What IS a Little BIT of Mercury?

Dentistry claims that it is safe to implant one of the most toxic substances known to science
into living human beings – Dentistry claims that mercury amalgam is safe and effective.

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Criteria 118 World Health Organisation 1991

The No Observable Effects Level (NOEL) for mercury is ZERO

There  is NO safe level of mercury vapour

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On 7 January 2003, the Superior Court in San Francisco
approved the warnings on dental amalgam mercury
that are required under California's Proposition 65

Warning on dental amalgam, used in many dental fillings,
causes exposure to mercury,
a chemical known to the state of California to cause
birth defects or other reproductive harm.

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Swedish Government report of 2003 states:

"With reference to the fact that mercury is a multipotent toxin
with effects on several levels
of the biochemical dynamics of the cell,
amalgam must be considered to be an unsuitable material
for dental restoration.
This is especially true since fully adequate and
less toxic alternatives are available."

(click here to read an extensive part of the report)

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The dental associations and even government bodies tell us that amalgam is safe because only a 'little bit' of mercury comes out of amalgam fillings. They support this comment by telling us that most of the mercury comes out at the time of amalgam placement, thus insinuate that it is OK once the amalgam is set.

The fact is that mercury is released from amalgam throughout the life of the filling.

In 1996 Dr Richard S. Tobin, Ph.D, then the Director of the Medical Devices Bureau, Canada Health, wrote to the Canadian Dental Association, in response to their position statement on dental amalgam and a set of questions and answers on amalgam to be used by dentists in responding to inquiries from patients.  (Click here for the full article)

Canadian Dental Association:
Q. Is the mercury which is released from fillings absorbed into the body?

A. Yes, but in extremely small amounts, i.e. in MILLIONTHS of a gram (this is very small amount, 0.000001 grams.)

Dr Tobin's Response:
"This answer is rather condescending and insulting to the intelligence of readers. By emphasizing only how small a microgram is it implies that a microgram of toxic material could not be harmful. What is significant is not now many zeroes there are in a microgram, but how many micrograms of mercury are released by and compared to the number of micrograms required to cause illness. The fact is that a level of only one hundred millionths of a gram (only 0.0001 gram) of mercury per gram of Creatinine in urine is considered to indicate clinical mercury poisoning."

 

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The latest NH&MRC statement on dental amalgam uses the same nonsensical argument to support the continued poisoning of the population - "Very small amounts of mercury are released from the surface of dental amalgam fillings, mainly as mercury vapour. ....In this way, some mercury can reach the rest of the body and accumulate in certain organs, particularly the kidneys"

OSHA in America and Australia, has set the maximum allowable mercury vapour levels for occupational exposure based on a 40 hour/week exposure at 50mcg Hg/m3. If this level is exceeded the work place must be closed down. Everyone else is under the jurisdiction of the US EPA who have set a maximum level of 0.2mcg Hg/m3. The Agency for Toxic Substances and Disease Registry which is part of the US EPA have agreed with the maximum level set by the EPA but also state that observable physiological changes will occur at levels as low as 0.03mcg Hg/m3.

Check these figures - numbers represent micrograms per cubic meter of air

OSHA - Occupational Safety & Health Association          50 mcg/m3
US Environmental Protection Agency                            0.2 mcg/m3
Agency Toxic Substances & Disease Registry                  0.03 mcg/m3
NOEL - No Observable Effects Level set by WHO 1991    0

In a mouth with 6 amalgam fillings                            20-120 mcg/m3
Opening a mixed amalgam capsule                           1000 mcg/m3
Drilling amalgam fillings - 18 inches from the mouth    4000 mcg/m3

"The number of amalgam fillings, for each age group, estimated to cause exposure equivalent to the TDI were:  1 filling in toddlers; 1 filling in children;  3 fillings in teens;  and 4 fillings in adults and seniors." 
(ASSESMENT OF MERCURY EXPOSURE AND RISKS FROM DENTAL AMALGAM by G. Mark Richardson PhD., Medical Devices Bureau, Environmental Health Directorate,  Health Canada Executive Summary.)   -   (adopted by Health Canada in 1996)

Most adults and children throughout the world have far more than 4 amalgam implants!  Mercury vapour levels in mouths with half a dozen amalgams have been measured up to 120mcg Hg/m3.

Dental personnel (and patients) should NOTE that levels of mercury vapour from dental amalgam (placing, drilling and polishing) within the dental environment will often exceed the level set by OSHA of 50 mcg/m3. 
All patients should ensure that their dentist does NOT use amalgam and that the suction units from all operatories must be vented to the outside of the building.

Keep away from amalgam! The vapour levels are beyond belief! See the Warnings about Amalgam Removal and also the paper about the health of dentists and dental personnel.

There is not a country anywhere which has found a safe level of mercury vapour and thus the 'NOEL' or 'No Observable Effects Level' is still set at 0 mcg Hg/m3.

 

In other words there is
NO safe level of mercury vapour!  

Material Safety Data Sheets (MSDS’s) for Dental Amalgam

Material Safety Data Sheets are information sheets about a particular product (or part thereof), compiled by the manufacturer, about the safety or otherwise of the particular product, aside from information of a more general kind.  MSDS’s are publicly available. You can easily find them on an internet search. 

It beggars belief that any dental association or university would have the audacity to claim that amalgam is safe and effective, while the manufacturers have told us so long ago that it is dangerous.  In fact the patent on one such amalgam is still owned by none other than the American Dental Association.  Is there a connection of vested interest??? 

AmDA has owned 2 patents on amalgams since 1977-78                    
                        1.United States Patent 4,018,600 Apr. 19, 1977.
                        2.United States Patent 4,078,921 Mar. 14, 1978.

Dispersalloy®

Dispersalloy® has an MSDS for each of its two components. Dispersalloy® Dispersed Phase Alloy and Mercury - Dated Revised 9/24/97
This MSDS was posted at this address - http://www.caulk.com/MSDSDFU/DispersDFU.html - within about 6 months this site was removed.  The information contained in the MSDS is compelling.  Contraindication means that their material 'should not be used in the following circumstances".

 

 

 

 

 

 

 

 

 

 

 

 

 

Side Effects/Warning
Prior to use, read the MSDS information and product instructions for this item.
Exposure to mercury may cause irritation to skin, eyes, respiratory tract and mucous membrane. In individual cases, hypersensitivity reactions, allergies, or electrochemically caused local reactions have been observed. Due to electrochemical processes, the lichen planus of the mucosa may develop.
Mercury may also be a skin sensitizer, pulmonary sensitizer, nephrotoxin and neurotoxin.

The use of amalgam is contraindicated;
1. In proximal or occlusal contact to dissimilar metal restorations.
2. In patients with severe renal deficiency.
3. In patients with known allergies to amalgam.
4. For retrograde or endodontic filling.
5. As a filling material for cast crown.
6. In children 6 and under.
7. In expectant mothers.

Mercury expressed during condensation and unset amalgam may cause amalgamation or galvanic effect if in contact with other metal restorations. If symptoms persist, the amalgam should be replaced by a different material.
Removal of clinically acceptable amalgam restorations should be avoided to minimize mercury exposure, especially in expectant mothers.

Precautions
The number of amalgam restorations for one patient should be kept to a minimum.
Inhalation of mercury vapor by dental staff may be avoided by proper handling of the amalgam, the use of masks, along with adequate ventilation.
Avoid contact with skin and wear safety glasses and gloves.
Store amalgam scrap in well sealed containers. Regulations for disposal must be observed.

http://www.caulk.com./MSDSDFU/DispersalloyMSDS.html
MATERIAL SAFETY DATA SHEET
1.1 Product Trade Name: Mercury
1.2 Part (Item) Number: 904061

