Dentists and Amalgam Fillings

If you talk to most of the contemporary practicing dentists about amalgam fillings, you may get an unsettling impression. According to many of them, amalgam fillings in your mouth are not dangerous and can cause no toxicity. Therefore they feel it is absolutely safe to put them in your mouth, particularly in places where it is difficult to reach. Amalgam fillings are inexpensive and cost effective. Most dentists have no hesitation putting them into their own mouths, or the mouths of their loved ones. Dentists are usually unaware of any professional risks to their own health; they do not hesitate to work with mercury: mixing, drilling or replacing amalgam fillings. In many clinics, particularly publicly funded ones, amalgam fillings are your only choice. Some dentists do not even hesitate to put a metal crown on top of an existing amalgam filling.

However, the story may change if you want to replace amalgam fillings. Dentists may point out that during the process you may develop significant side effects and they are reluctant to replace the fillings. In addition, insurance companies consider amalgam removal and replacement to be only of cosmetic value. When teeth containing amalgam are extracted they are treated as a very poisonous entity and must be disposed of as highly toxic material. When mercury is delivered to the office there is a skull and cross bones sign indicating material of extreme danger. But ironically, when in your mouth, dangerous mercury miraculously transforms into a safe material.

Unfortunately most of the dentists are refusing to reconcile the current situation and become quite frustrated when it is discussed. In addition to keeping rank and file in order, quite a few dentists have lost their licenses when supporting the validity of toxicity poisoning due to amalgam fillings.

Dentistry itself is a profession at risk. In a case report study by a dentist regarding mercury toxicity in his patients, the following emotional symptoms were described:

Irritability, critical excitability, fearfulness, restlessness, melancholy, depression, timidity, fatigue, weakness, indecisiveness, headaches, hopelessness- futile attitude about future.
D. Lesesne Smith, Jr. “Mental effects of mercury poisoning” Southern Medical Journal, 1978, Aug, 904-905

Like hatters before them, dentists are adamantly resisting any changes to their professional practice, even though devastating health issues are affecting them and their clients.

The Federal Drug Administration (FDA) considers amalgam fillings to be prosthesis and has been refusing to regulate its content.

But a political /scientific/practical approach has been evolving in western countries in the last twenty years.

For example, in 1996 Canada’s advisory on amalgam included the manufacturer’s listed contra-indications, i.e. No amalgam is allowed:

in children under 7
with other metals
under crowns
in pregnant or breast feeding women
in those with reduced kidney function
in people with hypersensitivity to amalgam

Bowing to pressure, in 1997 amalgam manufacturers of dental amalgam, Dentsply-Caulk and Ivoclar-Vivadent, altered their Manufacture Safety Data Sheets for Germany and California to include the following adverse health effects from chronic inhalation and/or ingestion of mercury:

tremor, fatigue, headaches, irritability, excitability, depression, insomnia, loss of memory, hallucinations, psychiatric disorders, mental deterioration and resentment to criticism, bronchitis, kidney failure, chest pain and palpitations, colitis, dermatitis, blood disorder, infertility and birth defects.

Theoretically speaking, it would mean that if you are in Los Angeles, your dentist must warn you about potential side effects of amalgam fillings, but if you are in New York he has no such legal obligation.

How many amalgam fillings are too much?

My opinion is that even one is too many. But in the G. M. Richardson study; “Monte Carlo Assessment of Mercury Exposure and Risks from Dental Amalgam” (Human and Ecological Risk Assessment: Vol. 2, No 4, pp.- 709-761, 1996.) he came to a different conclusion. Authors of this study assumed that a Tolerable Daily Intake (TDI) of mercury is 0.014 µg Hg/kg body weight/day is safe. Therefore based on the least conservative numbers of amalgam-filled teeth estimated not to compromise health, they consider it was safe to place: 1 filling in toddlers; 1 filling in children; 3 fillings in teens; 4 fillings in adults. Of course these numbers are based on complicated mathematical formulas and may have little to do with an individual person.

Who is responsible for protecting the public from mercury toxicity?

If you look at legal cases, nobody is responsible. Let’s look at cases that were tried in court:

The American Dental Association (ADA), in court: “The ADA owes no legal duty of care to protect the public from allegedly dangerous products used by dentists. The ADA did not manufacture, design, supply or install the mercury-containing amalgams.” (Case No. 718229, Superior Court of the State of California In and For the County of Santa Clara, October 22, 1992)

The ADA does NOT certify mixed dental amalgam: “The specification is not for dental amalgam. It is only for the alloy for dental amalgam. The amalgam does not form until the dentist mixes the alloy with mercury. Therefore, dental amalgam per se cannot be certified. We cannot certify a reaction product made by the dentist.” (ADA letter, May 22, 1986).

The FDA has NOT accepted and classified dental amalgam! FDA has accepted and classified only “Dental Mercury” and “Amalgam Mercury” to protect the manufacturers. (See website for approved dental devices!) FDA says: “FDA regulates the manufacture of medical devices. No manufacturer produces mixed dental amalgams. The mixed dental amalgam is prepared by dental clinicians.” (FDA letter, April 2, 1991)

But situations have been changing in the last twenty years. In several European countries where there is socialized medicine, amalgam fillings are prohibited.

In June, 2008 the Food and Drug Administration agreed to set a date to classify mercury amalgam as a substance that poses a health risk to pregnant women and unborn babies, and children. This is a settlement in response to a lawsuit: Moms against Mercury et al. v. Von Eschenbach. As part of the settlement, the FDA agreed to and, with uncharacteristic speed, has already changed its website— dramatically. The Updated June 3, 2008 FDA website now states, for example:

“Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetus.” “Pregnant women and persons who may have a health condition that makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden, should not avoid seeking dental care, but should discuss options with their health practitioner.”

For more information see http://www.mercurypolicy.org/.

Additional risks of amalgam fillings

Amalgam fillings consist of 50% amalgam and 50% alloys of other metals which are also toxic to the body. The combination of different metals creates a much higher toxicity than just the sum of two or more metals; they markedly increase the cumulative toxic effect.

As mercury evaporates from amalgam fillings it creates space for cavitations and chronic dental infections. So, amalgam is a poor dental material as well.

The risks of amalgam fillings can dramatically increase if other metal alloys are put into the mouth, like gold or steel. It creates a galvanic flow (electrical/chemical flow) in the mouth and accelerates the release of toxic metals from the alloys.