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Have doubt? Read me! The cream of the crop

Posted by JN on March 15, 1999 at 22:13:35:

TOXIC TEETH: THE CHRONIC MERCURY POISONING OF MODERN MAN.
Murray J. Vimy
Are mercury-based fillings slowly poisoning their owners? Evidence suggests that, far from being the best material to use in the mouth, these fillings should be banned
The issue of mercury exposure from dental "silver" fillings has gained considerable notoriety in the general media during the last decade. Specific attention has focused on the potential for human health consequences and the general well-being of the global environment. The modern silver amalgam (amalgam meaning mixed with mercury), traditionally known as a "silver" filling, has been employed as the principal tooth restorative material for over 180 years and presently accounts for 75-80% of all tooth restorations.1 These "silver" fillings contain approximately 50% mercury by weight, 35% silver, 13% tin, 2% copper and a trace of zinc.2 Each tooth restoration has a mercury mass of about 750-1000 mg and should more properly be called a mercury filling. They have a functional life of approximately 7-9 years, after which they are usually replaced with another mercury filling.3,4 Hundreds of metric tonnes of mercury are placed into teeth world wide each year and some of this material, as particulate waste from the dental office, finds its way into the sewerage and refuse systems.
Within the dental profession, the issue of mercury filling safety has cyclically recurred. After the introduction of the modern dental amalgam in 1812 by a British chemist, a "silver paste", which was a combination of silver filings from coins and mercury, became fashionable for tooth restoration. Since the coins were not pure, expansion of the material often resulted in tooth fracture and/or a "high bite". In America during the 1800s, concern regarding the possibility for mercury toxicity caused the American Society of Dental Surgeons to make mercury usage an issue of malpractice, mandating that its members sign an oath not to use mercury-containing materials. However, mercury fillings usage increased because it afforded an economic advantage to those dentists employing it; it is user friendly; and because of its durability in the mouth. By 1856, the American Society of Dental Surgeons was forced to disband due to dwindling membership over the mercury filling issue. In its place arose the American Dental Association, founded by those who advocated silver amalgam - mercury use in dentistry.5-7 Again in the 1920s, a controversy erupted after the publication of articles and letters by a German chemistry professor, who attacked mercury filling usage for possible toxic effects.8-13 That debate abated and the dental profession's opinion still remains unchanged.
Today, 182 years later, the American Dental Association has amended its Code of Ethics to make the removal of serviceable mercury fillings an issue of unethical conduct, if the reason for removal is to eliminate a toxic material from the human body and if this recommendation is made solely by the dentist.14 In the American Dental Association's view, a dentist is "ethical" to place the mercury material and recommend its safety. But, if the dentist suggests that the mercury fillings are potentially harmful or that exposure to unnecessary mercury can result, then the dentist is acting "unethically". Clinically serviceable mercury fillings can be "ethically" removed if: done for aesthetic reasons; at the request of a physician; or at the patient's request (without prompting). *** Release of mercury from dental fillings. Mercury vaporizes continuously from dental fillings, being intensified by chewing,15,16 tooth brushing17 and hot liquids.18 After mastication or tooth brushing ceases, it takes almost 90 minutes for the rate of vaporization to decline to the lower prechewing level (Fig. 1).16 Also, the greater the number of fillings and the larger the chewing surface area, the larger the mercury exposure.15,16 Thus, the average individual is on a roller coaster of mercury vapor exposure during the day. Breakfast will cause the release rate to increase and just as the rate is slowing again it is time for the midmorning coffee break. Lunch, mid-afternoon coffee or tea, the evening meal, and a snack before bedtime all contribute to the daily exposure to mercury from dental fillings.
It is estimated that the average individual, with eight biting-surface mercury fillings, is exposed to a daily dose uptake of approximately 10 micrograms mercury per day from dental fillings.19 Select individuals may have daily doses 10 times higher (100 micrograms per day) because of factors which exacerbate the mercury vaporization. Some of these factors are: frequency of eating, chronic gum chewing, chronic tooth grinding behaviour (usually during sleep), the chewing pattern of the individual, consumption of hot foods and drinks, mouth and food acidity.16 Corroborating human autopsy evidence20-22 showed that brain and kidney tissues contained significantly higher mercury in individuals who had mercury fillings. Furthermore, the concentration of brain mercury in the subjects with mercury fillings correlated with the number of these fillings present.
The historically espoused opinion of dentistry insists that, once mixed, the mercury is locked into the fillings.23 The aforementioned body of experimental evidence suggests that their opinion is totally without merit. Despite these replicated research findings, many national dental trade associations still claim that mercury fillings are safe.24 They base their conviction on the anecdotal facts that mercury fillings have been used for over 150 years, billions of fillings have been placed, and they do not see sickness or death from the mercury exposure.25 But, the diagnosis of mercury toxicity lies outside the purview of dentistry, falling more appropriately within the jurisdiction of medicine. Dental institutions do not have the scientific expertise or the resources to undertake the necessary studies to scientifically resolve this issue. Thus, the issue of mercury filling safety has not been suitably addressed until recently, when academic medicine became aware of this insidious exposure to mercury. From the medical perspective, dental amalgam fillings are a significant mercury source, having potential medical consequences.
Tissue uptake of mercury from dental fillings. Recent investigations in sheep and monkey animal models demonstrate that dental mercury accumulates in all tissues of the adult, being highest in the kidney and liver. This accumulation is so extensive that it can be visualized on a whole-body image scan (Fig. 2).26,27 Research also shows that a high level of dental amalgam mercury in monkey kidney is still present at one year after mercury filling placement.28 Also, mercury from dental amalgam will cross the placenta and begin accumulating in the developing fetus within two days after the filling placement in pregnant sheep and is highest in the fetal liver then the kidney. The mother's milk also showed evidence of mercury, suggesting that the newborn would have an additional exposure to mercury.29 Recent human chelation studies show a association between urinary mercury excretion and the presence of mercury fillings.30-33 For example, one study showed that, after a chelation challenge with DMPS, urinary mercury excretion is significantly higher from subjects with mercury fillings than from those with no such fillings. It was concluded that at least two-thirds of the excreted mercury originates from the dental restorations.30
On the basis of the research cited here, there is now international scientific consensus that the mercury from dental tooth restorations constitutes the largest non-occupational source of mercury in the general population, being greater than all other environmental sources combined!34-36 Yet, the dental profession still insists, without evidence, that the exposure is insignificant and has no potential to produce harm.
Pathophysiological consequences of mercury from dental fillings. During the last several years, medical research has demonstrated a relationship between mercury exposure and pathophysiology in various animal models.
In sheep exposed to mercury from in situ tooth fillings, kidney function has been shown to be impaired. After 30 days of chewing the sheep lost 50% of their kidney filtration ability; they began to have difficulty regulating sodium and they demonstrated a reduced albumin excretion. Control sheep treated with non-mercury dental fillings did not show such effects.37 In a study of 10 humans with mercury fillings, it was demonstrated that the plasma mercury level dropped by 50% and the urinary mercury level declined by 25% over a twelve month interval after filling removal compared to the pre-removal level. Most notable was the finding that 12 months after filling removal, the urinary albumin level was significantly higher than the level 4 months prior to removal.38 In the sheep, the placement of mercury fillings caused a fall in the urinary albumin, signifying renal pathophysiology. In humans, the removal of mercury fillings results in an elevation in urinary albumin, indicating a renal homeostatic readjustment. The agreement between this sheep and human data is remarkable.
In a recent collaborative paper between three North American universities, it was demonstrated in a primate model that oral and intestinal bacteria (eg. streptococci, enterococci, enterobacteriaceae) exhibit a significant increase in mercury and antibiotic resistance within two weeks following mercury filling placement.39 The mercury resistant bacterial species exhibited resistance to various antibiotics such as, ampicillin, tetracyclines, streptomycin, kanamycin, erythromycin, and chloramphenicol, which they had not demonstrated prior to placement.. This is the first direct experimental confirmation of a non-antibiotic factor, mercury, producing antibiotic resistance. This occurs because in some bacteria mercury-resistance and antibiotic-resistance are encoded on adjacent small genetic sites within plasmids.40 When exposed to environmental mercury, this genetic material is activated to protect the bacteria from the lethal mercury. The plasmid is also replicated and passed on to other bacteria, insuring species survival. In so doing, the antibiotic resistance also spreads to the other bacteria. Antibiotic resistance is a important issue in medicine today.41 It has been estimated that 80% of mercury-resistant bacterial strains also show an increased resistance to one or more conventional antibiotics. Thirty percent of all hospitalized patients in North America receive antibiotic therapy42 and antibiotics compromise 10% of the total $5.1 billion drug sales in Canada during 1992.43 Moreover, ten of the top 20 generic drugs prescribed during 1990 in the U.S.A. were antibiotics.44 Yet, antibiotics appear to be losing their clinical potency and stronger antibiotic medications at increasing dosages are necessary to combat many common infections.41