Health affects and first aid
Inhalation: Acute: Inhalation of a high concentration of mercury vapor can cause almost immediate dyspnea, cough, fever, nausea and vomiting, diarrhea, stomatitis, salivation, metallic taste, gingivitis, and cardiac abnormalities. Respiratory irritation may occur with chest pain and tightness. Symptoms may re solve or may progress to necrotizing bronchiolitis, pneumonitis, pulmonary edema, pneumothorax, interstitial fibrosis, and death. Acidosis and renal damage may also occur. Allergic reactions that may occur in previously exposed persons include dermatitis, encephalitis, and death. Metal fume fever, an influenza-like illness, may occur due to the inhalation of freshly formed metal oxide particles sized below 1.5 microns and usually between 0.02-0.05 microns. Symptoms may be delayed 4-12 hours and begin with a sudden onset of thirst, and a sweet, metallic or foul taste in the mouth. Other symptoms may include upper respiratory tract irritation accompanied by coughing and a dryness of the mucous membranes, lassitude and a generalized feeling of malaise. Fever, chills, muscular pain, mild to severe headache, nausea, occasional vomiting, exaggerated mental activity, profuse sweating, excessive urination, diarrhea and prostration may also occur. Tolerance to fumes develops rapidly, but is quickly lost. All symptoms usually subside within 24-36 hours.
Inhalation: Chronic: Inhalation of mercury vapor over a long period may cause mercurialism which is characterized by fine tremors and erethism. Tremors may affect the hands first, but may also become evident in the face, arms, and legs. Erethism may be manifested by abnormal shyness, blushing, self-consciousness, depression or despondency resentment of criticism, irritability or excitability, headache, fatigue, and insomnia. In severe cases, hallucinations, loss of memory, and mental deterioration may occur. Concentrations as low and 0.03 mg/m3 have induced psychiatric symptoms in humans. Renal involvement may be indicated by proteinuria, albuminuria, enzymuria, and anuria. Other effects may include salivation, gingivitis, stomatitis, loosening of the teeth, blue lines on the gums, diarrhea, chronic pneumonitis and mild anemia. Repeated exposure to mercury and its compounds may result in sensitization. Intrauterine exposure may result in tremors and involuntary movements in the infants. Mercury is excreted in breast milk. Paternal reproductive effects and effects on fertility have been reported in male rats following repeated inhalation exposures.
Skin contact: Acute : Direct contact with liquid may cause irritation and redness. Small amounts of mercury may be absorbed through intact skin. Allergic reactions that may occur in previously exposed persons include dermatitis, encephalitis, and death. Subcutaneous introcuction, from handling broken thermometers, may result in local inflammation, granulomatous skin reactions, and slight signs of mercury poisoning including digestive disorders, metallic taste in the mouth, and neuropsychic disorders.
Skin contact: Chronic: prolonged or repeated exposure may result in dermal sensitization and systemic effects as detailed in chronic inhalation exposure. Skin contact: Get medical attention immediately.
Eye contact: Acute: Direct contact with liquid may cause irritation and redness. Animal studies indicate diffusion and absorption of mercury into the tissues of the eye may occur. No clinical signs of conjunctivitis or inflammation occurred.
Eye contact: Chronic: Mercury exposure from inhalation ingestion, or skin contact may be indicated by mercurialentis, discoloration of the crystalline lens, on slit lamp examination of the eye.
Ingestion: May cause burning of the mouth and throat, thirst, nausea and vomiting. Metallic mercury is not usually absorbed sufficiently from the gastrointestinal tract to induce an acute toxic response. Rarely, a large single dose may result in sign and symptoms of chronic inhalation is sufficient amount of mercury are retained in the body.
Chronic: Repeated ingestion of small amount of mercury may result in the absorption of sufficient amounts to produce toxic effects as detailed in chronic inhalation exposure.

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Lojic
Manufacturer SDI Australia
HANDLING AND STORAGE
Handling: Do not breathe powder and avoid exposed mercury surfaces. Wear appropriate gloves, goggles, and protective clothing to prevent skin contact. Wash thoroughly after handling. Keep away from food, drink and around animal feed stuffs.
Storage: Keep container tightly closed and dry. Storage in large quantities (as in warehouse) should be in a ventilated, cool area. Do not store in metal containers. Keep away from sources of ignition and elevated temperatures.
TOXICOLOGICAL INFORMATION
Chronic Health Effects: Inhalation of mercury vapours, dusts or
organic vapours, or skin absorption or mercury over long periods can cause mercurialism. Symptoms include tremors, inflammation of mouth and gums, excessive salivation, stomatitis, blue lines on gums, pain and numbness in extremities, weight loss, mental depression, and nervousness. Exposure may aggravate kidney disorders, chronic respiratory disease and nervous system disorders. See Sections 3 and 4 for effects of acute exposure.
Contains mercury.
Toxic by inhalation.
Keep container tightly closed.
If you feel unwell, seek medical advice immediately.

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F400
Manufacturer SDI Australia
HANDLING AND STORAGE
Handling: Do not breathe powder and avoid exposed mercury surfaces. Wear appropriate gloves, goggles, and protective clothing to prevent skin contact. Wash thoroughly after handling. Keep away from food, drink and around animal feed stuffs.
Storage: Keep container tightly closed and dry. Storage in large quantities (as in warehouse) should be in a ventilated, cool area. Do not store in metal containers. Keep away from sources of ignition and elevated temperatures.
Chronic Health Effects: Inhalation of mercury vapours, dusts or
organic vapours, or skin absorption or mercury over long periods can cause mercurialism. Symptoms include tremors, inflammation of mouth and gums, excessive salivation, stomatitis, blue lines on gums, pain and numbness in extremities, weight loss, mental depression, and nervousness. Exposure may aggravate kidney disorders, chronic respiratory disease and nervous system disorders. See Sections 3 and 4 for effects of acute exposure.

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Permite
Chronic Health Effects: Inhalation of mercury vapours, dusts or
organic vapours, or skin absorption or mercury over long periods can cause mercurialism. Symptoms include tremors, inflammation of mouth and gums, excessive salivation, stomatitis, blue lines on gums, pain and numbness in extremities, weight loss, mental depression, and nervousness. Exposure may aggravate kidney disorders, chronic respiratory disease and nervous system disorders. See Sections 3 and 4 for effects of acute exposure.

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Ivoclar Vivadent
Vivacap
Amalcap Plus Non-Gamma-2
12/01/1997
(Spelling is original and from the MSDS exact)
Toxicological information
“Acute toxicity Alloy powder and mercury are predosed in closed capsules, therefore the danger of exposition to mercury vapours are low.
Do not open or damage the capsule before mixing.
Toxic by inhalation.
Subacute chronic toxicity Inhalation is hazardous to the central nervous system. In very rare cases amalgam allergies may occur.
Further information Avoid exposure of mercury to pregnant person.
Ecological information German Wassergefaehrdungs Klasse (WGK): The product must not enter effluent, ground water, surface water or the soil.
Disposal considerations Material in the elemental state and alos left-overs from restorations should be safed in a plastic contatiner for reuse or recycling. For disposal contac an expert for chemical waste, at your local-, federal- or state waste department. Any disposal practice must be in compliance with local and
national regaulations.”

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Tytin FC
Tytin Precapsulated
Sybraloy precapsulated
Contour
Manufacturer Kerr Corporation Germany
All carry the following warnings
HEALTH HAZARD DATA
Route of Entry:
Skin: Irritant/Sensitizer/Neurotoxin/Nephrotoxin
Acute Exposure: May cause redness and irritation Chronic Exposure: Possible sensitization, dermatitis and swelling. Mercury my be absorbed through intact skin causing urinary problems
Eyes: Irritant
Acute Exposure: Contact my cause irritation. Mercury is corrosive and my cause corneal injury or bums. Chronic Exposure: Mercury may be deposited in the lens of the eye, causing visual disturbances.
Inhalation: Irritant/Sensitizer/Nerotoxin
Acute Exposure: Inhalation of mercury vapor can cause cough, fever, nausea, and vomiting Chronic Exposure: Inhalation of high concentrations mercury vapor over a long period causes mercurialism. Findings are extremely variable & include tremors, salivation, stomatitis, loosening of teeth, blue lines on gums, pain & numbness in extremities.
Ingestion. Neurotoxic/Nephrotoxic
Acute Exposure: May cause nausea, vomiting, kidney damage and nerve effects. Chronic Exposure: Symptoms include Central Nervous System (CNS ) disorders.
TYTIN
“WARNING
This dental amalgam product contains mercury. The placement of a dental amalgam in a patient will increase the levels of mercury in the body of the patient. The use of a rubber dam may decrease the amount of mercury absorbed by a patient during the removal or placement of an amalgam.
The health authorities of the various countries including Canada, Germany, France, the United Kingdom, Norway and Austria have recommended against the placement or removal of amalgam in certain individuals such as pregnant and nursing women and persons with impaired kidney function.”
California Prop 65 warning:
This product contains mercury a product known to the state of California to cause birth defects and other reproductive harm.

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PHASEALLOY
Wykle Research inc
22nd Feb 1996
California Prop 65 warning:
This product contains mercury a product known to the state of California to cause birth defects and other reproductive harm.
Chronic Health Effects
Inhalation of mercury vapors, absorptioin through intact skin, dusts, over a long period cause mercurialism. Findings extremely variable and include tremors, salivation, stomatitis, loosening of the teeth, blue lines on the gums, pain and numbness in extremities, nephritis, diarrhea, anxiety, headache, weight loss, anorexia, mental depression, insomnia, irritability, and instability, hallucinations and evidence of mental deterioration,. (Mercury) may cause argyria (greyish-blue pigmentation of the skin.

