Are your dental fillings poisoning you?

THE MIX
"Amalgam" or silver fillings are called "silver" primarily due to the color of the filling material. In actuality, they are comprised of 50% mercury, 35% silver, 15% tin (or tin and copper), and traces of zinc. The term "mercury fillings" would appear more fitting, though understandably more difficult to market to the general public. Mercury is used in this "amalgam" mixture because it is liquid when in its free state, but in combination with other metals, it forms a paste that hardens within minutes.

HOW IT ALL STARTED
In 1833, silver/mercury fillings were promoted by two brothers in New York City who had no previous dental training. The American Dental Association (ADA) took up the banner in defense of amalgamfillings by the end of the 1800s, due to the cost factor, ease of placement, and "alleged" durability. The controversy over storage of this known poison in the teeth has raged for over 170 years. While a growing body of dentists now refuse to place silver/mercuryfillings, it is estimated that 125 million people in the U.S. still have potentially toxic materials in their mouths.

THE ISSUE OF SAFETY
The ADA initially declared the safety of silver/mercury filling material based upon the misinformed theory that mercury did not escape from the filling. This assessment came prior to the availabiity of instrumentation which could determine whether mercury was leaching from the fillings. The ADA's current position that the vapor that does escape is not enough to cause harm, comes prior to the availability of any long-term studies on human health. Present "safety" studies on mercury vapor are often compared to mercury levels in the workplace over an 8-hour day. By contrast, the fillings and residual mercury levels are in the body 24-hours a day, over an indefinite period of time. All that we need to do is examine the breast implant issue to understand why an unsafe product is rendered safe for so many years.

WHAT ARE THE ALTERNATIVES?
The dental materials that can be used as alternatives to silver/mercury fillings are porcelain, gold and composite. Porcelain has the most advantages and fewest disadvantages of any other material. It contains no known toxic materials, is tooth-colored filling material composed basically of plastics. Some individuals are sensitive to the plastic materials. Also, the larger and deeper the filling, the greater the chances of tooth sensitivity with the composites.

There is no perfect man-made dental material, each having at least one drawback. The best dentistry is no dentistry. Prevention is by far the best procedure available.

HOW ARE WE EXPOSED?
Scientific evidence shows that dental mercury implants can release mercury vapor continuously without any type of stimulation. however, activity such as chewing, drinking hot liquids, polishing or brushing the teeth increase mercury vapors as much as fifteen times (for up to 90 minutes after). In this vapor form, it is inhaled and absorbed through the lungs into the bloodstream. It then accumulates in vital organs and tissues.

We have pathways that carry mercury vapor from the mouth and nose directly to the brain. Autopsy reports of accident victims show that as few as five fillings can raise the level of mercury in the brain 300 percent and confirm the mercury residue is distributed to tissues and organs throughout the body. The main points of accumulation are the brain and kidneys; other common storage sites include the thyroid, pituitary, liver, heart and blood.

SIGNS & SYMPTOMS
Mercury can alter the function of any cell in the body. This means that an individual can experience a wide range of "systemic" symptoms anywhere in the body. The appearance of seemingly unrelated symptoms complicate the diagnosis and often leave the patient bewildered. Most often individuals who suffer adverse effects from silver/mercury fillings don't experience immediate symptoms, although some do. If the immune system is impaired, one may begin to experience chronic flu-like symptoms or chronic fatigue and may not make the connection until some time later. Others may experience a metallic taste, depression, confusion, difficulty concentrating, numbness and tingling, frequent urination, irritability or short-term memory loss.

HEALTH UPDATE
There is evidence that silver/ mercury fillings can impair the immune system. Medical researchers have also recently identified mercury as a possible cause of Alzheimer's disease.

Chronic low-level exposures to harmful substances can often be more dangerous than a sigle massive exposure. This is due to the fact that the body's defense mechanism is under continual assault and doesn't have the opportunity to rebuild itself. This often leads to permanent damage of the body's detoxification pathways. The result will be more and more individuals who will develop environmental illnesses (extreme sensitivities to a number of environmental agents).

HOW MUCH IS TOO MUCH?
First of all, let's establish one fact. Mercury is more toxic than arsenic or lead. How much of this highly toxic heavy metal can the human body tolerate? Unfortunately, no standard exists within the dental industry, for "safe" levels of oral mercury. However, no level of mercury can logically be considered safe.

The Jerome Mercury Vapor Analyzer is an instrument that accurately measures the level of mercury vapor escaping from the filling material. Presently, the Occupational Safety Health Administration (OSHA) uses 50 micrograms per cubic meter (over an 8 hour period) as their maximum allowable level of mercury vapor in the workplace. For those with several silver/mercury fillings, the average levels usually range from 50 to 150 micrograms per cubic meter. These levels are 13 times the maximum allowable levels established by OSHA.

PREGNANCY
It has been determined that mercury crosses the blood brain barrier and placental membrane and is taken up by the fetus. There is some evidence to support the fact that mercury can cause unwanted abortions, stillbirths and birth defects.