Recently, investigations have suggested that mercury may be involved in common brain pathologies and that the source of the mercury is likely the dental fillings45-47 In a human autopsy study, brain tissue from persons having Alzheimer's Disease at death were compared to an age-matched group of control brains from subjects without Alzheimer's Disease. The only significant difference in metal content between the two groups was mercury, being considerably higher in the Alzheimer group. The mercury concentration was prominent in the hippocampus, the amygdala and particularly in the nucleus basalis, all brain structures involved in memory function. Other metals examined were not significantly different in the two groups of subjects. The effect of mercury on cental nervous system neuron membrane integrity has been examined and shown that mercury specifically affects tubulin, a brain neuronal dimer protein responsible for proper microtubule formation of brain neurons.48 Both in vivo and in vitro experiments demonstrated that mercury chelated to amino acids maintains an abnormal polymerization state of tubulin. This effect may produce neurofibrillar tangles. Such tangles are a recognized lesion of Alzheimer's Disease. Inorganic mercury affects ADP-ribosylation of the rat brain neuronal proteins tubulin, actin and B-50, in both in vivo and in vitro experiments.49 ADP-ribosylation is the rate limiting process involved in polymerization of tubulin and actin monomers into the structure of the neuron membrane. Most recently, our laboratory has demonstrated that ionic mercury and elemental mercury vapour markedly diminishes the binding of tubulin to GTP and thus inhibits the polymerization of tubulin which is essential for the formation of microtubule in the central nervous system50 These studies are direct quantitative evidence for a connection between mercury exposure and neurodegeneration.
Other investigations have examined the mercury hypersensitivity from dental amalgam in patients with and without oral lichen planus lesions.51-53 These studies showed that patient groups having oral lichen planus had a much higher incidence of mercury patch-test reactivity (16-62%) than did control groups (3-8%). Removal of the mercury fillings resulted in amelioration of the oral symptoms.
Governmental regulatory action concerning mercury fillings. In 1987, the government of Sweden commissioned an "expert panel" to evaluate the available evidence regarding mercury filling safety. The panel concluded that mercury fillings were "unsuitable from a toxicological point of view". Based on this panels advice, the Swedish Socialstyrelsen announced that steps would be taken to eliminate dental amalgam usage and recommended that comprehensive mercury filling treatment on pregnant women should be stopped to prevent mercury damage to the fetus.54 Shortly thereafter, the German Ministry of Health (Bundesgesundheitsamt, BDA) issued an similar advisory.55 In October of 1989, the Swedish Director of Chemical Inspection (KEMI), responsible for environmental protection, declared that amalgam would be banned.56 In January of 1992, the German Ministry of Health (BDA) informed manufacturers of its intention to ban the production of amalgam.57 The BDA removed low copper non-gamma-2-amalgam from the market and published a pamphlet recommending avoiding mercury filling use in individuals with kidney disease, children to age 6, and pregnant women.58 In August of 1992, the Swedish government suggested a timetable to phase out mercury fillings. Environmental concerns were used as the official reason for amalgam discontinuation, but the government did acknowledge the toxicological risk to patients and stated that mercury fillings should no longer be used in children by July 1993, in adolescent to age 19 by July 1995, and in all Swedish citizens by 1997.59 The Austrian Minister of Health announced that the use of mercury fillings in children would be banned in 1996 and discontinued in all Austrians by the year 2000.60 In 1994, the Swedish Dental Association acknowledged that its leadership had previously been incorrect in their position regarding mercury filling safety. They now support a discontinuation of mercury use in dentistry.61 Other industrialized countries, for what ever reason, appear to be side stepping the issue.
Conclusions. As one might expect, the dental profession has not responded well to these data. Some national dental associations have attempted to influence public and governmental opinion by endorsing quasi academic symposia pervaded with amalgam advocates. These gatherings are non-consensus meetings often under government auspices, where the moderators responsible for drawing the conclusions are typically inclined toward the prevailing dental orthodoxy and the conclusions reached often blatantly disregard the experimental data presented.62 Most damning to the dental profession is that they have not advanced any reputable experimental evidence of their own to support their belief in mercury filling safety.
The medical research evidence has been clear for some time. Dental amalgam - mercury fillings - constitute a significant source of chronic exposure to mercury in the general population. This exposure is unnecessary and can not be justified by risk/benefit analysis. While incriminating medical research continues to be published, the dental profession persists in placing itself in the untenable predicament of advocating an anecdotal position of mercury filling safety. The mercury filling advocates can be criticized for their shortage of supporting research evidence; however, so can many mercury filling opponents, who irresponsibly go far beyond the limits of the experimental data, by suggesting that miraculous cures will occur after removal of the fillings. Still, the mercury exposure from dental silver amalgam is toxicologically significant and research into its possible effects is at an early stage. Perhaps a 1000 years from now, historians will look back and draw comparisons between the chronic lead poisoning of the Roman Empire and the insidious mercury poisoning from our toxic teeth.
Bibliography:
1. Baurer, J.G. and First, H.A., Calif. Dent. Assoc. J., 1982, 10, 47-61.
2. Skinner, E.W. and Phillips, R.W., The Science of Dental Materials, 6th ed., Philadelphia: W.B. Saunders Co., 1969., Chapt. 20, p. 303 and Chapt. 22, p. 332.
3. Paterson, N., Br. Dent. J. 157, 23-25.
4. Phillips, R.W., Hamilton, A.I. Jendresen, M.D. McHorris, W.H., and Schallhorn, R.G., J. Prosth. Dent., 1986, 55, 736-772.
5. American Academy of Dental Science, A history of dental and oral science in America. Philadelphia: Samuel White, publ., 1876
6. Bremmer, D.K., The story of dentistry, revised 3rd ed. Brooklyn: Dental Items of Interest Publishing Co Inc., 1954
7. Ring, M., Dentistry, an illustrated history. Harryu N. Abrams Inc., Publisher, New York, 1985.
8. Stock, A., Z Angew Chemie, 1926, 39, 984-989.
9. Stock, A., Z Angew Chemie, 1928, 41, 663-72.
10. Stock, A., Z Anorg Allgem Chemie, 1934, 217, 241-53.
11. Stock, A., Naturwissch, 1935, 28, 453-6.
12. Stock, A., Arch Gewerbepath Gewerbehygie, 1936, 7, 388-413.
13. Stock, A., Ber Dtsch Chem Ges, 1939, 72, 1844-57.
14. American Dental Association, Principle of ethics and code of professional conduct., section l-J; Representation of care and fees, 211 E. Chicago Avenue, Chicago IL U.S.A., 60611.
15. Vimy, M.J. and Lorscheider, F.L., J. Dent. Res., 1985, 64, 1069-71.
16. Vimy, M.J. and Lorscheider, F.L., J. Dent. Res., 1985, 64, 1072-5.
17. Patterson, J.E.; Weissberg, B.G.; and Dennison, P.J., Bull. Environ. Contam. Toxicol., 1985, 34. 459-68.
18. Fredin, B., Swed. Dent. J., 1988, 3, 8-15.
19. Vimy, M.J., and Lorscheider, F.L., J. Trace Elem. Exper. Med., 1990, 3, 111-123.
20. Schiele, R., Schellman, B., Schrodle, R. and Schaller, K.H., Amalgam aussagen von medizin und zahnmedizin; symposium, Koln, West Germany, March 1984, Abst. D29.
21. Nylander, M., Friberg, L., and Lind, B., Swed. Dent. J., 1987, 11, 179-187.
22. Eggelston, D.W. and Nylander, M., J. Prosth. Dent., 1987, 58, 704-707.
23. ADA News, Editorial and accompanying patient handout on the safety of dental amalgam., American Dental Association, Jan. 2, 1984.
24. Truono, E.J., Letter of Importance, J. Amer. Dent. Assoc., 1991, 122, 8-14.
25. American Dental Association News Release, 1990
26. Hahn, L.J., Kloiber, R., Vimy, M.J., Takahashi, Y., and Lorscheider, F.L., FASEB J., 1989, 3, 2641-2646.
27. Hahn, L.J., Kloiber, R., Leininger, R.W., Vimy, M.J., and Lorscheider, F.L., FASEB J, 1990, 4, 3256-3260.
28. Danscher, G. Horsted- Bindslev, P. and Rungby, J., Exp. Mol. Path., 1990, 52, 291-299.
29. Vimy, M.J., Takahashi, Y., and Lorscheider, F.L., Amer. J. Physiol., 1990, 258, R939-R945.
30. Aposhian, H.V., Bruce, D.C., Alter, W., Dart, R.C., Hurlbut, K.M. and Aposhian, M.M., FASEB J., 1992, 6, 2472-2476.
31. Gerhard, I., Waldbrenner, P. Thuro, H. and Runnebaum, B., Clin. Lab., 1992, 38, 404-411.
32. Zander, D., Ewers, U., Freier, I., and Brockhaus, A., Zbl. Hyg. Umwelt., 1992, 192, 447-54. 33. Zander, D., Ewers, U., Freier, I., and Brockhaus, A., Zbl. Hyg. Umwelt., 1992, 193, 318-328.
34. Clarkson, T.W., Hursh, J.B., Sager, P.R., and Syversen, T.L.M., In: Biological Monitoring of Toxic Metals (Clarkson, T.W., Friberg, L., Nordberg, G.F., and Sager P.R., eds.), Plenum Press, New York., 1988, 199-246,
35. Vimy, M.J., and Lorscheider, F.L., J. Trace Elem. Exper. Med., 1990, 3, 111-123.
36. World Health Organization, Environmental Health Criteria 118, Inorganic Mercury., WHO, Geneva, 1991, 36.
37. Boyd, N.D., Benediktsson, H., Vimy, M.J., Hooper, D.E., and Lorscheider, F.L., Am. J. Physiol., 1991, 261, R1010-R1014.
38. Molin, M., Bergman, B., Marklund, S.L., Schutz, A. and Skerfving, S., Acta Odontol. Scand., 1990, 48, 189-202.
39. Summers, A.O., Wireman, J., Vimy, M.J., Lorscheider, F.L., Marshall, B., Levy, S.B., Bennett, S. and Billard, L., Antimicrob. Agents & Chemother., 1993, 37, 825-834.
40. Gilbert, M.P. and Summers, A.O., Plasmid, 1988, 20: 127-136.
41. Cohen, M.L., Science, 1992, 257, 1050-1055.
42. Gilman, H.G., Rall, T.W., Nies, A.S. and Taylor, P. Goodman and Gilman's: The Pharmacologic Basis of Therapeutics, 8th ed., Pergamon Press, Elmsford, New York, 1990, p. 1018.
43. Intercontinental Medical Statistics, IMS, Canada, 1992.
44. Pharmacy Times, April 1991, 58.
45. Khatoon, S., Campbell, S.R., Haley, B.E. and Slevin, J.T., Ann. Neurol., 1989, 26, 210-215.
46. Thompson, C.M., Markesbery, W.R., Ehmann, W.D., Mao, Y-X. and Vance D.E., Neurotoxicology, 1988, 9, 1-7.
47. Wenstrup, D., Ehmann, W.D. and Markesbery W.R., Brain Res., 1990, 533, 125-131.
48. Duhr, E., Pendergrass, C., Kasarskis, E., Slevin, J. and Haley, B., FASEB J., 1991, 5, A456.
49. Palkiewicz, P., Zwiers, H. and Lorscheider, F.L., J. Neurochem., 1994, 62, 2049-2052.
50. Lorscheider, F.L., Vimy., M.J., Pendergrass, J.C. and Haley, B.E., Abst. presented at the 12th International Neurotoxicology Conference, Univ. Arkansas Med. Center, Hot Spring, AR, Oct.30 - Nov.2, 1994.
51. Finne, K.; Goransson, K.; and Winckler, L., Int. J. Oral Surg., 1982, 11, 236-9.
52. Lundstrom, I.M.C., Int. J. Oral Surg., 1983, 12, 1-9.
53. Mobacken, H.; Hersle, K.; Sloberg, K.; and Thilander, H., Contact Dermatitis, 1984, 10, 11-5.
54. Socialstyrelsen (Sweden, Social Welfare and Health Administration). Redovisar; kvicksilver/amalgam halsorisker. Allanna Forlaget AB, Stockholm, 10 32-39, 1987.
55. Bundesgesundheitsamt (Germany, Ministry of Health), Machine Design, p. 274, August 25, 1988.
56. KEMI (Sweden, Chenical Inspection Agency), Amalgam will be banned. Dagens Nyheter, October 6, 1989.
57. Bundesgesundheitsamt (Germany, Ministry of Health), Letter to pharmacetical companies, January 29; Artezeitung (Physician's Daily), March 3, 1992
58. Bundesgesundheitsamt (Germany, Ministry of Health), Amalgame - nevbenwirkungen und bewertung der toxizitat, Zahnartzt Woche (DZW), 1992, 8, 1.
59. Socialstyrelsen (Sweden, Social Welfare and Health Administration), Press Release. August 28, 1992.
60. Austrian Minister of Health, Austria to be amalgam free by year 2000. FDI Dental World, March/April, 1993, p. 6.
61. Swedish Dental Association, Swedish News Bureau, TT, January 17, 1994. 62. Lorscheider, F.L. and Vimy, M.J., FASEB J., 1993, 7, 1432-1433.



Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE)

Posted by Walt Stoll on March 16, 1999 at 14:32:48:

In Reply to: Have doubt? Read me! The cream of the crop posted by JN on March 15, 1999 at 22:13:35:

Thanks, JN.

I agree that this is critical information. I also agree with the statement that one of the most damning factors is the TOTAL lack of the conventional ADA's doing ANY research proving the safety of amalgams and their STILL insisting that they ARE safe. TALK ABOUT UNSCIENTIFIC!

I had all my amalgams out more than 10 years ago.

Walt



Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE)

Posted by
Peggy on March 16, 1999 at 18:07:39:

In Reply to: Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE) posted by Walt Stoll on March 16, 1999 at 14:32:48:

How would you go about finding someone to remove them?

Peggy



What are your fillings made of now? (NMI)

Posted by Peggy on March 16, 1999 at 18:09:12:

In Reply to: Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE) posted by Walt Stoll on March 16, 1999 at 14:32:48:

.



Re: abstracts

Posted by JN on March 16, 1999 at 18:14:20:

In Reply to: Have doubt? Read me! The cream of the crop posted by JN on March 15, 1999 at 22:13:35:


'Mercury Free' and Healthy

The Dental Amalgam Issue

Prepared May 1998 by

DAMS Inc. along with

Consumers for Dental Choice

A Project of the National Institute for

Science, Law and Public Policy

1424 16th Street, NW Suite 105

Washington, D.C. 20036

This web page presents information pertaining to the dental amalgam issue. Subjects presented in the contents list are linked to subsequent portions of the web page.
Contents List
I) Introduction of the Issue
II) The Truth and the Hippocratic Oath
III) Historical Overview of Mercury Use in Dentistry
IV) Paramount Scientific Studies
IV A1) Review
IV A2) Dental Mercury Impairs Kidney Function
IV A3) Dental Mercury Provokes an Increase in Oral and Intestinal Floras
IV A4) Dental Amalgam is the Source for Two-Thirds of the Mercury in the Human Population
IV A5) Mercury Exposure via Breast Milk
IV B) Fetal Malformations
IV B1) Sheep Study
IV B2) Rat Study
IV B3) Human Study
IV C) Alzheimer's Disease Studies
IV C1) Trace Elements Measured in Alzheimer's Disease Brains
IV C2) Mercury Vapor Inhibits Rat BrainsIV C3) Deleterious Effects of Mercury on Brain Tissue
IV D) Mercury in Dental Clinic Wastewater Discharge
V) Patient Reports
VI) Proper Amalgam Removal
VII) Amalgam Removal Studies
VII A) Amalgam Removal with out Patient Protection
VII B) Amalgam Removal with Patient Protection
VIII) Pregnancy Precaution
VIII) American Dental Association (ADA) Positions'
IX A) Journal of the American Dental Association
IX B) Superior Court Demurrer
IX C) ADA Code of Ethics
IX D) ADA Internet Site
X) Colorado Statute
XI) Amalgam Lawsuit
XII) Notice to Amalgam Manufactures
XIII) Government Phase Outs
XIV) Organizations
XV) Books Available
XVI) Newsletters
XVII) Amalgam Related Conventions
XVIII) Request for Finincial Support of Web Page
I) Introduction of the Issue
A "silver filling" is an euphemism for an amalgam restoration, which dentist place in patients teeth after a cavity is created by drilling out tooth decay. Amalgam restorations consist of mercury, silver, tin, copper, and a trace amount of zinc. After an amalgam is installed in a tooth it slowly releases mercury and other metallic vapor into the body. Mercury is the single most toxic non-radioactive metal; the most minute amount damages human cells. This challenges systemic functions of every individual and of developing fetuses; so it can lead to health problems and fetal malformations. Mercury leakage and its subsequent pathophysiologic effects are most often slow insidious processes. So health problems caused by dental mercury poisoning are perceived many years after the amalgams are placed.
Ever since dentist first started installing amalgams in patients' teeth there has been an issue as to whether they release mercury and causes health (pathophysiologic) problems. Then in 1984 a group of conscientious dentists formed the International Academy of Oral Medicine and Toxicology (IAOMT). One of their objectives was to scientifically explore the safety of amalgam restorations. Since 1984, members of the IAOMT have inspired many renowned medical scientists at universities around the world to research possible pathophysiologic effects associated with mercury leaking from amalgam restorations. Consequently, there are a growing number of scientific studies that document pathophysiologic effects associated with amalgam mercury.
II) The Truth and the Hippocratic Oath
Arthur Schopenhauer, 19th Century Philosopher ..."All truth passes through three stages: first it is ridiculed, second it is violently opposed, and third it is accepted as self-evident."
"...I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one, will I prescribe a deadly drug nor give advice which may cause his death. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot."
III) Historical Overview of Mercury Use in Dentistry
Lorscheider, F.L., Vimy, M.J., and Summers, A.O. "Mercury Exposure from Silver Tooth Fillings: Emerging Evidence Questions a Traditional Dental Paradigm." FASEB Journal (April 1995).
As early as the 7th century, the Chinese used a "silver paste" containing mercury (Hg) to fill decayed teeth. Throughout the Middle Ages, alchemists in China and Europe observed that this mysterious silvery liquid, extracted from cinnabar ore, was volatile and would quickly disappear as vapor when mildly heated. Alchemists were fascinated that at room temperature Hg appeared to "dissolve" powders of other metals such as silver, tin, and copper. By the early 1800's, the use of a Hg/silver paste as a tooth filling material was being popularized in England and France and it was eventually introduced into North America in the 1830s. Some early dental practitioners expressed concerns that the Hg/silver mixture (amalgam) expanded after setting, frequently fracturing the tooth or protruding above the cavity preparation, and thereby prevented proper jaw closure. Other dentists were concerned about mercurial poisoning, because it was already widely recognized that Hg exposure resulted in many overt side effects, including dementia and loss of motor coordination. By 1845, as a reflection of these concerns, the American Society of Dental Surgeons and several affiliated regional dental societies adopted a resolution that its members sign a pledge not to use amalgam. Consequently, during the next decade some members of the society were suspended for the malpractice of using amalgam. But the advocates of amalgam eventually prevailed and membership in the American Society of Dental Surgeons declined, forcing it to disband in 1856. In its place arose the American Dental Association, founded in 1859, based on the advocacy of amalgam as a safe and desirable tooth filling material. Shortly thereafter, tin was added to the Hg/silver paste to counteract the expansion properties of the previous amalgam formula.
There were compelling economic reasons for promoting dental amalgam as a replacement for the other common filling materials of the day such as cement, lead, gold, and tinfoil. Amalgam's introduction meant that dental care would now be within the financial means of a much wider sector of the population, and because amalgam was simple and easy to use, dentists could readily be trained to treat the anticipated large number of new patients. By 1895, the dental amalgam mixture of metals had been modified further to control for expansion and contraction, and the basic formula has remained essentially unchanged since then. Scientific concerns about amalgam safety initially surfaced in Germany during the 1920's, but eventually subsided without a clear resolution. At the present time, based on 1992 dental manufacturer specifications, amalgam (at mixing) typically contains approximately 50% metallic Hg, 35% silver, 9% tin, 6% copper, and a trace of zinc. Estimates of annual Hg usage by U.S. dentists range from approximately 100,000 kg in the 1970's to 70,000 kg today. Hg fillings continue to remain the material preferred by 92% of U.S. dentists for restoring posterior teeth. More than 100 million Hg fillings are placed each year in the U.S. Presently, organized dentistry has countered the controversy surrounding the use of Hg fillings by claiming that Hg reacts with the other amalgam metals to form a "biologically inactive substance" and by observing that dentists have not reported any adverse side effects in patients. Long-term use and popularity also continue to be offered as evidence of amalgam safety.
IV) Paramount Scientific Studies
Some of the more paramount scientific studies are presented below.
IV A1) Review
Lorscheider, F.L., Vimy, M.J., and Summers, A.O. "Mercury Exposure from Silver Tooth Fillings: Emerging Evidence Questions a Traditional Dental Paradigm." FASEB Journal (April 1995).
SUMMARY: This document reviews results of animal and human studies of pathophysiologic effects related to mercury leaking from amalgam restorations. Some pertinent points presented include:
every amalgam daily releases on the order of 10 micrograms of mercury into the body (i.e. 3,000,000,000,000,000 mercury atoms per day),
more than 2/3 of the excretable mercury in humans is derived from amalgams,
mercury crosses the maternal placenta into the tissue of a developing fetus,
mercury is capable of inducing auto immunity,
mercury immediately and continually challenges the kidney's functioning,
mercury can enhance the prevalence of multiple antibiotic resistant intestinal bacteria, and
people exposed to mercury on a sustained bases are at risk to lowered fertility.
IV A2) Dental Mercury Impairs Kidney Function
Boyd, N.D., H. Benediktsson, M.J. Vimy, D.E. Hooper, and F.L. Lorscheider, "Mercury From Dental "Silver" Tooth Fillings Impairs Sheep Kidney Function", Am.J. Physiol. 261, Regulatory Integrative Comp. Physiol. 30: R1010-R1014, (1991).
ABSTRACT: In humans Hg vapor is released from "silver" amalgam fillings that contain 50% Hg by weight. Previous studies show that when 12 such fillings are placed in sheep teeth, the kidneys will concentrate amalgam Hg at levels ranging from 5 to 10 ug Hg/g renal tissue 4 to 20 weeks after placement. In the present study 12 occlusal fillings were placed in each of six adult female sheep under general anesthesia, using standard dental procedures. Glass ionomer occlusal fillings (12) were inserted in tow control sheep. At several days before dental surgery, and at 30 and 60 days after placement of filings, renal function was evaluated by plasma clearance of inulin and by plasma inulin clearance rate of 69.5 + 7.2 ml/min before amalgam placement was reduced to 32.3 + 8.1 ml/min by 30 days and remained low at 27.9 + 8.7 ml/min after 60 days. Inulin clearance did not change in controls. After amalgam placement urine concentration of albumin decreased from 93.0 + 20.5 to 30.1 + 15.3 mg/l and urine Na concentrations increased steadily from 24.8 + 7.7 to 82.2 + 20.3 mmol/l at 60 days. Concentrations of K, urea, Y-glutamyl transpeptidase, alkaline phosphatase, and total protein did not change significantly form 0 to 60 days in urine. Plasma levels of Na, K, urea, and albumin remained unchanged form 0 to 60 days after amalgam. Renal histology remained normal in amalgam-treated animals. It is concluded that amalgam Hg levels in kidney are sufficient to significantly reduce the rate of inulin clearance by non defined mechanisms and that electrolyte patterns in urine are consistent with impaired renal tubular reabsorption.
IV A3) Dental Mercury Provokes an Increase in Oral and Intestinal Floras
Summers, A.O., J.Wireman, M.J. Vimy, F.L. Lorscheider, B. Marshall, S.B. Levy, S. Bennett, and L. Billard, "Mercury Released form Dental "Silver" Fillings Provokes an Increase in Mercury- and Antibiotic-Resistant Bacteria in Oral and Intestinal Floras of Primates", Antimicrobial Agents and Chemotherapy, (April 1993), pages 825 - 834.
ABSTRACT: In a survey of 640 human subjects, a subgroup of 356 persons without recent exposure to antibiotics demonstrated that those with a high prevalence of Hg resistance in their intestinal floras were significantly more likely to also have resistance to two or more antibiotics. This observation led us to consider the possibility that mercury released from amalgam ("silver") dental restorations might be a selective agent for both mercury- and antibiotic-resistant bacteria in the oral and intestinal floras of primates. Resistances to mercury and the several antibiotics were examined in the oral and intestinal floras of six adult monkeys prior the the installation of amalgam fillings, during the time they were in pace, and after replacement of the amalgam fillings with glass ionomer fillings (in four of the monkeys). The monkeys were fed and antibiotic-free diet, and fecal mercury concentrations were monitored. There was a statistically significant increase in the incidence of mercury-resistant bacteria during the 5 weeks following installation of the amalgam fillings and during the 5 weeks immediately following their replacement with glass ionomer fillings. These peaks in incidence of mercury-resistant bacteria correlated with peaks of Hg elimination (as high as 1mM in the feces) immediately following amalgam placement and immediately after replacement of the amalgam fillings. Representative mercury-resistant isolates of three selected bacterial families (oral streptococci, members of the family Enterobacteriaceae, and enterocaocci) were also resistant to one or more antibiotics, including ampicillin, tetracycline, streptomycin, kanamycin, and chloramphenicol. While such mercury- and antibiotic-resistant isolates among the staphylococci, the enterococci, and members of the family Enterobacteriaceae, have been described, this is the first report of mercury resistance in the oral streptococci. Many of the enterobacterial strains were able to transfer mercury and antibiotic resistances together to laboratory bacterial recipients, suggesting that the loci for these resistances are genetically linked. Our findings indicate that mercury released from amalgam fillings can cause an enrichment of mercury resistance plasmids in the normal bacterial floras of primates. Many of these plasmids also carry antibiotic resistance, implicating the exposure to mercury from dental amalgams in an increased incidence of multiple antibiotic resistance plasmids in the normal floras of nonmedicated subjects.
IV A4) Dental Amalgam is the Source for Two-Thirds of the Mercury in the Human Population
Aposhian, H.V., D.C. Bruce, W. Alter, R.C. Dart, K.M. Hurlbut, M.M. Aposhian, "Urinary Mercury after Administration of 2, 3-dimercaptopropane-1-sulfonic acid: Correlation with Dental Amalgam Score" FASEB J. 6: 2472-2476; (1992).