 

Health Canada’s Recommendations
Concerning the Use of Dental Amalgam
(Health Canada, 1996a)

1. Non-mercury filling materials should be considered for restoring the primary teeth of children where the mechanical properties of the material are suitable.

2. Whenever possible, amalgam fillings should not be placed in or removed from the teeth of pregnant women.

3. Amalgam should not be placed in patients with impaired kidney function.

4. In placing and removing amalgam fillings, dentists should use techniques and equipment to minimize the exposure of the patient and ;the dentist to mercury vapour, and to prevent amalgam waste from being flushed into municipal sewage systems.

5. Dentists should advise individuals who may have allergic hypersensitivity to mercury to avoid the use of amalgam. In patients who have developed hypersensitivity to amalgam, existing amalgam restorations should be replaced with another material where this is recommended by a physician.

6. New amalgam fillings should not be placed in contact with existing metal devices in the mouth, such as braces.

7. Dentists should provide their patients with sufficient information to make an informed choice regarding the material used to fill their teeth, including information on the risks and benefits of the material and suitable alternatives.

8. Dentists should acknowledge the patient’s right to decline treatment with any dental material.

The only place that dental amalgam  can be stored safely and legally
is in the mouth of a living person!  Everywhere else it is TOXIC WASTE!

Swedish Government Report
On Dental Amalgam and Mercury

Title: Dental Materials and Health
Author: Maths Berlin

Download the full report at http://www.social.regeringen.se/inenglish/publications/index.htm

Introduction
In April 2002, the Swedish Government appointed a Special Investigator to propose measures aimed at boosting knowledge of health problems relating to amalgam and other dental materials. The Investigator's duties also included reviewing current regulations concerning individuals' scope for having their dental fillings removed at a subsidised price, and proposing measures to improve care and consideration for patients who associate their symptoms with dental materials.
The Investigator submitted a final report (in Swedish) to the Minister for Health and Social Affairs, Lars Engqvist, on 3 June 2003. Enclosed with the report were annexes that made up part of the documentation compiled by the Commission. One of the annexes is an account of the past five years' scientific publications concerning amalgam, mercury and health, including a risk analysis in terms of environmental medicine. The author of this report is Maths Berlin, a Professor Emeritus of Environmental Medicine.
An English translation of this internationally acclaimed annex is published here, with a summary of the final report.

Summary and conclusions
The past five years' research has yielded further evidence that amalgam can give rise to side-effects in a sensitive portion of the population. Thus:

• 
  Research in molecular biology has elucidated mechanisms that may underlie the toxic effects of mercury.

• Studies of the effects of mercury on the immune system in rodents have enhanced knowledge of the mechanisms whereby mercury affects the immune system. Clinical studies of occupationally exposed employees have objectively confirmed subclinical influence of mercury on the immune system at low levels of mercury exposure.

• The thyroid has been identified as the target organ for the toxic effect of mercury in occupational exposure to mercury vapour in low doses.

• Experimental studies of primates and rodents have revealed that mercury is accumulated and persists for years in the retina as a result of exposure to mercury vapour. The consequences of this accumulation are, however, unclear.

• Clinical studies of the effects of mercury on occupationally exposed workers, using modern diagnostic methods, have elucidated the connection between dose and effect. They have also identified and quantified neuropsychological symptoms at low exposure levels.

• The lowest exposure, in terms of urinary mercury secretion, that has been found to give rise to a demonstrable toxic effect has fallen from 30-50 mg/l till 10-25 mg/l Accordingly, the safety margin that it was thought existed with respect to mercury exposure from amalgam has been erased.

• Studies Of Workers previously exposed to mercury have shown that prolonged exposure to mercury vapour, with mercury concentrations in urine of some 100 mg/l, may result in symptoms emanating from the nervous system that persist decades after exposure has ceased. This suggests that exposure causes lasting damage to the central nervous system, which complicates the interpretation of results of low-dose studies of occupationally exposed populations.

• Clinical reports of acute or subacute cases of mercury intoxication where modern diagnostic methods have been applied have revealed a remarkably high degree of polymorphism in human reactions to toxic mercury exposure.

• Both animal experiments and clinical observations have demonstrated gender differences in the toxicokinetics of mercury.

• Additional facts have come to light that may indicate that mercury vapour can affect human foetal development.

• Clinical provocation studies, with exposure to small quantities of mercury through skin exposure or inhalation, have confirmed that individuals with deviant high sensitivity exist.

With reference to the fact that mercury is a multipotent toxin with effects on several levels of the biochemical dynamics of the cell, amalgam must be considered to be an unsuitable material for dental restoration. This is especially true since fully adequate and less toxic alternatives are available.

With reference to the risk of inhibiting influence on the growing brain, it is not compatible with science and well-tried experience to use amalgam fillings in children and fertile women. Every doctor and dentist should. where patients are suffering from unclear pathological states and autoimmune diseases, consider whether side-effects from mercury released from amalgam may be one contributory cause of the symptoms.

 

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Sweden Imposes TOTAL BAN
on ALL Mercury

Press release 15 January 2009
Ministry of the Environment
      (Full Article Click Here)

Government bans all use of mercury in Sweden

The Government today decided to introduce a blanket ban on mercury. The ban means that the use of dental amalgam in fillings will cease and that it will no longer be permitted to place products containing mercury on the Swedish market.

"Sweden is now leading the way in removing and protecting the environment from mercury, which is non-degradable. The ban is a strong signal to other countries and a Swedish contribution to EU and UN aims to reduce mercury use and emissions," says Minister for the Environment Andreas Carlgren.

 

 

Are you a Toxic Waste Dump ?

by Robert Gammal BDS

Introduction

Most dental association claim that different forms of mercury have different degrees of toxicity and imply that mercury from dental amalgam is harmless. The bulk of the scientific research on the other hand shows a different reality. All forms of mercury are toxic. Elemental mercury, the type derived from dental amalgam, is totally bio-available - in other words it is absorbed by biological systems. Mercury from amalgam fillings has been shown to be neurotoxic, embryotoxic, mutagenic , teratogenic , immunotoxic and clastogenic . It is capable of causing immune dysfunction and auto-immune diseases.

When asked if there was any safe level of mercury, Dr Lars Friberg who was the world's leading authority on mercury poisoning and was Chief Adviser to the World Health Organisation on mercury safety answered:

"No, there is no safe level of mercury, and no one has actually shown that there is a safe level. I would say mercury is a very toxic substance."

                                    

Increasing public awareness of the dangers associated with the use of dental amalgam is leading more and more people to seek the services of dentists who are practicing a safer form of bio-compatible dentistry. Most people by now are aware that the silver fillings in their mouths should more accurately be called mercury fillings as they are made of about 50% mercury and only about 35% silver.   Amalgam is a mixture of an alloy of Silver, Tin, Zinc and Copper with an equal amount of Mercury. These fillings have been in use for about 180 years originating in England and spreading to Europe and America. At the time they gained immediate acceptance by the dentists as they provided a cheap and reasonably effective alternative to any other filling techniques of the time.

"In America during the 1800s, concern about the possible 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, use of mercury fillings increased because it offered dentists an economic advantage. The fillings were also user friendly and durable in the mouth. By 1856, the American Society of Dental Surgeons was forced to disband because of dwindling membership over the mercury filling issue. In its place rose the American Dental Association, founded by those who advocated silver amalgam - mercury use in dentistry. ' Again in the 1920s, a controversy erupted after the publication of articles and letters by a German chemistry professor, Alfred Stock, who attacked mercury filling usage for possible toxic effects. 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. . In the Association's view, a dentist is 'ethical' to place the mercury material and recommend its safety. However, if the dentist suggests that mercury fillings are potentially harmful or that exposure to unnecessary mercury can result, then the dentist is acting 'unethically'."

The dental authorities tell us that it is a stable material. They suggest that the mercury is locked into the fillings. As recently as 1997 the Victorian branch of the Australian Dental Association wrote to a patient and said, regarding the release of mercury from amalgam:

"amalgam fillings are not and never have been a potential source. There is no recognized scientific body, world wide, that would contradict that statement. Free mercury does not exist in amalgam, which is an alloy formed in the mixing process, and cannot break down into elemental mercury or dangerous mercury compounds as it is molecularly linked to the other component metals."

