debilitating neurological impairment. Her doctors offered no solution, but diagnosed her with multiple sclerosis (MS) and advised her that her vision and health would continue to decline. She found a physician interested in alternative medicine and, after a thorough workup, this doctor was convinced that Jill's problems were linked to mercury exposure from her numerous amalgam fillings. After having them replaced, she followed a protocol for mercury detoxification, experiencing a positive reaction almost immediately. Today, over fifteen years later, she is in vibrant health and is convinced that this process literally saved her life.
These stories may sound remarkable, but they are not unique. Every holistic dentist can cite dozens, if not hundreds, of such case histories. Mercury poisoning can cause a wide variety of symptoms as it damages enzyme systems, cell walls, and other physiological processes. It can be difficult to diagnose, since its symptoms often mimic other medical conditions, including psychological disturbances, oral abnormalities, gastrointestinal problems, and cardiovascular, neurological, respiratory, immune and endocrine disorders. It can affect the skin, lead to impaired kidney function, and contribute to chronic fatigue, joint pain and muscle weakness. Manufacturer's directions accompanying dental amalgam include the statement that, "Mercury has been reported to be associated with a wide variety of health effects, including reproductive toxicity."
Mercury poisoning comes from mercury exposure. Is the exposure from amalgam fillings really enough to be a problem? Well documented scientific studies over the past fifteen years or so, demonstrate that mercury from amalgam fillings accumulates in all body tissues.4 Alarmingly, it has also been shown to pass through the placenta into fetal blood supply and fetal tissues.5 It also accumulates in mother's milk, further exposing the newborn.6 It can reduce kidney function and create antibiotic resistant bacteria in the gut.7 And, it has been implicated in neurological damage similar to Alzheimer's Disease.8
Though silver fillings have been standard practice for the past 150 years, dentists have always been advised to handle mercury and amalgam with extreme care. Strict protocols are followed to protect the dentist and staff from the toxic effects of mercury. "Scrap" amalgam that's left over after placing a filling is handled cautiously and stored in a sealed, leakproof container until it is taken to a certified, licensed metal recycler. At this point, it is considered hazardous waste by the US Environmental Protection Agency.
If the substance shouldn't come into contact with a dentist's fingers, should it come into contact with the more tender, often compromised tissues of the mouth? Should it be placed anywhere near the brain, whose base lies just 1 inch from the roof of the mouth? Shouldn't the public have the right to know about potential negative "side effects" posed by mercury-laden fillings? Shouldn't it be the responsibility of dentists to provide this information? Unfortunately, dentists are not only discouraged from doing so by the ADA, but in some states are actually forbidden by their Boards of Dentistry to present such information and will lose their license if they talk about it! Why?
The American Dental Association is a trade organization whose roots are tangled in the mercury controversy (see Sidebar...end of article). Since they accredit virtually every American dental school, they dictate curriculum. The ADA Code of Ethics, often adopted by State Dental Boards, considers it unethical for a dentist to remove and replace "serviceable" amalgam fillings in order to remove an allegedly toxic material from the body-if this is done solely at the recommendation of the dentist.8 But the code states it is ethical for a dentist to replace "serviceable" mercury fillings for aesthetic reasons. Might there be a discrepancy here? Might it have to do with money? (Again, see Sidebar).
Quack, Quack, Where's The Duck?
Those who practice holistic, mercury-free dentistry are sometimes labeled as "quacks." Some have been harassed or persecuted; some have even had their licenses revoked, simply because their conscience dictates they refrain from using what they understand to be a poison inside their patients' mouths.
Ironically, the original use of the term "quack" described dentists who used silver mercury amalgam fillings, mercury being known as quicksilver in the United States, but "quacksilver" in Europe. "Quacks" also described people who applied mercury topically to "cure" diseases such as syphilis. Skin lesions treated with mercury did disappear; however it served only to drive the disease deeper into the body, penetrating vital organs and nervous system, causing a painful death. Perhaps because of such a heinous history, European countries have seriously restricted or discouraged the use of mercury amalgam fillings.
Such progressive action actually mirrors the position of the original American Society of Dental Surgeons, which, in 1848, required its members to sign pledges promising NOT to use mercury in filling material. When a number of member dentists in New York City violated the pledge and used mercury, they were suspended from the organization for "malpractice by using silver mercury fillings." According to Morton Walker, D.P.M. ("Elements of Danger") the suspended fellows refused to give up their toxic ways because working with mercury offered an easily malleable filling material which required much less time and effort to apply, at a lesser cost than other materials. They formed a new, competitive dental organization, recognized today as the American Dental Association.
Though it strongly supports the use of amalgam, the ADA distances itself from potential liability regarding the substance. It does not certify amalgam, claiming it is a "reaction product" mixed by the dentist. Similarly, the FDA has never certified or even classified "mixed" amalgam. In a tort liability suit, ADA attorneys pleaded: "The ADA owes no legal duty to protect the public from allegedly dangerous products used by dentists. The ADA did not manufacture, design, supply or install the mercury-containing amalgams, and does not control those who do."8 So, although many dentists have been persecuted for not using amalgam, the majority of those who do are most likely unaware that the American Dental Association has abandoned them legally.
Fortunately, State Dental Boards and Attorneys General in several states have been successfully stopped from prosecuting holistic dentists. In March of this year, the Oregon Dental Board was forced to rescind its "gag order" statutes that had forbidden dentists from even discussing with patients the potential toxic effects of mercury amalgam. States with similar statutes are now on notice, since the ACLU stepped in, claiming that Oregon was in violation of First Amendment rights. A few months ago, California Governor Gray Davis threw out the entire state Dental Board for their irresponsible actions relating to mercury amalgam information. The ADA has been named in numerous class action lawsuits, which allege fraudulent misrepresentation regarding the amalgam issue. Congressional hearings are scheduled for this session and many state actions are pending.