ABSTRACT: There is a considerable controversy as to whether dental amalgams may cause systemic health effects in humans because they liberate elemental mercury. Most such amalgams contain as much as 50% metallic mercury. To determine the influence of dental amalgams on the mercury body burden of humans, we have given volunteers, with and without amalgams in their mouth, the sodium salt of 2, 3-dimercaptopropane-1-sulfonic acid (DMPS), a chelating agent safely used in the Soviet Union and West Germany for a number of years. The diameters of dental amalgams of the subjects were determined to obtain the amalgam score. Administration of 300 mg DMPS by mouth increased the mean urinary mercury excretion of the amalgam group from 0.70 to 17.2 ug and that of the non amalgam group from 0.27 to 5.1 ug over a 9 hour period. Two-thirds of the mercury excreted in the urine of those with dental amalgams appears to be derived originally from the mercury vapor released from their amalgams. Linear regression analysis indicated a highly significant positive correlation between the mercury excreted in the urine 2 hours after DMPS administration and the dental amalgam scores. DMPS can be used to increase the urinary excretion of mercury and thus increase the significance and reliability of this measure of mercury exposure or burden, especially in cases of micromercurialism.
IV A5) Mercury Exposure via Breast Milk
Vimy, M.J.: Hooper, D.E.; King, W.W.; Lorscheider, F.L., "Mercury from Maternal "Silver" Tooth Fillings in Sheep and Human Breast Milk: A Source of Neonatal Exposure" Biological Trace Element Research, 56:143-52, (1997).
ABSTRACT: Neonatal uptake of Hg from milk was examined in a pregnant sheep model, where radioactive mercury (Hg203)/silver tooth fillings (amalgam) were newly placed. A crossover experimental design was used in which lactating ewes nursed foster lambs. In a parallel study, the relationship between dental history and breast milk concentration of hg was also examined.
Results from the animal studies showed that, during pregnancy, a primary fetal site of amalgam, Hg concentration is in the liver, and after delivery the neonatal lamb kidney receives additional amalgam Hg from mother's milk. In lactating women with aged amalgam fillings, increased Hg excretion in breast milk and urine correlated with the number of fillings or Hg vapor concentrations levels in mouth air.
It was concluded that Hg originating from maternal amalgam tooth fillings transfers across the placenta to the fetus, across the mammary gland into milk ingested by the newborn and ultimately into neonatal body tissues. Comparisons are made to the U.S. minimal risk level recently established for adult Hg exposure. These findings suggest the placement and removal of "silver" tooth filings in pregnant and lactating humans will subject the fetus and neonate to unnecessary risk of Hg exposure.
IV B) Fetal Malformations
James Paget Lancet 2:1017, 1882
We ought not to set them aside with idle thoughts or idle words about "curiosities" or "chances." Not one of them is without meaning; not one that might not become the beginning of excellent knowledge, if only we could answer the question - why is it rare or being rare, why did it in this instance happen?
McKeown T., "Human Malformations: Introduction" British Medical Bulletin Vol. 32 Number 1 (January 1976).
"...it is a sobering thought that after several decades of research, a number of international conferences and many other meetings, seminars and symposia, the problem of human malformations remains essentially unchanged." "...at least in the immediate future, it seems likely that the problem of human malformations will continue at about the present level (27 per every 1000 births)."
When dental mercury crosses over the placenta into the tissue of the developing fetus, does it cause fetal malformations? These studies answer that question.
IV B1) Sheep Study
Vimy, M.J., Y. Takahashi, and F.L. Lorscheider "Maternal-fetal distribution of mercury (203Hg) released from dental amalgam fillings." Am. J. Physiol. 258 (Regulatory Integrative Comp. Physiol. 27): R939-R945 (1990).
ABSTRACT: In humans, the continuous release of Hg vapor from dental amalgam tooth restorations is markedly increased for prolonged periods after chewing. The present study establishes a time-course distribution for amalgam, Hg in body tissues of adult and fetal sheep. Under general anesthesia, five pregnant ewes had twelve occlusal amalgam fillings containing radioactive 203Hg placed in teeth at 112 days gestation. Blood, amniotic fluid, feces, and urine specimens were collected at 1- to 3-day intervals for 16 days. From days 16-140 after amalgam placement (16-41 days for fetal lambs), tissue specimens were analyzed for radioactivity, and total Hg concentrations were calculated. Results demonstrate that Hg from dental amalgam will appear in maternal and fetal blood and amniotic fluid within 2 days after placement of amalgam tooth restorations. Excretion of some of this Hg will also commence within 2 days. All tissues examined displayed Hg accumulation. Highest concentrations of Hg from amalgam in the adult occurred in kidney and liver, whereas in the fetus the highest amalgam Hg concentrations appeared in the liver and pituitary glands. The placenta progressively concentrated Hg as gestation advanced to term, and milk concentration of amalgam Hg postpartum provides a potential source of Hg exposure to the newborn. It is concluded that accumulation of amalgam Hg progresses in maternal and fetal tissues to a stead state with advancing gestation and is maintained.
IV B2) Rat Study
Fredriksson, A., Dencker, L., Archer, T., Danielsson, B.R. "Prenatal Coexposure to Metallic Mercury Vapor and Methyl Mercury Produce Interactive Behavioral Changes in Adult Rats." Neurotoxicol Teratol., 18(2): 129-34, (1996).
ABSTRACT: Pregnant rats were either 1) administered methyl mercury (MeHg) by gavage, 2 mg/kg/day during days 6-9 of gestation, 2) exposed by inhalation to metallic mercury (Hg) vapor (1.8 mg/m3 air for 1.5 hours per day) during gestation days 14-19, 3) exposed to both MeHg by gavage and Hg vapor by inhalation (MeHg + Hg), or 4) were given combined vehicle administration for each of the two treatments (control). The inhalation regimen corresponded to an approximate dose of 0.1 mg Hg/kg/day.
Clinical observations and developmental markers up to weaning showed no differences between any of the groups. Testing of behavioral functions was performed between 4 and 5 months of age and included spontaneous motor activity, spatial learning in a circular bath, and instrumental maze learning for food reward.
Offspring of dams exposed to hg vapor showed hyperactivity in the motor activity test chambers over all three parameters: locomotion, rearing and total activity; this effect was potentiated in the animals of the MeHg + Hg group. In the swim maze test, the MeHg + Hg and Hg groups evidenced longer latencies to reach a submerged platform, which they had learned to mount the day before, compared to either the control or MeHg group. In the modified, enclosed radial arm maze, both the MeHg + Hg and Hg groups showed more ambulations and rearings in the activity test prior to the learning test. During the learning trial, the same groups (i.e., MeHg + Hg and Hg) showed longer latencies and made more errors in acquiring all eight pellets.
Generally, the results indicate that prenatal exposure to Hg causes alterations to both spontaneous and learned behaviors, suggesting some deficit in adaptive functions. Coexposure to MeHg, which by itself did not alter their functions at the dose given in this study, served to significantly aggravate the change.
IV B3) Human Study
Drasch et. al. "Mercury Burden of Human Fetal and Infant Tissues" European Journal of Pediatrics (August 1994).
ABSTRACT: The total mercury concentrations in the liver (Hg-L), the kidney cortex (Hg-K) and the cerebral cortex (Hg-C) of 108 children aged 1 day- 5 years, and the Hg-K and Hg-L of 46 fetuses were determined. As far as possible, the mothers were interviewed and their dental status was recorded. The results were compared to mercury concentrations in the tissues of adults for the same geographical area. The Hg-K (n=38) and Hg-L (n=40) of fetuses and Hg-K (n=35) and Hg-C (n=35) of older infants (11-50 weeks of life) correlated significantly with the number of dental amalgam fillings of the mother. The toxicological relevance of the unexpected high Hg-K of older infants from mother with higher numbers of dental amalgam fillings is discussed. Conclusion: Future discussion on the pros and cons of dental amalgam should not be limited to adults or children with their own amalgam fillings, but also include fetal exposure. The unrestricted application of amalgam for dental restorations in women before and during the child-bearing age should be reconsidered. Abbreviations: Hg-C total mercury concentration in the cerebral cortex (ng/g wet weight). Hg-K total mercury concentration in the renal cortex (ng/g wet weight). Hg-L total mercury concentration in the liver (ng/g wet weight).
IV C) Alzheimer's Disease Studies
An on-going study at the University of Kentucky has linked many aspects of amalgam mercury to brain tissue damage found in patients with Alzheimer's Disease. Abstracts of this on-going study are presented below.
IV C1) Trace Elements Measured in Alzheimer's Disease Brains
Wenstrup, D., Ehmann, W.D., and Markesbery W.R., "Trace Element Imbalances in Isolated Subcellular Fractions of Alzheimer's Disease Brains" Brain Research, 533 125-131 Elsevier Science Publishers (1990).
ABSTRACT: Concentrations of 13 trace elements (Ag, Br, Co, Cr, Cs, Fe, Hg, K, Na, Rb, Sc, Se, Zn) in isolated subcellular fractions (whole brain, nuclei, mitochondria, microsomes) of temporal lobe from autopsied Alzheimer's disease (AD) patients and normal controls were determined utilizing instrumental neutron activation analysis. Comparison of AD and controls revealed elevated Br (whole brain) and Hg (microsomes) and diminished Rb (whole brain, nuclear and microsomes), Se (microsomes) and Zn (nuclear) in AD. The elevated Br and Hg and diminished Rb are consistent with our previous studies in AD bulk brain specimens. Comparison of element ratios revealed increased Hg/Se, Hg/Zn and Zn/Se mass ratios in AD. Se and An play a protective role against hg toxicity and our data suggest that they are utilized to detoxify Hg in the AD brain. Overall our studies suggest that Hg could be and important toxic element in AD. Whether Hg deposition in AD is a primary or secondary event remains to be determined.
IV C2) Mercury Vapor Inhibits Rat Brains
Lorscheider, F. L., Vimy, M.J., Pendergrass, J.C., Haley, B.E., "Mercury Vapor Exposure Inhibits Tubulin Binding to GTP in Rat Brain: A Molecular Lesion also Present in Human Alzheimer Brain." FASEB Journal 9(4): A-3845. FASEB Annual Meeting, Atlanta, Georgia (March 10, 1995).
ABSTRACT: Methyl mercury will interact with tubulin and disassemble microtubules that function to maintain neurite structure. Numerous reports also establish that mercury vapor (Hg0) is continuously released from "silver" amalgam tooth fillings into mouth air.
In this present study rats were exposed to Hg0 4 hr/day for 0, 2, 7, 14, and 28 days at 250 mcg Hg/m3 air, a concentration present in mouth of humans with large numbers of amalgam fillings. Average rat brain Hg concentrations increased significantly (40-100 fold) with duration of Hg0 exposure.
By day 14 of Hg0 exposure, photoaffinity labeling of the b-subunit of the tubulin dimer with (a32P)8N3GTP in brain hamogenates was decreased 75% , as seen on analysis of SDS-PAGE autoradiograms.
The identical neurochemical lesion of similar magnitude is evident in Alzheimer brain homogenates when compared to human age-matched controls. Since the rate of tubulin polymerization is dependent upon binding of tubulin dimers to GTP, we conclude that chronic inhalation of low-level Hg0 can inhibit polymerization of tubulin essential for formation of microtubules.
IV C3) Deleterious Effects of Mercury on Brain Tissue
Pendergrass, J., Israel, M., and Haley, B. "The Deleterious Effects of Low Micromolor Mercury on Important Brain and Cerebrospinal Fluid Proteins" American Association of Pharmaceutical Scientists, Annual Meeting, Miami, Florida (November 1995).
ABSTRACT: Alzheimer's Disease (AD) is the most common cause of adult onset dementia. There is no effective treatment or proven diagnostic indicator of AD. While the etiology and pathogenesis of AD are not known, there have been several published reports of altered protein-nucleotide interactions.
Our laboratory developed the technique of nucleotide photoaffinity labeling as a method for identifying the nucleotide binding domains of several important enzymes. We have also shown this technique to be very sensitive and reliable tool for identifying changes in nucleotide-proteins interactions when comparing AD brain and CSF (cerebrospinal fluid) to non-demented control tissues. For example, we have shown using 32P8N3GTP and 32P8N3ATP that b-tubulin and creatine kinase (CK) interactions, respectively, are aberrant in AD brain homogenates relative to age-matched neurologic controls. This is despite both proteins being present near control levels, indicating that both tubulin and CK have been modified in the disease state.
Currently, photolabeling technology coupled with high resolution 2-D gels (IEF X SDS-PAGE) has been developed to enhance the ability to detect changes in protein-nucleotide interactions in brain and CSF samples. This approach shows what appears to be specific changes in the 32P8N3ATP photo labeling profile of 2D separated CSF proteins of AD patients versus those of non-demented control CSFs or in CSF of other neurodegenerative diseases.
This technology also shows that exposure of human control brain homogenates to 1-3 microM Hg2+-EDTA complex produces 32P8N3GTP-b-tubulin interactions comparable to that of AD brains.
IV D) Mercury in Dental Clinic Wastewater Discharge
This study measures the level of mercury discharged to the public waste water systems by dental offices.
Arenholt-Bindslev, D.; Larsen, A.H. "Mercury Levels and Discharge in Waste Water from Dental Clinics" Water Air Soil Pollution, 86(1-4):93-9, (1996).
ABSTRACT: Data was obtained on the amount of Hg discharged with the wastewater from dental clinics. Waste water from 20 Danish dental clinics was collected during one working day and analyzed for the amount of Hg using the technique of cold vapor atomic absorption spectrophotometry (CVAAS). From clinics without amalgam separator mean value was 270 mg Hg per dentist per day (range 65 to 842), from clinics equipped with amalgam separator mean value was 35 mg Hg per dentist per day (range 12 to 99).
It was concluded that Hg is released with the waste water from dental clinics. Several hundred grams of Hg per clinic may be discharged annually with the waste water. Installation of efficient amalgam separators may reduce the Hg outlet markedly.
COMMENT: Very few dental offices in the United States have amalgam separators. Taking the mean daily level of 270 milligrams times 200 (working) days per year yields an annual value of 54 grams of Hg per dental office per year. Utilizing a conservative figure of 100,000 dental offices in the United States, a total of 5400 kilograms (12,172 pounds) of mercury exits U.S. dental offices in waste water each year.
V) Patient Reports
Siblerud, R.L. "Health Effects After Dental Amalgam Removal" Journal of Orthomolecular Medicine. Vol. 5, No. 2, (1990).
SUMMARY: A Utah dentist provided the names and addresses of approximately 300 people who had their amalgams removed. A health questionnaire was sent to these people; 86 subjects responded. Eighty (80) % of the s