This statement is blatantly false. By definition an amalgam is a mixture of one or more metals with mercury. It is not an alloy - it is a mixture.  As such the whole substance has free mercury as part of its components. To suggest that all scientific bodies would agree that mercury is locked in to these fillings is clearly in disregard of the World Health Organisation for starters. As you will see there are many scientific bodies who would strongly disagree with the Australian Dental Association statement. In fact the statements made by the dental authorities in this country have no support from any scientific organisation in Australia. There are reports by committees of various trade organisations who claim to have reviewed the scientific literature and decided that amalgam is safe. These organisations include the Swedish Medical Health Council, and the Federation Dentaire International. It is important to remember that these are trade organisations - they are NOT scientific organisations. Their reports are not peer reviewed scientific papers.

The Australian Dental Association have also claimed support for the safety of amalgam from some rather prestigious organisations in Australia. These include the Australian College of Physicians and the National Health and Medical Research Council. The Australian College of Physicians have not to date supplied any reports or studies on amalgam, but instead take the advice of the National Health and Medical Research Council. In August 1997 the National Health and Medical Research Council withdrew totally their only statement on amalgam safety. The new position statement from the NHMRC in 2002, reference the ADA as one of their sources of information.  The ADA reference the NHMRC as their source of information.  INTERSTING!

Note that the Australian Dental Association is NOT a scientific organization - it is a trade organization.  Recently a court case in the USA saw a patient trying to sue the American Dental Association, a manufacturer and a dentist for poisoning him with mercury from amalgam fillings. The American Dental Association were let off by issuing the following statement:

"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." (Note that in this paragraph the letters ADA refers to the American Dental Association)

None the less the Australian Dental Association has its own certification for dental products and you will find that dental amalgam is listed as one of the 'certified products'. This certification is only by a trade organization for its members. It is not a certification of safety nor does it apply to any Australian standards on safety.

The American Dental Association make the following point to support their position:

"The strongest and most convincing support we have for the safety of dental amalgam is the fact that each year more than 1,100 million amalgam fillings are placed in the United States"

This anecdotal, unscientific statement is to support a position for which they cannot present one scientific paper to demonstrate that amalgam is toxicologically safe. As Carl Sagan points out "the absence of evidence is not evidence of absence." Figures released from the Gold Institute in Washington show that America and Japan use proximately 100 metric tons of silver per year for the fabrication of dental material. (ie amalgam) In contrast the world wide usage of silver for dental x-rays is only 2.1 metric tonnes. Are there other vested interests involved in maintaining the status quo?

The symbiosis between the dental and industrial communities and their scientific journals by Bengtsson, Ulf is a great site to overview some of the vested interests within the dental community. http://vest.gu.se/~bosse/ybftBEN95a.html

In Australia dental amalgam is listed by the TGA as a "dental device". There is no requirement in this listing that ensures toxicological safety. As with many areas of dentistry we are supposed to consider teeth as independent units, separate from the rest of the body. In America also it does not have FDA approval.

 

In reality dental amalgam is an implant into living tissue!

Mechanical Arguments Vs Systemic Disease

Another common argument given for the continued use of amalgam is that it is mechanically better than the alternatives, it is cheaper and easier to use. Since when does an argument based on mechanics take precedence over an argument about systemic poisoning!

Amalgam fillings do not stick to the tooth. To retain the filling in the tooth, the cavity must be prepared with 'undercuts'. These undercuts not only lock in the amalgam filling but also cut off the nutrient supply to the dentine above the cut. Therefore the tooth structure above and to the side of the filling becomes brittle.

All metals in the mouth will undergo some corrosion. Amalgam also corrodes at a reasonably fast rate. When amalgam corrodes it also expands and it does so in all directions. The force created by this expansion will often create minute fractures in the tooth that is already more brittle due to the shape of the cavity preparation. At this stage the patient returns to the dentist to report that all they were eating was some soft bread and the tooth broke!

To repair such a problem, the dentist will usually drill a small hole into the dentine and insert a self-tapping screw - called a pin. The pin is reinforcement for the amalgam filling which will go back in. Even if this pin is made of titanium it will undergo corrosion when in contact with amalgam. Again the corrosion will cause an enlargement of the pin (sometimes up to five times its diameter) which will then crack the tooth further - but this time lower down the root surface. This tooth is now a candidate for a crown because the filling, which has to go back into the tooth, is now so large that it cannot sustain the forces of chewing for very long.

Composite fillings do stick to the tooth. They are bonded chemically and mechanically to the tooth. They do not require a cavity, which is undercut and therefore do not require such a large or damaging cavity. In fact a composite filling can be used to rebuild a broken cusp without the use of pins or other mechanical support. I personally have not used a pin for years and have had great success with such restorations.

Studies comparing the fracture resistance of the tooth when filled with amalgam or composite indicate that amalgam will weaken the tooth structure whereas bonded composite fillings will strengthen the tooth. There is absolutely NO reason to continue the use of mercury amalgam!

The dental literature contains many references which demonstrate that composite resins are better than amalgam from a mechanical viewpoint. There is no justification that amalgam is a better filling material - the dental authorities that make this claim have obviously not read their own research. , , , , , , , , ,

Quintessence International is one of the most respected international dental journals. In 1995 the editor-in-chief of Quintessence (Volume 26, Number 3,1995), Dr Richard Simonsen wrote:

"Amalgam should never be used as a restorative material in paediatric dentistry."
Why? Because better alternatives are available.

"Amalgam should never be used as a first time restorative material."
Why? Because better alternatives are available.

"Move Over Amalgam - At Last"

 

This sentiment is echoed by Dr. Harold Loe, the Director of the National Institute of Dental Research ( NIDR), who stated in the September, 1993 edition of "Dental Products Report":

"That first filling is a critical step in the life of a tooth. Using amalgam for the first filling requires removing a lot of the tooth substance, not only diseased tooth substance but healthy tooth substance as well. So, in making the undercut you sacrifice a lot, and this results in a weakened tooth. The next thing you know the tooth breaks off, and you need a crown. Then you need to repair the crown...and so it continues to the stage where there is no more to repair and you pull the tooth. With the first filling you should do something that can either restore the tooth or retain more healthy tooth substance. Use new materials-composites or materials you can bond to the surface without undercuts. You can do this with little removal of the tooth substance so that the core of the tooth is still there."

 

What Dentists are Taught about Amalgam

· As dentists we are given very specific training in how to handle dental amalgam safely:

Do no touch amalgam with bare hands as the mercury can enter the body through the skin.
Use good through ventilation as the mercury vapour produced from amalgam is easily absorbed into the body by inhalation.
Amalgam cut out of teeth and that left over from filling the teeth must be stored under photographic fixer in a sealed glass container. The high sulphur content of the solution helps to prevent release of mercury vapour into the atmosphere.
It is illegal to dispose of waste amalgam into the sewerage or drain water as it will pollute the environment.
Specialists in this field must dispose of waste amalgam as Toxic Waste.
Mercury spills must be cleaned immediately and must not be vacuumed as this will vaporize the mercury.

Therefore the only safe and legal place to keep this toxic waste, is in the mouth of a living person!

It is interesting to note that every crematorium chimney spews out about 11kg of mercury per year into the environment.

If the mercury vapour levels in a factory were as high as levels found in some people's mouths, the factory would be closed down. If you have amalgams in your mouth you can consider yourself to be a toxic waste dump!

In the 1994 Panorama editorial DR BOYD HALEY (University of Kentucky) is quoted as saying;

"If you have something that's been put in your mouth that you can't dispose of in a waste basket without breaking environmental protection laws, there's no point in keeping it around, there's no point in taking that type of risk - there's no point in exposing people to any level of mercury toxicity if you don't have to."

In the same program Dr Haley continues :

"We can't go inside a living human being and look at their brain, so we have to work outside, and do scientific experiments such as we've done. And to the best that we can determine with these experiments, mercury is a time-bomb in the brain, waiting to have an effect. If it's not bothering someone when they're young, especially when they age it can turn into something quite disastrous."

How much mercury comes out?

Mercury escape from amalgam all of the time. Increase in temperature, friction and electrical currents will cause an increase in the release of mercury vapour from amalgam throughout the life of the filling. Every time you have a hot drink, chew or grind your teeth the levels of mercury coming from the amalgams will be elevated. This elevated level remains for about 90 minutes.33 Thus most of us on a regular cycle of eating and tooth grinding will be living with a permanently elevated level of mercury vapour in our mouths.

In 1991 the World Health Organisation released their report on environmental mercury - Criteria 118. This was the first time that dental amalgam had been considered by WHO as a source of dietary mercury. Their conclusion was that dental amalgam constituted the greatest source of mercury to the general population and that there was no level of mercury vapour that was found to be harmless.