EPA documents state that "women chronically exposed to mercury vapor experienced increased frequencies of menstrual disturbances and spontaneous abortions; also a high mortality rate was observed among infants born to women who displayed symptoms of mercury poisoning. "

CHILDREN
Again, because "norms" don't exist for dentistry, industrial mercury levels often used for comparison were never meant to protect the health of a child, simply because children aren't found in workplaces containing mercury fumes. For this standard to apply to children at all, it would have ta be reduced proportionately to their weight. A young child exposed to mercury in their mouths must somehow cope with the effects of mercury, with an immature defense mechanism. Studies have shown that mouth-air mercury levels of children having received silver/mercury fillings were raised significantly immediately after placement and one week later. With the lack of safety studies targeted ta children, placing silver fillings in a child seems analogous to creating a toxic waste site in their mouths.

WORKERS
OSHA has found that approximately 10% of all dental offices are severly mercury-contaminated. Most dental offices have inadequate mercury decontamination systems. The results of a study presented to the Society of Toxicology earlier this year showed reduced fertility in dental assistants who are occupationally exposed to mercury vapor from amalgam. The high incidence of suicide among dental professionals may also point to the "neurotoxic" effects of mercury accumulated in the brain.

WHO'S DECIDED WHAT?
In December, 1990, CBS' 60 Minutes decided to let 40 million people know about the potential dangers of mercury in their mouths. The public became increasingly aware. . . and concerned. Then, in March of last year, the FDA Dental Products Panel of the Medical Devices Advisory Committee decided that there was not sufficient evidence that amalgam was harmful, but legitimized the need for further investigation. In addition, it was decided that fillings would not be classified as implants, circumventing the need for extensive biocompatibility testing. In August 1991, the National Institutes of Health determined that virtually all restorative materials have components with potential health risks. . .however, "quantities of mercury released do not cause verifiable adverse effects to render them unsafe." Their final decision was, unfortunately, contrary to the scientific evidence presented to the panel.

LEGISLATIVE DEVELOPMENTS
On February 1, 1992, the German Ministry of Health authorized only restricted use of amalgam fillings. This action took effect in March based upon the adverse health effects observed in patients exposed to mercury released from the amalgam fillings. Dentists have been instructed not to use amalgams in root canals, anterior fillings, side teeth, in children up to six years of age and in pregnant women.

Currently lawmakers in Alaska Michigan and California are drafting legislation that would require dentists to inform patients of the possible health hazards of mercury. SB 934, introduced to the California state legislature by Senator Diane Watson, passed the senate floor in January 1992. The bill is scheduled to be heard before the assembly health subcommittee before this summer. If passed, this will be the first successful effort to mandate "informed consent" in this country.

ENVIRONMENTAL CONCERNS
Nationwide, the dental industry uses 100 tons of mercury per year. Dentists have been essentially responsible for monitoring their own toxic waste. However, the City of Seattle just published a study which found mercury levels in waste streams of dental offices to be as high as 750 times the limit. Finding similar problems in Pima County, Arizona, dental offices there are now required to have permits to dump mercury.

The problem is that amalgam traps do not catch the fine mercury dust particulates created when drilling, which ends up going down the drain. Unused scrap metal is often sold to unlicensed recyclers who remove the silver and discard the mercury indescriminately. The National Institutes of Health recommended that dentists install devices to "recover waste amalgam residues in their offices for recycling to reduce environmental contamination."

WHAT THE FUTURE HOLDS
Informed consumers of dentistry will continue to demand full disclosure of dental materials being used. They'll also insist on being advised of all available options. Hopefully more dentists will espouse the notion that teeth are actually attached to a human being. And that the tissues, cells and nerves in the oral cavity are somehow connected to other parts of the body. This line of thinking describes the growing network of holistic dentists. These are practitioners who work closely with other supportive therapists, and who use the least toxic alternatives--from anesthetics to filling materials. Typically this would involve products and procedures deemed safe for the practitioner, the patient. . . and the planet.

Obviously, the burden of the amalgam controversy cannot be carried by dentists alone. Research must involve the disciplines of toxicology, medicine, epidemiology, statistics and behavioral sciences. But tomorrow's ideals don't help much when you've got a cavity today. Just remember, you do have a choice.

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By Joyal Taylor, DDS

Joyal W. Taylor, DDS, author of Mercury Toxicity From Dental Fillings and president of the Environmental Dental Association (EDA), has a private practice in San Diego, California. For more information on how to locate a mercury-free dentist in your area, and to receive a free packet of information, call the EDA at 1-800-388-8124.

GUM DISEASE PREVENTION UPDATE
New products are appearing in the marketplace to aid in gum disease prevention. Regular flossing and dental checkups are a necessity but electric toothbrushes such as Interplak and Braun's entry in the field are important.

The latest device is termed "the easiest, fastest way to floss called FLOSS PLUS Registered Trademark. Massage and cleaning is accomplished by a well-designed, lightweight unit. High speed vibration stimulates teeth and gums and safely removes plaque. For information call 1-800-832-2464.

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