Re: abstracts 2

Posted by j on March 16, 1999 at 18:18:36:

In Reply to: Re: abstracts posted by JN on March 16, 1999 at 18:14:20:

V) Patient Reports
Siblerud, R.L. "Health Effects After Dental Amalgam Removal" Journal of Orthomolecular Medicine. Vol. 5, No. 2, (1990).
SUMMARY: A Utah dentist provided the names and addresses of approximately 300 people who had their amalgams removed. A health questionnaire was sent to these people; 86 subjects responded. Eighty (80) % of the subjects reported that they felt better following amalgam removal. Nearly all of the subjects 91% said they were glad their amalgams had been removed and 88% said they would do it again. An increase in happiness and peace of mind was experienced by 58% of the subjects. This evidence suggests that the well being of these subjects improved immensely after amalgam removal.
Mary Davis editor "Defense Against Mystery Syndromes" Chek Printing Co. March 1994
SUMMARY: This book presents patient reported case histories, where they associate their health problems to dental amalgam mercury. Case histories include: Chronic Fatigue Syndrome, Seizures, Memory Loss, Migraines, Multiple Allergies, Multiple Sclerosis, Depression, Lupus, Maldigestion, Chemical Sensitivities, Insomnia, Miscarriages, Paralysis, Sinus Problems, Emotional & Mental Disorders, Infertility, Endometriosis, Crohn's Disease, Rashes, Anxiety, Tremors & Spasms, Amyotrophic Lateral Sclerosis, Universal Reactor and many others.......
VI) Proper Amalgam Removal
WARNING: If you have a serious health problem consult a medical doctor who is informed on proper removal protocols before having your amalgams removed.
IAOMT Standards of Care, Preferred Procedure, "Reducing Mercury Vapor Exposure for the Patient During Amalgam Removal." (September 1992)
The IAOMT has currently established the following amalgam removal protocols. If these protocols are followed then the amount of mercury released during amalgam removal is reduced.
place a rubber dam around the tooth to isolate it from the body,
provide an alternative source of air to the patient,
place a saliva ejector under the dam to remove mercury vapor that penetrates the latex,
use high volume evacuation with isolate attachment,
section amalgams and remove in as large pieces as possible,
remove and properly dispose of rubber dam and mercury after amalgam removal.
Other amalgam removal precautions in addition to the protocols listed above include:
remove no more than two amalgams per appointment,
time amalgam removal appointments at least one month apart,
administer intravenous Vitamin C before removal (Hg has a greater affinity to Vitamin C that is present in the blood than it does for body tissue),
don't remove amalgams from a pregnant woman.
VII) Amalgam Removal Studies
The following two studies demonstrate: 1) the amount of mercury that is released into the body during amalgam removal, and 2) that after amalgam removal mercury is purged from the body.
VII A) Amalgam Removal with out Patient Protection
This study measures the mercury level when amalgams are removed not following the protocols presented above.
Molin, M., Bergman B., Marklund, S.L., Schutz, A., Skerfving, S., "Mercury, Selenium, and Glutathione Peroxidase Before and After Amalgam Removal in Man" Acta Odontal Scandinavia; 48:189-202. Oslo. ISSN 0001-6357 (1990).
ABSTRACT: In 10 healthy persons all amalgam fillings were replaced with gold inlays. Blood and urinary levels were measured on 10 occasions during a 4-month period before and a 12-month period after amalgam removal. These variables were also measured three times in 10 healthy controls. A strong statistically significant relation was found between plasma mercury values and both the total number of amalgam surfaces (r=0.71, p=0.0006) and the total surface area of the fillings (r=0.73, p=0.004). In the immediate post removal phase plasma mercury rose three- to four-fold, whereas the urinary and erythrocyte mercury rose about 50%. These peak values declined to the pre-removal level at about 1 month after removal. Twelve months after the removal plasma and urinary mercury levels were reduced to 50% and 25%, respectively, of the initial values for the experimental group. Apart from the significantly lower plasma selenium values 5 and 10 days after removal no significant differences were found with regard to plasma selenium or erythrocyte glutathione peroxidase either within or between the experimental and the control groups. A large number of supplementary biochemical analyses did not show any influence on organ functions or any differences between the groups before or after the amalgam removal. Amalgam fillings considerably contributed to the plasma and urinary mercury levels.
VII B) Amalgam Removal with Patient Protection
This study measures the mercury level when amalgams are removed following the IAOMT protocols presented above.
Molin, M., Berglund, J.R., Mackert, J.R., "Kinetics of Mercury in Blood and Urine after Amalgam Removal." J. Dental Research, 74:420,IADR abstract 159, (1995).
ABSTRACT: Even through a number of studies have not been able to reveal any correlation between subjective symptoms and amalgam load there still are speculations whether patients with subjective symptoms related by the patients themselves to their amalgam fillings could have a changed pattern of elimination of mercury. The aim of the present investigation was to study the elimination half-time of mercury in plasma, erythrocytes and urine over an extended period of time after amalgam removal in a group of 10 patients with subjective symptoms by the patients themselves referred to their amalgam fillings and a group of 8 healthy subjects. The average number of occlusal and total amalgam surfaces in the patient group were 13.0 (range 4-20) and 44.4 (range 24-68), respectively. Corresponding figures in the control group were 12.9 (range 10-16) and 40.9 (range 24-63).
The amalgam removal using rubber dam, water spray cutting and high volume vacuum evacuator, was carried out at one and the same time. Blood and urine samples were collected at two occasions before the amalgam removal, then blood was collected at thirty two occasions and urine at forty three occasions during the following year. The mercury content was analyzed by CVAAS technique.
The measured P-, Ery- and U-Hg concentrations before amalgam removal were slightly higher in the control group 6.43.3 nmol/L, 19.46.6 nmol/L, and 2.71.3 nmol/nmol creatinine respectively than in the symptom group 5.61.8 nmol/L, 14.88.8 nmol/L, and 1.60.9 nmol/nmol creatinine respectively.
The Hg-concentrations did not significantly increase in the two groups after amalgam removal. Six days after the removal the plasma mean concentration was significantly decreased at P level and ten days after the decrease was at a permanent P level. The mean Ery-Hg level was significantly decreased after eleven days (p), a level that remained stable for the rest of the year. The mean U-Hg level was significantly decreased one month after the removal and after six months the mean level was reduced with 80 % compared to the initial level in both groups.
The conclusion to be drawn for the present study is that the symptom group did not have a changed pattern of elimination of mercury compared to the healthy group.
VIII) Pregnancy Precaution
The continuous release of mercury from amalgam restorations may be responsible for a portion of birth defects seen today. While you might wish to avoid any further exposure to this material by having your fillings removed immediately, an unborn baby is very much at risk to mercury in its mother's blood. When amalgam filling are removed or an amalgam-filled tooth is extracted, a surge of mercury may be released into the bloodstream. So women who are pregnant should not have amalgam fillings removed. Women should have their amalgam fillings removed at least one year in advance of when they intend to become pregnant and discuss the risk with an informed medical doctor or dentist.
IX) American Dental Association's Position
The American Dental Association has taken the following positions about "the dental amalgam issue."
IX A) Journal of the American Dental Association
Journal of the American Dental Association (April, 1990).
The strongest and most convincing support we have for the safety of dental amalgam is the fact that each year more than 100 million amalgam fillings are placed in the United States. And since amalgam has been used for more than 150 years, literally billions of amalgam fillings have been successfully used to restore decayed teeth.
IX B) Superior Court Demurrer
The Superior Court of the State of California Case No. 718228, Demurrer (October 22, 1992).
The American Dental Association (ADA) owes no legal duty of care to protect the public form allegedly dangerous products used by dentists. The ADA did not manufacture, design, supply or install the mercury-containing amalgams. The ADA does not control those who do. The ADA's only alleged involvement in the product was to provide information regarding its use. Dissemination of information relating to the practice of dentistry does not create a duty of care to protect the public from potential injury.
IX C) ADA's Code of Ethics
The American Dental Association's (ADA) code of ethics makes the removal of serviceable mercury amalgam restorations an issue of ethical conduct. In the ADA's point of view, it is ethical for a dentist to place mercury amalgam restorations in a patient and claim their safety. However, according to the ADA's code of ethics a dentist who acknowledges that mercury amalgam restorations are toxic and recommends their removal has acted unethically ("...the removal of amalgam restorations from the non-allergic patient for the alleged purpose of removing toxic substances from the body when such treatment is performed solely at the recommendation of the dentist is improper and unethical...." ADA Resolution 42H-1986. Transaction 1986:536) On the basis of the ADA's code of ethics, state dental boards have taken disciplinary action against mercury free dentists who have practiced their profession in accordance with current scientific knowledge and their conscience. The disciplinary action has ranged from restrictions placed on their practice to the loss of license.
IX D) ADA's Internet Site
Additional information about the ADA's position's on the dental amalgam issue can be found on the web page: http://www.ada.org/topics/amalgam.html
X) Colorado Statute
Nothing in this section shall be construed to deprive any dental patients of the right to choose or replace any professionally recognized restorative material, nor to permit disciplinary action against a dentist solely for removing or placing any professionally recognized restorative material.
XI) Amalgam Lawsuit
Bio-probe Newsletter, Volume 12, Issue 6 (November 1996).
After considering evidence and extensive arguments from attorneys for the plaintiff and defendants, the judge in the California case of Tolhurst vs. Johnson & Johnson Consumer Products, Inc. ruled that it is not generally accepted in the scientific community that mercury from amalgam dental fillings is capable of causing Guillain Barre' Syndrome, the affliction allegedly suffered by plaintiff Tolhurst. The judge therefore suppressed any evidence at the trial demonstrating that mercury was the cause of the plaintiff's illness. The evidentiary hearing was held in response to a defense motion based on the Frye rule. This rule requires a plaintiff to demonstrate that the scientific tests, techniques, and methods on which he/she intends to rely at trial are "sufficiently established to have gained general acceptance in the particular field in which it belongs." The test emphasizes a comparison of the members of the relevant scientific community who do or do not consider the proposed scientific test, method, or technique as valid and reliable.