The WHO estimated that dietary contibution of mercury on a daily basis was;

Air & Water               0 mcg/day
Other Foods              0.3 mcg/day
Fish & Seafood           2.3 mcg/day
Dental Amalgam        3 - 17mcg/day

In 2003 the WHO revised their estimates for dental amalgam to 1 - 27 mcg/day

The Agency for Toxic Substances and Disease Registry in the USA, stated in 1990

"Long-term exposure to either organic or inorganic mercury can permanently damage the brain, kidneys, and developing fetuses."

"Short-term exposure to high levels of inorganic and organic mercury will have similar health effects; but full recovery is more likely after short-term exposures, once the body clears itself of the contamination."

In other words the type of poisoning you will get from your amalgam fillings is more dangerous than a single short acute exposure.

The dental authorities claim only minute amounts of mercury are released from dental amalgam. This is true. It is important however to put this small amount into a context of toxicological effects. 1 microgram is 0.000001 of a gram. The number of zeros after a decimal point has absolutely no meaning toxicologically. In comparison the oral reference dose used by Health Canada reveals the lowest TDI (Tolerable Daily Intake) of Dioxin is 10 picogramms - 0.000,000,000,0001. Perhaps the dental authorities would look at such a small amount as insignificant also?   

See Health Canada's comments in this regard.

As professor Vimy points out; "It is estimated that the average individual, with eight biting surface mercury fillings, is exposed to a daily dose uptake of about 10ug mercury from their fillings. Select individuals may have daily doses 10 times higher (Lou) because of factors which exacerbate the mercury vaporisation. These factors include frequency of eating, chronic gum chewing, chronic tooth grinding behavior (usually during sleep), the individual's chewing pattern, consumption of hot foods and drinks, and mouth and food acidity Corroborating human autopsy evidence , showed that brain and kidney tissues contained significantly higher amounts of mercury in individuals who had mercury fillings".

In fact autopsy studies have shown that the level of mercury in the brain is directly proportional to the number of amalgam fillings in the mouth.16,29,31

Canada Health

In 1995 the Richardson Report was released by the Canadian government. It states quite clearly that for people with amalgam fillings they will be getting more than their tolerable daily intake of mercury if they have more than the following number of fillings: 1 filling in children, 3 in teenagers and 4 in adults. , This was enough for Canada health to issue the following directives regarding the use of dental amalgam:

1. Non-mercury filling materials should be considered for restoring the primary teeth of children where the mechanical properties of the material are suitable.

2. Whenever possible, amalgam fillings should not be placed in or removed from the teeth of pregnant women.

3. Amalgam should not be placed in patients with impaired kidney function.

4. In placing and removing amalgam fillings, dentists should use techniques and equipment to minimize the exposure of the patient and the dentist to mercury vapour, and to prevent amalgam waste from being flushed into municipal sewage systems.

5. Dentists should advise individuals who may have allergic hypersensitivity to mercury to avoid the use of amalgam. In patients who have developed hypersensitivity to amalgam, existing amalgam restorations should be replaced with another material where this is recommended by a physician.

6. New amalgam fillings should not be placed in contact with existing metal devices in the mouth, such as braces.

7. Dentists should provide their patients with sufficient information to make an informed choice regarding the material used to fill their teeth, including information on the risks and benefits of the material and suitable alternatives.

8. Dentists should acknowledge the patient's right to decline treatment with any dental material.

This does not leave many people who can safely handle dental mercury amalgam!

(see also the implications of the contraindications posted by Caulk Company)

Mercury is a cumulative poison. It stays in your body and the levels are topped up continuously. This type of poisoning is called Micromercurialism. The earliest symptoms are sub-clinical neurological - fatigue, headaches, forgetfulness, reduced short term memory, poor concentration, shyness and timidity, confusion, rapid mood swings, unprovoked anger, depression, suicidal tendencies. , ,

In 1979 The New York Sate Dental Journal ran an article about mercury toxicity. Here is an abstract:

"The symptoms of mercury poisoning from chronic inhalation develop gradually and thus, may be difficult to notice. With the exception of tremor, the symptoms may be ignored by the victim or attributed to other causes. This lack of awareness is particularly likely in the case of erethism, a condition characterized by; irritability, outbursts of temper, excitability, · shyness, resentment of criticism, headache, fatigue, and indecision. Erethism is the most difficult manifestation of mercury poisoning to evaluate, especially if tremors are absent, and its symptoms may be attributed to anxiety or neuroasthenia.

Other general symptoms associated with mercury poisoning include weakness, unusual fatigue, loss of weight, loss of appetite, insomnia and gastrointestinal disturbances.

A condition known as Micromercurialism, is said to account for psychological changes observed in persons frequently exposed to low concentrations of mercury in the air, concentrations found in the majority of dental offices surveyed. The syndrome is characterized by decreased productivity, loss of memory, loss of self confidence, depression, fatigue and irritability .."

A variety of scientific studies indicates that 20mcg to 150mcg of mercury vapour is released into the mouth of someone with amalgam fillings. 100mcg of mercury vapour is 500 times greater than the level quoted by the USEPA (0.3m /m3 ) as safe. It is 3,300 times greater than the level regarded as an acute exposure. i.e. 0.02mcg/m3 is known to effect your health when the exposure is only transient. Note that the ATSDR's Minimal Risk Level for chronic exposure (that derived from amalgam) is even less than this at 0.014mg/m3

It is estimated that an amalgam filling will release up to half of its mercury content over a ten year period (50% corrosion rate) For a one gram filling this is equivalent to 136mcg of mercury per day. Paints which contained mercury had to be taken off the market after releasing only 2-3mcg/m3

The Agency for Toxic Substances and Disease Registry (ATSDR) of the U.S. Public Health Service have listed on their Internet site the top 20 hazardous substances. Mercury is number 3 after arsenic and lead. It ranks above DDT, Dieldrin and Cadmium. This material is implanted into millions of people throughout Australia.

Dental Amalgam Is Neither Safe or Effective

Where does the Mercury go?

Retention of mercury in the body is estimated to be 1mcg/filling/day.44, 45 

Up to 80% of inhaled mercury vapour is absorbed through the lungs.46

A percentage of mercury vapour adheres to the lining of the nose and mouth and is transported directly into the brain.39 

Mercury from amalgam easily crosses the blood brain barrier and damages the whole of the central nervous system. 39  

Some mercury is also transported along the nerve fibres (retrograde axonal transport) back to the brain.
Mercury has been found all the way down the spinal chord. 39  
This may result in symptoms similar to Motor Neuron Disease and sensations of pain, itching and tingling throughout the body.

The levels of mercury in the brain are directly proportional to the number of fillings in the mouth.41,43,45

Minute amounts of mercury in the brain will cause the same type of damage as is found in the brains of patients with Alzheimer's Disease.   Low levels of mercury in the brain will severely disturb cellular function and reduce the growth of nerve fibres. 39    Professor Boyd Haley, from Kentucky University Centre for Ageing, said on a 1994 Panorama interview; " there is no doubt in my mind that low levels of mercury, present in the brain, could cause the normal cell death and that this could lead to a dementia which would be similar to Alzheimer's disease."

Professor Stortebecker has shown that the "brain accumulates about 10 times more mercury after exposure to mercury vapour, compared to equal amounts of mercuric ions being injected or ingested".

The ultimate in ridiculous treatments is performed regularly in dentistry - they implant amalgam fillings directly in to the bone. This treatment has the grand name of a Retrograde Root filling (a filling placed at the end of the root). In reality it is an implant of mercury directly into the brain. - would any other branch of medicine condone such an absurd practice? In Australia the dental authorities teach and condone this practice! There is even an item number that covers health fund rebates for this treatment. One wonders if the health funds are aware that they are paying for a treatment which may cost them far more from the secondary diseases created by it.

More recently, amalgam has not been the material of choice for retrograde root fillings.  Instead it is a product called Pro Root MTA (Mineral Trioxide Aggregate).  THe Material Safety Data Sheet for this product states; 

"Impurities may include Crystaline Silica (Carcinogen), calcium oxide, magnesium oxide, potassium and sodium sulphate compounds. ... This product contains chemicals (trace metals) known to the state of California to cause cancer, birth defects or other reproductive harm.

The major components of Pro Root (calcium silicate compounds, and calcium compounds containing aluminium oxide and gypsum) are considered Hazardous.

Exposure to wet substance may cause irreversible skin or eye destruction in the form of chemical third degree burns. May cause blindness.  Prolonged exposure can cause severe skin damage in the form of caustic chemical burns. Exposure to moisture will produce caustic calcium Hydroxide.

Pro Root MTA … chemically reacts with water, and some of the intermediate products of this reaction pose a far more severe hazard than does the material itself."

Mercury from amalgam may be found in all cells of the body and is stored principally in the kidney, liver and brain. The Australian Dental Association claim in many of their writings that the most accurate method of determining body burdens of mercury is to measure the mercury concentration in the urine or blood. They go on to claim that "the normal range of mercury in these fluids is well established."