And at least one Federal bill (titled the Mercury in Dental Fillings Disclosure and Prohibition Act) has been introduced, by Congresswoman Diane Watson of California, seeking to ultimately rid dentistry of this pre-Civil War material.
Dental Mercury-An Enviro Hazard
Another concern is municipal water contamination. Whenever an amalgam filling is placed or removed, scrap amalgam (in the form of a sludge of very fine particles) gets scooped up by the dental vacuum unit and goes down the drain. Wastewater treatment agencies around the country have expressed growing concern about mercury levels in dental office wastewater, and several municipalities have followed King County, Washington's requirement that dental offices be equipped with devices that capture and keep mercury out of the wastewater.
What To Do?
Educate yourself. Research the facts. Insist that your dentist use alternative, mercury-free materials when filling cavities. Though there is no perfect material in dentistry, composite resins and ceramics are durable, natural looking, and highly bio-compatible. They do require more time, skill and advanced training than amalgam fillings, and therefore are more expensive.
If you decide to have amalgam fillings removed, choose an experienced
holistic dentist who follows specific protocols for protecting
you from mercury exposure during the treatment process, who can
assess the bio-compatibility of alternative materials, and who
can refer you to someone skilled in mercury detoxification. Mercury
is very persistent in body tissues. To remove it from the mouth
but not from the rest of the body does only half the job. Heavy
metal detoxification may involve nutritional recommendations,
supplements, chelation therapy, sauna treatments, colonic cleansing
and other procedures. This is not a do-it-yourself project!
Finding an appropriate dentist in your area shouldn't be too difficult, though the numbers are still fairly small. The associations listed at the end of this article provide references. Often, holistically oriented medical doctors and naturopathic physicians will be aware of "mercury-free" dentists. When interviewing a potential dentist, don't hesitate to ask questions such as the following:
1. How long has the dentist been practicing mercury-free?
2. Do they ever use amalgams? An office that will use alternative materials when you ask, but still uses amalgam on other patients is not committed to mercury-free dentistry!
3. Have they had advanced training for safely treating patients with mercury toxicity?
4. Do they have protective protocols for patients and staff?
5. Are they affiliated with any of the organizations listed below?
6. Do they have amalgam fillings in their own mouths?
The resources listed below offer further, in-depth information. When you are well informed, share what you've learned with friends, as well as with professionals in the medical and dental fields. Ask your Congressional Representative to support Diane Watson's bill on dental amalgam (H.R.4163). Many parts of the country are actively trying to get mercury out of the environment (banning mercury thermometers and other products containing mercury). Remember the expression, "Think Globally, Act Locally?" It doesn't get any more "local" than your own mouth.
Mercury amalgam was first introduced into this country in the 1830's. Dentistry was an emerging profession, more or less divided between mechanically oriented craftsmen and medically oriented professionals trying to rise above the barber/dentist image. Amalgam provided a cheap, easy method of filling cavities. But many looked upon it as poisonous and medically unsound. In the 1840s the American Society of Dental Surgeons urged its members to sign a pledge not to use this inferior material. A major battle took place, economics won out, and the ASDS began to fall apart.
A new group of amalgam-using dentists split from their more medically oriented predecessors and formed the American Dental Association in 1856. Today, this organization still claims that amalgam fillings are safe and appropriate, in spite of scientific evidence to the contrary. They may even have profited through patents on amalgam formulas (now expired) and on fees for their "Seal of Approval" program. The majority of well-meaning, skilled and caring dentists rely almost solely on ADA sponsored publications and sources for their information. This information is highly biased and often inaccurate, resulting in regrettable dental practices. Organizations such as the International Academy of Oral Medicine and Toxicology (see below) have tried to counterbalance this by providing valid research and information that dentists don't otherwise hear.
International Academy of Oral Medicine and Toxicology: 407-298-2450 http://www.iaomt.org;
Holistic Dental Association: 970-259-1091 http://www.holisticdental.org;
American Academy of Biological Dentistry:
1. Press Release from the American Dental Association, June 13, 2001.
2. World Health Organization, Environmental Health Criteria 118: Inorganic Mercury, Geneva, 1991.
3. Hahn, U. et al, "Whole body imaging of the distribution of mercury released from dental fillings into monkey tissues." FASEB J, 4:3256-3260, 1990.
4. Vimy, M.J. et al, "Maternal-fetal distribution of mercury released from dental amalgam fillings". Am J Physiol, 258, R939-R945, 1990.
5. Vimy, M.J. et al, "Mercury from maternal 'silver' tooth fillings in sheep and human breast milk. A source of neonatal exposure." Biol Trace Elem Res 56(2):143-52, 1997.
6. Boyd, N.D. et al, "Mercury from dental 'silver' tooth fillings impairs sheep kidney function." Amer J Physiol, 261:R1010-R1-14, 1991.
7. Pendergrass, J.C. et al, "Mercury vapor inhalation inhibits binding of GTP to tubulin in rat brain: similarity to a molecular lesion in Alzheimer diseased brain." NeuroToxicology, 18:315-324, 1997.
8. Case No. 718228, In The Superior Court of California in and for the County of Santa Clara, 22 October, 1992.
About Dr. Rubin:
Dr. Paul Rubin has practiced biocompatible dentistry in Seattle for over twenty years and he can be reached at 206-367-6453.