XII) Notice to Amalgam Manufactures
Reeves & Associates of Lexington, Kentucky sent the following letter on behalf of the IAOMT to amalgam manufactures in May and September of 1992:
The potential for harmful health effects resulting from mercury exposure from mercury/silver amalgam dental fillings is no longer a matter of scientific debate. Such adverse effects have now been documented and reported by qualified medical scientists. Serious questions exist regarding mercury's role in loss of kidney function, Alzheimer's Disease, and a host of neurological disorders. My client, the International Academy of Oral Medicine and Toxicology (IAOMT) has compiled and reviewed all relevant scientific documentation and has found a total lack of scientific rigor to support statements that chronic exposure to mercury from dental amalgam is harmless to patients. I am sure you and your attorneys are all too aware of the potential for product liability under Restatement of Torts, Section 402A and other relevant law. In view of the totality of the information that is now available, not only does it seem likely that there will be an avalanche of product liability in the future, but that for those companies which continue to market the product, there will be a real potential for the assessment of punitive damages, much as we have seen against the asbestos industry. We believe it in your company's best interest, as well as in the interest of public health, that all use of mercury as a dental filling material cease immediately. The IAOMT has more specific information if you desire.
The above letter was sent to the following amalgam manufactures:
CHIEF EXECUTIVE OFFICER, ADEC, 2601 CRESTVIEW DR, NEWBERG, OR, 97132
CHIEF EXECUTIVE OFFICER, BUFFALO DENTAL MFG CO INC, 575 UNDERHILL BLVD, SYOSSET, NY, 11791
CHIEF EXECUTIVE OFFICER, CRESCENT DENTAL, 7750 W 47TH ST. LYONS, IL, 60534-1826
CHIEF EXECUTIVE OFFICER, DARBY DENTAL SUPPLY CO, 100 BANKS AVE, ROCKVILLE CENTRE, NY, 11570
CHIEF EXECUTIVE OFFICER, EASTERN SMELTING & REFINING CORP, 37 39 BUBIER ST, LYNN, MA, 01901
CHIEF EXECUTIVE OFFICER, G HARTZELL & SON, 2372 STANWELL CIRCLE, CONCORD, CA, 94520
CHIEF EXECUTIVE OFFICER, GARFIELD REFINING CO, 810 T EAST CAYUGA, PHILADELPHIA, PA, 19124-3892
CHIEF EXECUTIVE OFFICER, HAMMOND DENTAL MFG CO, 4496 INDUSTRIAL DR, SIMI VALLEY, CA, 93063
CHIEF EXECUTIVE OFFICER, HEALTH CO INTL INC, 25 STUART ST, BOSTON, MA, 02116
CHIEF EXECUTIVE OFFICER, HENRY SCHEIN, 5 HARBOR PARK DR, PORT WASHINGTON, NY, 11050
CHIEF EXECUTIVE OFFICER, HU FRIEDY, 3232 N ROCKWELL ST, CHICAGO, IL, 60618
CHIEF EXECUTIVE OFFICER, INDIUM CORPORATION OF AMERICA, 1676 LINCOLN, UTICA, NY, 13502
CHIEF EXECUTIVE OFFICER, J F JELENKO, 99 BUSINESS PK DR, ARMONK, NY, 10504
CHIEF EXECUTIVE OFFICER, KULZER, 10005 MUIRLANDS BLVD, IRVINE, CA, 92718
CHIEF EXECUTIVE OFFICER, LS PLATE C/O WIRE CORP, 70 17 51ST AVE, WOODSIDE, NY, 11373-0667
CHIEF EXECUTIVE OFFICER, MERCURY REFINING CO INC, 790 WATER VLIET-SHAKER ROAD, ALBANY, NY, 12110
CHIEF EXECUTIVE OFFICER, METZ METALLURGICAL CORP, 3900 S CLINTON AVE, SOUTH PLAINFIELD, NJ, 07080
CHIEF EXECUTIVE OFFICER, MILTEX INSTRUMENT CO, 6 OHIO DR, LAKE SUCCESS, NY, 11042
CHIEF EXECUTIVE OFFICER, MINIMAX CO, 5905 N CLARK ST, CHICAGO, IL, 60660-3207
CHIEF EXECUTIVE OFFICER, ORAL B LABORATORIES INC, 1 LAGOON DR, REDWOOD CITY, CA, 64065
CHIEF EXECUTIVE OFFICER, PARKELL, 155 SCHMITT BLVD BOX S, FARMINGDALE, NY, 11735
CHIEF EXECUTIVE OFFICER, PATTERSON DENTAL, 1100 E 80TH ST, MINNEAPOLIS, MN, 55420
CHIEF EXECUTIVE OFFICER, PREMIER DENTAL PRODUCTS, 1710 ROMANO DR, MORRISTOWN, PA, 19404
CHIEF EXECUTIVE OFFICER, PULPDENT CORP, 80 OAKLAND ST, WATERTOWN, MA, 02272
CHIEF EXECUTIVE OFFICER, SAFECO DENTAL SUPPLY, 527 S JEFFERSON ST, CHICAGO, IL, 60607-0625
CHIEF EXECUTIVE OFFICER, SDL GROUP, 742 CENTRAL AVE, DEERFIELD, IL, 60015
CHIEF EXECUTIVE OFFICER, SS WHITE DTL PROD INT,100 SOUTH STREET, HOLMDEL, NJ, 07733
CHIEF EXECUTIVE OFFICER, SUREPURE CHEMETALS INC, 23 WOODBINE RD, FLORHAM PK, NJ, 07932
CHIEF EXECUTIVE OFFICER,THREE M DENTAL PRODUCTS DIV, BLDG 225 45 11 3 M CTR, ST PAUL, MN, 55144
CHIEF EXECUTIVE OFFICER, ULTRAFINE POWDER TECHOLOGY INC, 500 PARK EAST DRIVE, WOONSOCKET, RI, 02895-6148
CHIEF EXECUTIVE OFFICER, ZENITH DENTAL, 242 S DEAN, ENGLEWOOD, NJ, 07631
XIII) Government Phase Outs
In the interest of protecting their citizens' health, Sweden, Germany, Denmark, Austria, Finland and Canada have recently taken steps to limit and phase out the use of amalgam restorations.
The United States of America Food and Drug Administration has not recently reviewed the safety of amalgam restorations.
XIV) Organizations
Dental Amalgam Mercury Syndrome (DAMS)
A support group of dental mercury victims who feel a strong obligation to inform fellow citizens of the health hazards associated with amalgam fillings. Most of the dedicated individuals involved in DAMS are victims and volunteers. A basic information packet is available from DAMS. A 7$ donation to DAMS is requested for the information packet. Contact:
DAMS, Inc.
P.O. Box 64397
Virginia Beach, VA 23467-4397
1-800-311-6265
International Academy of Oral Medicine and Toxicology (IAOMT)
If you are a mercury-free dentist or are contemplating going mercury-free, you need to join the IAOMT. The IAOMT has helped fund or has been the catalyst for much of the current scientific research demonstrating that dental amalgam is not the benign dental material that 150 years of use and the ADA would like you to believe. Furthermore, the IAOMT is doing something about Standards of Care and Protocols that protect you, your staff and the patient. For membership contact:
IAOMT
P.O. Box 608531
Orlando, FL 32860-8531
American College of Advancement in Medicine (ACAM)
An association of doctors who practice alternative or complementary medicine. Most of them also practice celation therapy, which is used to detoxify the body.
ACAM
P.O. Box 3427
Laguna Hills, CA 92654
American Academy of Environmental Medicine (AAEM)
The American Academy of Environmental Medicine is dedicated to the purpose of recognition, treatment and prevention of illness induced by exposures to biological and chemical agents encountered in air, food, and water. AAEM members recognize that human beings, though marvelously adaptable, must struggle to cope with an often hostile environment. Environmental Medicine is an integration of concepts drawn from both the primary and specialty care medical fields and the basic sciences. Discovering the cause-and-effect relationships of disease allows a physician to initiate treatment protocols that can result in genuine healing.
AAEM
P.O. Box CN1001-8001
New Hope, PA 18938
Consumers for Dental Choice (CDC)
A project of the National Institute for Science, Law, and Public Policy created to "level the playing field " between the powerful state Dental Boards and all licensed dentists, whether or not mercury-free. Furthermore, CDC has grown to involve Governors, Attorney Generals, and Directors of Health in the fight to allow dentists to practice which ever way within their professional opinion is safe and effective.
CDC
1424 16th Street, NW Suite 105
Washington, D.C. 20036
XV) Books Available
Bio-Probe Inc. has several books pertaining to dental amalgam mercury. They advertise these books on the world wide web at http://www.bioprobe.com.
XVI) Newsletters
A quarterly International DAMS Newsletter is published quarterly. The subscription price is $25.00 per year. Contact DAMS, Inc., P.O. Box 64397 Virginia Beach, VA 23467-4397.
The Bio-Probe Newsletter is published bi-monthly. Editorial office is at 5508 Edgewater Dr., Orlando, FL 32810. The subscription price is $65.00 per year for USA and Canadian subscribers, and $85.00 per year for other countries. Postage paid at Orlando.
XVII) Amalgam Related Conventions
The next IAOMT and DAMS meetings are schedualed for September 10-12, 1998 at the Antlers Doubletree Hotel in Colorado Springs, CO. 80903.