Blood, urine and feces sampling are poor ways of estimating body burdens of mercury, as most of the mercury is locked onto the cells of the body (Retention Toxicity). There is very little circulating in the blood or being excreted in the urine which is part of the reason that it is a cumulative poison. Mercury binds to the sulphydril groups of proteins and is locked onto the cells. It is bound to body fats including the sheath that surrounds the nerve fibres. The only reliable test is a DMPS challenge test. , DMPS is a chelating agent which takes heavy metals of the cells and binds it in a way that can be excreted. This excretion is measurable.

Is mercury from amalgam harmful?

The Australian Dental Association say that mercury from amalgam does not cause a specific disease - This is the only point I agree with - mercury from amalgam causes long term, low-level mercury poisoning which, is characterised by a very wide range of symptoms - micromercurialism.  If mercury were as safe as what the ADA claim than it would not rate as the third most toxic substance known after arsenic and lead.

Immune System

The Australian Dental Association claim that "that there is no scientific evidence that these tiny amounts of mercury released from dental fillings are a danger to health, apart from those rare cases where some individuals are unusually sensitive to this material."

The American Dental Association Journal claims that only 3% of the population show a true allergy to amalgam. If this is the case, than in Australia there could be 270,000 people who are sick from their amalgam fillings, assuming that only half of the population have amalgam in their mouths. Most of these people will possibly be mistreated for their allergic symptoms as most medical practitioners are unaware of the dangers of low level mercury poisoning.

In fact the latest research indicates that true allergy to mercury is really in the order of 13%. It is interesting to note the comments of Bio-Probe Newsletter to this research:

"The finding of 13.0% allergic to mercury is very important, especially combined with the finding that the subjects with amalgam fillings had significantly higher levels of mercury allergy. The authors even stated (page 205): "If the use of amalgams was to be limited, the prevalence of Hg sensitization would be expected to lessen."

This is yet another controlled study demonstrating a high incidence of allergy to mercury. In sixteen years of investigation, we have yet to find one single controlled study supporting the position of organized dentistry that allergy to mercury is "very rare", "one in a million", "less than 1%", or any other vague, unsupportable level! Continued public promotion of these unsupportable statements by health professionals could constitute negligent misrepresentation."

True allergy to amalgam is only one type of immune reaction. There are literally hundreds of peer reviewed scientific papers discussing the damaging effects mercury has on the immune system. Mercury from amalgam may result in an increase in allergies, skin rashes and itching. Mercury will always have a detrimental effect on the immune system. This creates an environment in the body for other diseases to develop. When mercury binds to proteins, these proteins will appear to the cells of the immune system as foreign substances. They will then be attacked by the immune system and may lead to a cascade of events ending in overt auto immune diseases.69,70,68   (See the MELISA website at www.melisa.org)

An example of a local immune reaction is the redness and inflammation that some people have to stainless steel ear rings. This is obviously not a major toxic reaction. It is a reaction to a few atoms of the metal (usually nickel). Any of the metals in amalgam or other dental reconstructive appliances can cause exactly the same reaction. This includes gold.69

Mercury will bind strongly to Selenium, a trace element needed for a wide variety of enzyme functions. Latest research indicates a direct relationship between reduced blood selenium levels and an increase in the rate of cancer. Although this has been published in the alternate medical journals for years it is only now becoming known in the traditional medical journals.  Selenium is critically important for normal heart function.

Mercury and Reproductive System

"Women chronically exposed to mercury vapour experienced increased frequencies of menstrual disturbances and spontaneous abortions….. A high mortality rate was observed among infants born to women who displayed symptoms of mercury poisoning." (This was written back in 1984! By the USEPA) 80

Mercury from amalgam fillings will cross the placenta and concentrate in the foetus.  Mercury from amalgam will also cross the breast milk and concentrate in the body of the feeding infant. Breast milk increases the bioavailability of mercury to the infant. Prenatal exposure to mercury may cause developmental defects and may effect neurological development.93,

Not only does the mercury enter the developing child's body but the level of Mercury in liver, kidney and brain tissue of the foetus, new-born and young child is directly Proportional to the Number of Amalgam Fillings in the Mother's Mouth! 94 In the conclusion of this study, Prof. Drasch of Munich University states

"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."

In another paper by the same author, the following conclusion is presented: "These results show that amalgam fillings release silver as well . Silver is a reliable marker for the fact that the elevated concentrations of inorganic mercury found in tissues of people with amalgam filings, derive mainly from these fillings and not from other theoretically possible sources."

Dr Aposhian has this to say about research that is now available:

"I'm worried that the amount of mercury coming from dental amalgams that we're putting in the mouths of young children today might be harmful to them as far as effecting their learning abilities, their performance abilities. I'd hate to think that 20 years from now we will have hurt some of these children when we could have prevented it by proper scientific research, and that is what we must do now."

There is a statistically significant relationship between mercury levels in the mother and infertility, miscarriage and still births.

If you are pregnant try not to have amalgam fillings removed. Never allow amalgam fillings to be placed in your mouth. Do not go into a dental surgery where amalgam is used as the mercury vapour levels in the air may be harmful to the foetus. This is not a melodramatic warning - it is a real possibility.

Blood

Mercury can cause a weakening in the wall of the small blood vessels - Micro-angiopathies - this results in a reduction of blood supply to the tissues resulting in reduced function and cell death.38 This may present as cold hands and feet or heart attacks.

Mercury is also known to bind to hemoglobin in red blood cells. It occupies one of the sites which would otherwise carry oxygen. If we don't get enough oxygen we become fatigued!

Kidney

Mercury from amalgam fillings has been shown to cause a 50% reduction in kidney filtration after just two months in the mouth (animal studies) . This does not mean that you will get immediate kidney failure but does indicate a great reduction in the ability of the kidneys to eliminate toxic waste from your body.

Antibiotic Resistance

Internationally there is great concern within the medical profession of the dramatic increase in antibiotic resistance of bacteria. We are seeing an increase in diseases such as TB and many other infectious diseases, which are resistant to antibiotic treatment. There are many reasons for the antibiotic resistance developing but little attention has been paid to the role of mercury.

Research from 1993 and later has shown that mercury from amalgam fillings will cause an increase in the number of antibiotic resistant bacteria in the gut and mouth. , , The number of antibiotic resistant bacteria fall rapidly after the amalgams are removed.

This is a major public health issue! Various medical authorities internationally are beginning to look into the seriousness of this research.

Amalgam And Other Metals In The Mouth

Placing gold into a mouth with amalgam fillings will create an increase in electrical currents in the fillings which results in an increase in the release of mercury from all of the fillings.

Placing a gold crown over an amalgam filling may cause a four fold increase in the amount of mercury being driven through the tooth. , Amalgam is still the most commonly used material to build a core for a crown. Gold crowns on top of amalgam creates a permanent galvanic cell.

The text books warn against creating galvanic reactions in the mouth, yet this technique is taught as the best way of restoring a badly broken down tooth. Again there is an item number for the health funds to pay on!

In 1997 Caulk Co, one manufacturer of amalgam, in their MSDS warned against placing amalgam in a mouth with other metals and specifically warns against using amalgam as a core under cast metal crowns.

Effects On Dental Personnel

To justify their position the dental authorities claim that if dental amalgam is so dangerous for the public then why is it that dentists, who are exposed to far greater concentrations of mercury, are not sick.  Fair arguement if it were true.

The published research shows a strikingly different situation concerning the health of dentists and dental personnel.

· Twice the rate (as in the rest of the population) of miscarriage, infertility and still births have been noted in female dental personnel exposed to mercury.45,77,81,82 The probability of conception each menstrual cycle for women who prepared 30 or more amalgams per week, was only 63% of that for unexposed women.

Another study of 298 dentists showed that: "30% of the high mercury dentists had polyneuropathies. No polyneuropathies were detected in the control group. The high mercury group had mild visuographic dysfunction; they also had more symptom-distress than did the control group. These findings suggest that the use of mercury as a restorative material is a health risk for dentists."

In studies of dentists by Professors Echeverria and Apshian dentists were shown to be severely effected by mercury:

DR Diana Echeverria (University of Washington): "The kinds of things that we have found are: losses in function associated with the ability to move very small things with your hands - a manual dexterity problem; other kinds of really distinct functions concentration, the inability to concentrate. Actually those are skills that anybody needs."

PROFESSOR APOSHIAN: "The implications are that in the dental technicians the mercury has caused very definite central nervous system disorders."