Re: 1991 World Health Organisation report

Posted by j on March 16, 1999 at 18:23:37:

In Reply to: Have doubt? Read me! The cream of the crop posted by JN on March 15, 1999 at 22:13:35:

This report contains the collective views of an international group of experts and does not necessarily represent the decisions or the stated policy of the United Nations Environment Programme, the International Labour Organisation, or the World Health Organization.
Environmental Health Criteria 118
INORGANIC MERCURY - SUMMARY AND CONCLUSIONS
Published under the joint sponsorship of the United Nations Environment Programme, the International Labour Organisation, or the World Health Organization.
First draft prepared by dr L Friberg, Karolinska Institute, Sweden
World Health Organization
Geneva, 1991
(To IAOMT-Sweden home page)
1. SUMMARY AND CONCLUSIONS
1.1 Identity
1.2 Physical and chemical properties
1.3 Analytical methods
1.3.1 Analysis, sampling, and storage of urine
1.3.2 Analysis and sampling of air
1.4 Sources of human and environmental exposure
1.4.1 Natural occurrence
1.4.2 Sources due to human activities
1.5 Uses
1.6 Environmental transport, distribution, and transformation
1.7 Human exposure
1.8 Kinetics and metabolism
1.8.1 Reference and normal values
1.9 Effects in humans
This monograph concentrates primarily on the risk to human health from inorganic mercury, and examines research reports that have appeared since the publication of Environmental Health Criteria 1: Mercury (WHO, 1976). In the period since 1976, new research data has become available for two main health concerns related to inorganic mercury, i.e. mercury in dental amalgam and in skinlightening soaps. The emphasis in this monograph is on exposure from these two sources, but the basic kinetics and toxicology are reviewed with all aspects of inorganic mercury in mind. Human health concerns related to the global transport, bioaccumulation, and transformation of inorganic mercury almost exclusively arise from the conversion of mercury compounds into methylmercury and exposure to methylmercury in sea-food and other food. The global environmental and ecological aspects of inorganic mercury have been summarized in this monograph. More detailed descriptions may be found in Environmental Health Criteria 86: Mercury Environmental Aspects (WHO, 1989) and Environmental Health Criteria 101: Methylmercury (WHO, 1990).
1.1 Identity
Mercury exists in three states: Hg0 (metallic); Hg2++ (mercurous); and Hg++ (mercuric). It can form organometallic compounds, some of which have found industrial and agricultural uses.
1.2 Physical and chemical properties
Elemental mercury has a very high vapour pressure. The saturated atmosphere at 20oC has a concentration over 200 times greater than the currently accepted concentration for occupational exposure.
Solubility in water increases in the order: elemental mercury < mercurous chloride < methylmercury chloride < mercuric chloride. Elemental mercury and the halide compound of alkylmercurials are soluble in non-polar solvents.
Mercury vapour is more soluble in plasma, whole blood, and haemoglobin than in distilled water, where it dissolves only slightly. The organometallic compounds are stable, although some are readily broken down by living organisms.
1.3 Analytical methods
The most commonly used analytical methods for the quantification of total and inorganic mercury compounds are atomic absorption of cold vapour (CVAA) and neutron activation. Detailed information relating to analytical methods are given in Environmental Health Criteria 1: Mercury (WHO, 1976) and Environmental Health Criteria 101: Methylmercury (WHO, 1990). All analytical procedures for mercury require careful quality control and quality assurance.
1.3.1 Analysis, sampling, and storage of urine
Flameless atomic absorption spectrophotometry is used in routine analysis for various media. Particular care must be taken when choosing the anticoagulant used for blood sampling in order to avoid contamination by mercury compounds. Special care must also be taken in the sampling and storage of urine, since bacterial growth can change the concentration of the numerous forms of mercury that may be present. Addition of hydrochloric acid or bactericidal substances and freezing the sample are the best methods to prevent alteration of urine samples. Correction of concentration by reference to urine density or creatinine content are recommended.
1.3.2 Analysis and sampling of air
Analytical methods for mercury in air may be divided into instant reading methods and methods with separate sampling and analysis stages. Instant reading methods can be used for the quantification of elemental mercury vapour. Sampling in acid-oxidizing media or on hopcalite is used for the quantification of total mercury.
The cold vapour atomic absorption (CVAA) technique is the most frequently used analytical method.
1.4 Sources of human and environmental exposure
1.4.1 Natural occurrence
The major natural sources of mercury are degassing of the earth's crust, emissions from volcanoes, and evaporation from natural bodies of water.
The natural emission are of the order of 2700-6000 tonnes per year.
1.4.2 Sources due to human activities
The world-wide mining of mercury is estimated to yield about 10 000 tonnes/year. These activities lead to some losses of mercury and direct discharges to the atmosphere. Other important sources are fossil fuel combustion, metal sulfide ore smelting, gold refining, cement production, refuse incineration, and industrial applications of metals.
The specific normal emission from a chloralkali plant is about 450 g of mercury per ton of caustic soda produced.
The total global amount and release of mercury, due to human activities, to the atmosphere has been estimated to be up to 3000 tonnes/year.
1.5 Uses
A major use of mercury is as a cathode in the electrolysis of sodium chloride. Since the resultant chemicals are contaminated with mercury, their use in other industrial activities leads to a contamination of other products. Mercury is used in the electrical industry, in control instruments in the home and industry, and in laboratory and medical instruments. Some therapeutic agents contain inorganic mercury. A very large amount of mercury is used for the extraction of gold.
Dental silver amalgam for tooth filling contains large amounts of mercury, mixed (in the proportion 1:1) with alloy powder (silver, tin, copper, zinc). Copper amalgam, used mostly in paediatric dentistry, contains up to 70% mercury and up to 30% copper. These uses can cause exposure of the dentist, dental assistants, and also of the patients.
Some dark-skinned people use mercury-containing creams and soap to achieve a lighter skin tone. The distribution of these products is now banned in the EEC, in North America, and in many African countries, but mercurycontaining soap is still manufactured in several European countries. The soaps contain up to 3 % of mercuric iodine and the creams contain ammoniated mercury (up to 10%).
1.6 Environmental transport, distribution, and transformation
Emitted mercury vapour is converted to soluble forms and deposited by rain onto soil and water. The atmospheric residence time for mercury vapour is up to 3 years, whereas soluble forms have a residence time of only a few weeks.
The change in speciation of mercury from inorganic to methylated forms is the first step in the aquatic bioaccumulation process. This can occur non-enzymically or through microbial action. Methylmercury enters the foodchain of predatory species where biomagnification occurs.
1.7 Human exposure
The general population is primarily exposed to mercury through the diet and dental amalgam. Depending on the concentration in air and water, significant contributions to the daily intake of total mercury can occur. Fish is a dominant source of human exposure to methylmercury. Recent experimental studies have shown that mercury is released from amalgam restorations in the mouth as vapour. The release rate of this mercury vapour is increased, for example, by chewing. Several studies have correlated the number of dental amalgam fillings or amalgam surfaces with the mercury content in tissues from human autopsy, as well as in samples of blood, urine, and plasma. Both the predicted mercury uptake from amalgam and the observed accumulation of mercury show substantial individual variation. It is, therefore, difficult to make accurate quantitative estimations of the mercury release and uptake by the human body from dental amalgam tooth restorations.
Experimental studies in sheep have examined in greater detail the distribution of mercury released from amalgam restorations.
Use of skin-lightening soap and creams can give rise to substantial mercury exposure.
Occupational exposure to inorganic mercury has been investigated in chloralkali plants, mercury mines, thermometer factories, refineries, and in dental clinics. High mercury levels have been reported for all these occupational exposure situations, although levels vary according to work environment conditions.
1.8 Kinetics and metabolism
Results of both human and animal studies indicate that about 80% of inhaled metallic mercury vapour is retained by the body, whereas liquid metallic mercury is poorly absorbed via the gastrointestinal tract (less than 1%). lnhaled inorganic mercury aerosols are deposited in the respiratory tract and absorbed, the rate depending on particle size. lnorganic mercury compounds are probably absorbed from the human gastrointestinal tract to a levet of less than 10% on average, but there is considerable individual variation. Absorption is much higher in newborn rats.
The kidney is the main depository of mercury after the administration of elemental mercury vapour or inorganic mercury compounds (50-90% of the body burden of animals). Significantly more mercury is transported to the brain of mice and monkeys after the inhalation of elemental mercury than after the intravenous injection of equivalent doses of the mercuric form. The red blood cell to plasma ratio in humans is higher (>1) after administration of elementat mercury than mercuric mercury and more mercury crosses the placental barrier. Only a small fraction of the administered divalent mercury enters the rat fetus.
Several forms of metabolic transformation can occur:
- oxidation of metallic mercury to divalent mercury
- reduction of divalent mercury to metallic mercury;
- methylation of inorganic mercury;
- conversion of methylmercury to divalent inorganic mercury.
The oxidation of metallic mercury vapour to divalent ionic mercury (section 6.1.1) is not fast enough to prevent the passage of elemental mercury through the bloodbrain barrier, the placenta, and other tissues. Oxidation in these tissues serves as a trap to hold mercury and leads to acccumulation in brain and fetal tissues.
The reduction of divalent mercury to Hg0 has been demonstrated both in animals (mice and rats) and humans. The decomposition of organomercurials, including methylmercury, is also a source of mercuric mercury.
The faecal and urinary routes are the main pathways for the elimination of inorganic mercury in humans, althrough some elemental mercury is exhaled. One form of depletion is the transfer of maternal mercury to the fetus.
The biological half-time, which only lasts a few days or weeks for most of the absorbed mercury, is very long, probably years, for a fraction of the mercury. Such long half-times have been observed in animal experiments as well as in humans. A complicated interplay exists between mercury and some other elements, including selenium. The formation of a selenium complex may be responsible for the long half-time of a fraction of the mercury.
1.8.1 Reference and normal values
Limited information from deceased miners shows mercury concentrations in the brain, years after cessation of exposure, of several mg/kg, with still higher values in some parts of the brain. However, lack of quality control of the analysis makes these data uncertain. Among a small number of deceased dentists, without known symptoms of mercury intoxication, mercury levels varied from very low concentrations up to a few hundred ug/kg in the occipital lobe cortex and from about 100 ug/kg to a few mg/kg in the pituitary gland.
From autopsies on subjects not occupationally exposed but with a varying number of amalgam fillings, it seems that a moderate number (about 25) of amalgam surfaces may on average increase the brain mercury concentration by about 10 ug/kg. The corresponding increase in the kidneys, based on a very limited number of analyses, is probably 300-400 ug/kg. However, the individual variation is considerable.
Mercury levels in urine and blood can be used as indicators of exposure provided that the exposure is recent and relatively constant, is long-term, and is evaluated on a group basis. Recent exposure data are more reliable then those quoted in Environmental Health Criteria I: Mercury (WHO, 1976). Urinary levels of about 50 ug per g creatinine are seen after occupational exposure to about 40 ug mercury/ m3 of air. This relationship (5:4) between urine and air levels is much lower that the 3:1 estimated by WHO (1976). The difference may in part be explained by different sampling technique for evaluating air exposure. An exposure of 40 ug mercury/m of air will correspond to about 15-20 ug mercury/litre of blood. However, interference from methylmercury exposure can make it difficult to evaluate exposure to low concentrations of inorgnic mercury, by means of blood analysis. A way to overcome the problems is to analyse mercury in plasma or analyse both inorganic mercury and methylmercury. The problem of interference from methylmercury is much smaller when analysing urine, as methylmercury is excreted in the urine to only a very limited extent.
1.9 Effects in humans
Acute inhalation exposure to mercury vapour may be followed by chest pains, dyspnoea, coughing, haemoptysis, and sometimes interstitial pneumonitis leading to death. The ingestion of mercuric compounds, in particular mercuric chloride, has caused ulcerative gastroenteritis and acute tubular necrosis causing death from anuria where dialysis was not available.
The central nervous system is the critical organ for merury vapour exposure. Subacute exposure has given rise to psychotic reactions characterized by delirium, hallucinations, and suicidal tendency. Occupational exposure has resulted in erethism as the principal feature of a broad ranging functional disturbance. With continuing exposure a fine tremor develops, initially involving the hands. In the milder cases erethism and tremor regress slowly over a period of years following removal from exposure. Decreased nerve conduction velocity has been demonstrated in mercuryexposed workers. Long-term, low-level exposure has been asociated with less pronlunced symtoms of erethism.
There is very little information available on brain mercury levels in cases of mercury poisoning, and nothing that makes it possible to estimate a no-observed-effect level or a dose-response curve.
At a urinary mercury excretion level of 100 ug per g creatinine, the probability of developing the classical neurological signs of mercurial intoxication (tremor, erethism) and proteinuria is high. An exposure corresponding to 30 to l00 ug mercury/g creatinine increases the incidense of some less severe toxic effects that do not lead to overt clinical impairment. In a few studies tremor, recorded electrophysiologically, has been observed at low urine concentrations (down, to 25-35 ug/g creatinine). Other studies did not show such an effect. Some of the exposed people develop proteinuria (proteins of low relative molecular mass and microalbuminuria). Appropriate epidemiological data covering exposure levels corresponding to less than 30-50 ug mercury/g creatinine are not available.
The exposure of the general population is generally low, but may occasionally be raised to the level of occupational exposure and can even be toxic. Thus, the mishandling of liquid mercury has resulted in severe intoxication.
The kidney is the critical organ following the ingestion of inorganic divalent mercury salts. Occupational exposure to metallic mercury has long been associated with the development of proteinuria, both in workers with other evidence of mercury poisoning and in those without such evidence. Less commonly, occupational exposure has been followed by the nephrotic syndrome, which has also occurred after the use of skin-lightening creams containing inorganic mercury, and even after accidental exposure. The current evidence suggests that this nephrotic syndrome results from an immunotoxic response. Until recently, effects of elemental mercury vapour on the kidney had been reported only at doses higher than those associated with the onset of signs and symtoms from the nervous system.
New studies have, however, reported kidney effects at lower exposure levels. Experimental studies on animals have shown that inorganic mercury may induce auto-immune glomerulonephritis in all species tested, but not in all strains, indicating a genetic predisposition. A consequence of an immunological etiology is that, in the absence of dose-response studies for groups of immunologically sensitive individuals, it is not scientifically possible to set a level for mercury (e.g., in blood or urine) below which (in individual cases) mercury-related symptoms will not occur.
Both metallic mercury vapour and mercury compounds have given rise to contact dermatitis. Mercurial pharmaceuticals have been responsible for Pink disease in children, and mercury vapour exposure may be a cause of "Kawasaki" disese. In some studies, but not in others, effects on the menstrual cycle and/or fetal development have been reported. The standard of published epidemiological studies is such that it remains an open question whether mercury vapour can adversely affect the menstrual cycle or fetal development in the absence of the wellknown signs of mercury intoxication.
Recently, there has been an intense debate on the safety of dental amalgams and claims have been made that mercury from amalgam may cause severe health hazards. Reports describing different types of symptoms and signs and the results of the few epidemiological studies produced are inconclusive.