Other research shows that dental personnel are severely effected by the mercury they are exposed to:

• twice the rate of glioblastomas than the rest of the population.
• Reduced IQ levels have been demonstrated , ,
• Psycho-motor and psycho-emotional studies of dentists demonstrate a severe drop in scores compared to the rest of the population.
• Twice the rate of suicide of any professional group.
• 20% of Canadian dentists are on permanent disability for psychological reasons

And for those totally cynical dentists who still believe that their health is not effected, the following excerpt from the Bio-Probe Newsletter is worth considering:

Mercury Exposure of the Population: IV - Mercury Exposure of Male Dentists, Female Dentists and Dental Aides. Zander, D; Ewers, U; Freier, I; Brockhaus, A.

Zentralbl Hyg Umweltmed, 193(4):318-328, Dec 1992.

ABSTRACT [Article in German]: Urinary mercury levels were determined in 22 dentists and 46 dental nurses and assistants working in 15 private dental offices in West Germany. For comparison, urinary mercury levels of 29 subjects without occupational mercury exposure were studied.

On average, urinary mercury in dental personnel was higher than in the reference group. Individual mercury levels, however, were all significantly below present occupational exposure limits. Urinary mercury was significantly correlated with the number of amalgam fillings in dental personnel as well as in the reference group. Following administration of Dimaval a significant increase of mercury excretion was observed in both groups.

Regarding total exposure to mercury in dental personnel, the contribution of mercury exposure from the occupational environment is of the same order of magnitude as their exposure from their own amalgam fillings. Dental nurses were found to be more exposed than dentists. This finding seems to

be related predominantly to the larger number of amalgam fillings in dental nurses.

BIO-PROBE COMMENT: Data from the American Dental Association (ADA) comparing the health and mortality of dentists to the general population are frequently cited as proof that amalgam mercury is harmless, as the dentists are claimed to be as healthy as the general public. These ADA studies do not separate dentists who use mercury from those that do not use mercury, nor do they consider the presence of amalgam fillings in either the dentists or the general public. The ADA data therefore, is totally irrelevant to the question of exposure to amalgam mercury.

This study demonstrates that, even in dental personnel, body burden of mercury from amalgam fillings is at least equal to the occupational exposure. Even more foreboding, the dental assistants had larger exposures than did the dentists. Through the years, the ADA has focused on mercury exposure in dentists (via the invalid technique of non-challenge urine mercury measurements), while totally ignoring exposure in dental assistants and hygienists!

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What You Can Do

After reading this it is tempting for people to be concerned enough to rush to their dentist and demand that all of their amalgams be replaced.

DO NOT DO THIS.

Unless correct precautions are taken, you may be exposed to extremely high levels of mercury, and you may become seriously ill. Protocols do exist for the safer removal of amalgam - they have been designed to maximize the benefit of this type of treatment for the patient. Simply removing the amalgams is like turning of the bath taps. It will stop the greatest source of mercury into your body. You will still need to empty the bath tub - mercury is stored in the body and takes a long time to come out. In some cases it will be important to work with a medical doctor who is able to treat mercury poisoning. These people are trained in environmental medicine.

We are told often by the dental authorities that removing amalgam does nothing for a persons health. These same authorities have the audacity to use such an unjustified position to suggest that amalgam removal for the sake of health improvements is 'unethical'!

There is now ample research which demonstrates that not only is amalgam the greatest source of mercury to the general population but also the removal of amalgam produces an overall reduction in the body's burden of mercury. The Bio-Probe Newsletter comments on these studies are pertinent:

"The two preceding studies demonstrate, without doubt, that the removal of amalgam dental fillings results in decreased exposure to mercury. Toxicology reference books state that elimination of exposure is the key factor in addressing mercury intoxication. The new USEPA findings and recommendations define a risk from mercury exposure at much lower levels than previously thought."

Never allow amalgam to be placed in your mouth ever again. There are alternatives. If your dentist still believes that the alternatives are not as good as amalgam perhaps you could suggest he/she read the published literature demonstrating that amalgam is in fact one of the worst mechanical restorative materials. Alternately you can change dentists - you do have the right to choose.

Never go into a dental surgery where amalgam is used. The mercury vapour levels may be so high as to be immediately hazardous to your health. This warning is particularly relevant if you are pregnant, have impaired immune function or impaired kidney function. Mercury vapour levels in dental surgeries have been measured to be as high as 150mcg/m3 . Thus, to choose a dentist the first thing you should do is ring and ask the receptionist if amalgam is used in the practice! If a dentist is still using amalgam he/she is still unaware of the dangers of this material. Keep well away!

Ensure that the exhaust from the dental suction system is vented out of the building.   Many dental practices vent back into the premises.  You will in effect be sitting in a concentrated cloud of mercury vapour every time the dentist is drilling an amalgam implant.

When you do have your amalgams removed there are some dietary supplements which have been shown to be helpful to either remove mercury from the body or to start to repair some of the damage caused by mercury. Research released in 1996 shows that the only thing that is known to take mercury out of the brain and across the blood brain barrier is 'fresh coriander'. Chlorella is an algae which is also known to assist the removal of mercury from your body. Selenium is a basic supplement but in Australia you will need a prescription to get it.

If you are a dentist and are upset by what you have just read please look up the references and prove it to yourself.

Conclusion

The overwhelming quantity and quality of scientific research leaves no doubt
that dental amalgam is a serious health hazard
and that the only morally correct stand
that any government should take is to ban its use immediately.
There are plenty of good alternatives.

 

References:

1. Babich et al ., The mediation of mutagenicity and clastogenicity of heavy metals by physio chemical factors. Environ Res., 1985:37;253-286

2. Hansen K et al A survey of metal induced mutagenicity in vitro and in vivo J Amer Coll Toxicol ., 1984:3;381-430

3. Hansen K et al A survey of metal induced mutagenicity in vitro and in vivo J Amer Coll Toxicol ., 1984:3;381-430

4. Khera et al., Teratogenic and genetic effects of mercury toxicity. The biochemistry of Mercury in the environment. Nriagu, J.O.Ed Amsterdam Elsevier, 503-18,1979

5. PelletierL et al., In - vivo self reactivity of mononuclear cells to T cells and macrophages exposed to HgCl2 Eur. J Immune., 1985: 460-465

6. Verchaeve L et al., Comparative in vitro cytogenetic studies in mercury exposed human lymphocytes Mutation Res., 1985:157;221-226.

7. Americsn Acaderny of Dental Science, 'A history of dental and oralscience in America', Philadelphia: Sarnuel White, 1876

8. Bremmer, D.K, 'The story of dentistry', Revised 3rd Edition, Broo/dyn:

9. Ring, M., 'Dcntistry, an illustrated history', New York: Harryu NAbrams,1985

10. Stock, A., Z Angew. Chemie, 1926, 39, 984-9

11. Stock, A., ibid, 1928, 41,663-72

12. Stock, A., Z ,lnorg. Jlllgem. Chemie, 1934, 217, 241-53

13. Stock, A., Naturwisch, 1935, 28, 453-6

14. Stoek,A.,Arch. GewerbepathGcwerbchygie, 1936,7,388-413

15. Stoek, A., Ber Dtsch Chem. Ges., 1939, 72, 1844 57

16. American Dental Association, 'Pnnciple of ethics and code of professional conduct', Section l-J: Representation of care and fees, 211 E Chicago Avenue, Chicago IL US,64611

17. Toxic Teeth: The Chronic Mercury Poisoning of Modern Man Murray J Vimy Chemistry & Industry 2 January 1995 17

18. Johansson BI Bergman B Corrosion of titanium and amalgam couples: effect of fluoride, area size, surface preparation and fabrication procedures. Dent Mater (1995 Jan) 11(1):41-6

19. Replacement of missing cusps: an in vitro study. LC; Smith-BG J-Dent. 1994 Apr; 22(2): 118-20

20. Clinical evaluation of a highly wear resistant composite. Dickinson-GL; Gerbo-LR; Leinfelder-KF Am-J-Dent. 1993 Apr; 6(2): 85-7

21. Evaluation of occlusal marginal adaptation of Class II resin-composite restorations ASDC-J-Dent-Child. Jul-Oct. 1993

22. Three-year follow-up of five posterior composites: in vivo wear. Willems-G; Lambrechts-P; Braem-M; Vanherle-G J-Dent. 1993 Apr; 21(2): 74-8

23. Directed Shrinkage Technique in Class V Composite Restorations: in Vivo Microscopic Evaluation and Clinical Procedure, Ferrari, M., Practical Periodontics and Aesthetic Dentistry, Vol. 5, No. 7, September 1993, pp. 29-36.