Re: abstracts 2

Posted by Michele on March 16, 1999 at 19:54:30:

In Reply to: Re: abstracts 2 posted by j on March 16, 1999 at 18:18:36:

I cannot believe the code of Ethics with the ADA. Any dentist removing mercury amalgams from a "non-allergenic" patient is subject to disciplinary action?!!! What is WRONG here???



Re: abstracts 2

Posted by j on March 17, 1999 at 03:55:25:

In Reply to: Re: abstracts 2 posted by Michele on March 16, 1999 at 19:54:30:

The tremendous financial liability. Dentists are not neuroscientists. Just "plumbers".



Re: What are your fillings made of now? (NMI)

Posted by j on March 17, 1999 at 04:00:21:

In Reply to: What are your fillings made of now? (NMI) posted by Peggy on March 16, 1999 at 18:09:12:

Use dental porcelain, on titanium posts. (IPS Empress from Switzerland). The Use of porcelain requires the debntal technician to have certification from manufacturers, and many with marginal quality of work with materials such as gold will never pass the tests! Gold can be corrected after cast was made , porcelsin rather not!



Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE)

Posted by j on March 17, 1999 at 05:25:30:

In Reply to: Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE) posted by Peggy on March 16, 1999 at 18:07:39:

It is difficult since many are still refusing to even consider such posibility.
Find environmental Ecologist and ask for referal to such. Some Dentists do have sites on Internet, and they advertise mercury freedentistry. The point is to sponsor dentists who support anti mercury campaign, and not those who do not, and do it only for money. The dentist must use a "dam" in the mouth and suction, so you will not swallow the mercury, since such can be evenworst. Go to Yahoo, type amalgam and visits the sites which explain pro and con, and the procedures. Than make a wise decision. Do not act as reaction to what I posted but be sure that this is right decision. I know what is right and what is wrong based on my experience. I do not want to create the spontanious need for such procedure. This must be a well made decision based on your personal conviction after you read the evidence.
The sweedish sites are very good. You will find out also what happened to a student who swallowed mercury while such was in the ice cream from cracked mercury thermometer.



Re: What are your fillings made of now?

Posted by Walt Stoll on March 17, 1999 at 10:24:19:

In Reply to: What are your fillings made of now? (NMI) posted by Peggy on March 16, 1999 at 18:09:12:

Hi, Peggy.

I had them removed by the dentist I had working with me in my office. He had studied with the best in the world about how to determine which materials matched the individual (Hal Huggins was one). Some are acrylic and some are ceramic.

ALL patients should be tested to see which replacement material will not cause problems before removal of the amalgams.

Walt



Re:(Dental Amalgams) (ARCHIVE) How to find a knowledgable dentist.

Posted by Walt Stoll on March 17, 1999 at 10:29:56:

In Reply to: Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE) posted by Peggy on March 16, 1999 at 18:07:39:

Hi, Peggy.

I would call Hal Huggins, DMD at his center in CO and ask how to find someone well trained in your part of the country. His # is (800) 331-2303.

Also, if you have not read much on this, I would suggest "The Mercury in Your Mouth" by Lydia Bront`, PhD (She is also the author of "The Longevity Factor").

Earlier this week I posted how to find that book if the bookstore is not cooperative.

Let us know what you learn.

Walt



Re: What are your fillings made of now?

Posted by Johnelle on March 17, 1999 at 11:14:29:

In Reply to: Re: What are your fillings made of now? posted by Walt Stoll on March 17, 1999 at 10:24:19:

Dr. Stoll

How does one get tested to see which type of fillings are
best for you?

Johnelle............




Re:(Dental Amalgams) (ARCHIVE) How to find a knowledgable dentist.

Posted by JN on March 17, 1999 at 16:40:04:

In Reply to: Re:(Dental Amalgams) (ARCHIVE) How to find a knowledgable dentist. posted by Walt Stoll on March 17, 1999 at 10:29:56:

Higgins web site is


http;//www.halnet.com



Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE)

Posted by Peggy on March 17, 1999 at 18:30:53:

In Reply to: Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE) posted by j on March 17, 1999 at 05:25:30:

Don't worry, I won't do anything prematurely...I've been thinking about this amalgam stuff for several months now. I just want to keep gathering information at this point.

Thanks,
Peggy



Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE)

Posted by JN on March 18, 1999 at 02:44:18:

In Reply to: Re: Have doubt? Read me! The cream of the crop (Dental Amalgams) (ARCHIVE) posted by Peggy on March 17, 1999 at 18:30:53:

Good, you are in control. While as youmay noticed know it beyond boubt, I am always concern about those wh may not understand and act spontanieously on an impulse. Thos is why I made such a blunt remark after my post.
I had neurospasms, and buckling knees.
I suggest also to look for quality non metallic replacement. The main reason that gold alloys even contain metals which are known to be toxic. The strangiest was an evidence that some people with metal appliances developed symptoms where th metal appliance acted as an antenna, and they were hearing radio frequencies through the metal appliances while doctors were refering them as usual ad as expected for psychiatric evaluation.



Re: Fillings bio-compatibility!

Posted by JN on March 18, 1999 at 03:29:48:

In Reply to: Re: What are your fillings made of now? posted by Johnelle on March 17, 1999 at 11:14:29:

The porcelain is more durable, but it hardness is critical to prevent to other teeth "injury". The composites, acrylic and other resins have tendency to "peel off" once every 2 years with life cycle maximum of 5 years. Composits however have tendency to change color, once the miniature intermolecular spaces are being saturated with foods, tea, and coffe. Porcelain however retain the color better.
The worknmanship of the dental lab is however critical.
Many dental lab is using cheap and poorly trained dental technicians. There is new generation of dental labs whic is using quickly trained "oriental" technicians who butcher the crowns and bridges. The result is that while such need to be replaced the permanent damage to bite.
Some dentists to compensate for shoddy crowns and bridges rather than redo them, will grind life teeth, to allign the bite. The grainding of crowns porcelain on metal is not possible since will destroy the crown.
I had excellent results with EPS (or IPS) Empress porcelain which I have for over 2 years and highly recommend. (presume is bio-compatible).
I guess the electromagnetic conductivity is ceritical for perfect match. One of my friends had custom made experimental sillica fillings (no metal). She developed as she explained electromagnetic incompatibility, which caused her muscle to contract, something like total body bracing. She was unable to have any metals. She has Phd in "letters and Science", and she was able to relate her health problems to "shifting of the energy".
In deed she is, as hard to believe, able to analyze energy of human body. She "dropped" her Phd, and now is studying chineese and eastern medicine. Her findings once a while appear to be highly irrational. But the events with incompatible materials from silica were shocking.
The infrared photography confirmed (prior and after) that her body neuromuscular system is being affected and "was shifting" with incompatible dental materials.
In deed she was forced to file medical malpractice against one of her past dentists, and the ARBITRATOR BASED ON THIS EVIDENCE RULLED AGAINST THE DOCTOR.
The issue was that the dentist advertised computerised alignment of her jaws (required due to pain of the neck and shoulder), and while he conducted computerised analysis, he concluded that she needed teeth "treaming", to compensate for bite shifting. After he grinded her teeth, she was almost like paralized, since her jaws were "sliding".
State stop short, as result of his attorneys intervention, from revoking his licence to practice dentistry after this discovery.
The cost of this practice and test was about $ 6,000.00.
It was than determined that the metals in her dental appliances caused some strange neuromuscular contractions contractions (beyond my understanding).
Such condition was however documented in the past by dental experts who determined that shifting of the jaws, and sliding may cause severe neuromuscular problems.
This is why as Dr. Walt stated the compatibility tests are an opportunity to prevent such nightmares. Usually such are nedeed for metals. It is however belived that some dental materials as silica are having high aluminium content.
Well for your information, my friend removed all fillings and now for past two years is with open cavities and no fillings at all, due to such incompatibilities.
This will not be my choise. Additives of some metals to dental alloys such as berillium, or chromium, are not always desirable, and may cause bio- incompatibility.



Re: What are your fillings made of now?

Posted by Walt Stoll on March 18, 1999 at 12:06:13:

In Reply to: Re: What are your fillings made of now? posted by Johnelle on March 17, 1999 at 11:14:29:

HI, Johnelle.

I would call Hal Huggins center & find a dentist close to where I lived & ask that question of him/her. I always sent patients I thought needed this approach to our dentist and he did this for me.

Walt



Re:(Dental Amalgams) (ARCHIVE) How to find a knowledgable dentist.

Posted by Walt Stoll on March 18, 1999 at 12:08:20:

In Reply to: Re:(Dental Amalgams) (ARCHIVE) How to find a knowledgable dentist. posted by JN on March 17, 1999 at 16:40:04:

Thanks, JN.

I had hugnet.com the last I knew.

Walt



Re: What are your fillings made of now? (NMI)

Posted by
David on May 21, 1999 at 10:22:44:

In Reply to: Re: What are your fillings made of now? (NMI) posted by j on March 17, 1999 at 04:00:21:


What are goldfillings composed of?



Re: What are your fillings made of now?

Posted by Walt Stoll on May 22, 1999 at 10:38:32:

In Reply to: Re: What are your fillings made of now? (NMI) posted by David on May 21, 1999 at 10:22:44:

Hi, David.

You are going to ask your dentist this one.

Walt



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