24. Longevity of dental restorations in selected patients from different practice environments. Mahmood-S; Smales-RJ Aust-Dent-J. 1994 Feb; 39(1): 15-7

25. Evaluation of occlusal marginal adaptation of Class II resin composite inlays

26. Kreulen-CM; van-Amerongen-WE; Borgmeijer-PJ; Gruythuysen-RJ ASDC-J-Dent-Child. 1994 Jan-Feb; 61(1): 29-34

27. Three-year follow-up of five posterior composites: in vivo wear. Willems-G; Lambrechts-P; Braem-M; Vanherle-G J-Dent. 1993 Apr; 21(2): 74-8

28. Posterior adhesive composite resin: a historic review. Fusayama-T J-Prosthet-Dent. 1990 Nov; 64(5): 534-8

29. Health risks from exposure to mercury from crematoria. The Institute of Environmental Medicine, Karolinska Institute Report, 51M 1/92.

30. More mercury from crematoria : Nature 1990 Aug 16;346(6285):615.

31. Comment on: Nature 1990 Oct 18;347(6294):623 Nature. 1991 Feb 28; 349(6312): 746-

32. Vimy, M.J., & Lorscheider, F.L., J. Trace Elem. Exper. Med., 1990, 3, 111-23

33. Vlmy, M.J., & Lorscheider, F.L., ibid, 1985, 64, 1072-5

34. aussrgen von medizin und zahnmedizin', Syrnposium, Koln, West Germany, Mar.;h 1984, Abst. D29

35. Nylander, M., Friberg, L., & Lind, B., Swed. Dent. J., 1987, 11, 179-87

36. Eggelston, D.W., & Nylander, M., J. Prosth. Dent., 1987, 58, 704-7

37. G. Mark Richardson PhD.,Medical Devices Bureau, Environmental Health Directorate, Health Canada December 1995 this paper was later published in Human and Ecological Risk Assesment Vol2 No4: 709-61, 1996

38. Stortebecker. Mercury Poisoning from Dental Amalgam 1985

39. Stortebecker, P.. The Lancet, May 27, 1989.

40. Mercury Contamination In the Dental Office. . NYS Dental Journal November 1979 pp 457-458

41. Magnus Nylander,. ICBM 1988

42. Svare CW et.al. J. Dent. Res.60(9):1668-1671,1981

43. Ott K et. al. Dtsch. Zahnarztl Z 39(9):199-205, 1984

44. VimyMJ. LorscheiderFL J. Dent Res. 64(8):1069- 1071.,1985

45. Matts Hanson.J. Orthomolecular Psychiatry Vo12 No 3 Sept 1983

46. Langan,Fan,Hoos. JADA Vol 115 December 1987., 867 Donated by The ADA

47. Sam Queen; Chronic Mercury Toxicity; New Hope Against an Endemic Disease.

48. The US EPA maximum safe level is only 0.3 mcg /m3

49. The Agency for Toxic Substances and Disease Registry (ATSDR) of the U.S. Public Health Service recently published its Toxicological Profile for Mercury (Update) [ATSDR. TP-93/10]. Nov. 1994.

50. Patrick Störtebecker, Stockholm.. Mercury Poisoning from Dental Amalgam- a hazard to the human brain.

51. ATSDR/EPA Priority List 1995

52. Koos et al.,. Am J Obstet And Gynecol., 1976:126;390-409

53. Stortebecker, P. Mercury poisoning from dental amalgam through a direct nose-brain transport. The Lancet, May 27, 1989.

54. Arvidson, B Acta Neurol Scand. 82(4):234-7. Oct 1990.

55. Arvidson B. Muscle Nerve. 15(10):1089-1094, Oct 1992.

56. Aschner: Acta Pharmacol Toxicol (Copenh) (1986 Nov) 59(5):349-55

57. Retrograde Axonal Transport of Mercury in Primary Sensory Neurons Innervating the Tooth Pulp in the Rat. Neurosci Lett. 115(1):29-32. Jul 17, 1990

58. Neurosci Lett. 115(1):29-32. Jul 17, 1990

59. WD; Markesbery, Wenstrup, D; Ehmann, WR. Trace Element Imbalances in Isolated Subcellular Fractions of Alzheimer's Disease Brains. Brain Research. 553: 125-31. 1990

60. Duhr, E; Pendergrass, C; Kasarskis, E; Slevin, J; Haley, B. Federation of American Societies for Experimental Biology (FASEB). 75th Annual Meeting. Atlanta, Georgia. 21-25 April 1991. Abstract 493.

61. Stortebecker. P: Mercury Poisoning from Dental Amalgam

62. Australian Dental Association, Sydney, NSW, 1989

63. Aposhian-HV; Maiorino-RM; Rivera-M; Bruce-DC; Dart-RC; Hurlbut-KM; Levine- Zheng-W; Fernando-Q; Carter-D; et-al J-Toxicol-Clin-Toxicol. 1992; 30(4): 505-28

64. Godfrey Campbell J. Advanced Medicine 7(1) 1994

65. Australian Dental Association internet homepage November 1997

66. JADA, Vol. 122, Aug. 1991, p. 54

67. An Epidemiological Study of Mercury Sensitization. Sato, K; Kusada, Y; Zhang, Q; Yanagihara, M; Ueda, K; Morihiro, H; Ishii, Y; Mori, T; Hirai, T; Yomiyama, T; Iida, K. Allergology International, 46:201-6, 1997.

68. Hultman P Johansson U Turley SJ Lindh U Enestrom S Pollard KM FASEB J (1994 Nov) 8(14):1183-90

69. Stejskal VDM, Cederbrant K, Lindvall A & Forsbeck M Melisa - an in vitro tool for the study of metal allergy. Toxic in Vitro 8(5):991-1000 (1994)

70. Veron et al Amalgam Dentaires et allergies J Biol Buccale., 1986 : 14; 83-100

71. Abraham J, Svare C , Frank C,. J. Dent. Res. 63(1):71-73,1984

72. Malmström C., Hansson M., Nylander M., Conference on Trace Elements in Health and DIsease. Stockholm May 25-1992

73. Matts Hanson. ICBM conference Colorado 1988

74. Hal Huggins. Observations From The Metabolic Fringe. ICBM conf. Collarado 1988

75. Verchaeve L et al., Mutation Res., 1985:157; 221-226.

76. PelletierL et al., Eur. J Immun., 1985: 460-465

77. Amalgam Hazards - an assesment of research By Irwin Mandel DDS Assoc. Dean for Research School of dental and Oral Surgery Columbia University New York Published JADA Vol. 122 August 1991

78. Hultman P Johansson U Turley SJ Lindh U Enestrom S Pollard KM FASEB J (1994 Nov) 8(14):1183-90

79. Dr W. Kostler., President of the Austrian Oncology Society. Paper presented at the World Congress on Cancer. April 1994 Sydney Australia

80. EPA Mercury Health Effects Update Health Issue Assessment. Final report 1984 EOA-600/8- 84f. USEPA, Office of Health and Environmental Assesment Wsahington DC 20460

81. Gordon - Proceedings of Intl conference on Mercury Hazards in Dental Practice Sept. 2-4 Glasgow 1981

82. Lee, L.P. and Dixon Effects of Mercury on Spermatogenisis J Pharmacol Exp Thera 1975: 194(1); 171-181.

83. - VimyMJ, TakahashiY, LorscheiderFL Maternal -Fetal Distribution of Mercury Released From Dental Amalgam Fillings. 1990 published in FASEB faculty of Medicine, Univ of Calgary, Calgary Alberta Cannada 1990 published in FASEB

84. BrodskyJB. Occupational exposure to Mercury in dentistry and pregnancy outcome. JADA111(11):779- 780., 1985

85. Till et al. Zahnarztl. Welt/reform 1978:87;1130-1134.

86. Mohamed et al. J. Androl.,7(1):11-15.,1986.

87. Inouye M., Murao K., Kajiwara Y., Neurobeahv.Toxicol Teratol. ,1985:7;227-232

88. Koos et al., Mercury toxicity in pregnant women, fetus and newborn infant. Am J Obstet And Gynecol., 1976:126;390-409

89. Khera et al., Teratogenic and genetic effects of Mercury toxicity. The biochemistry of Mercury in the environment. Nriagu, J.O.Ed Amsterdam Elsevier, 503-18,1979

90. Babich et al ., Environ Res., 1985:37;253-286

91. Vimy, MJ; Hooper, DE; King, WW; Lorscheider, FL. Biological Trace Element Res., 56:143-52, 1997

92. Oskarsson, A; Schultz, A; Skerfving, S; Hallen, IP; Ohlin, B; Lagerkvist, BJ. Arch Environ Health, 51(3):234-51, 1996.

93. Drasch et. al. J Trace Elements in Medicine and Biology; 9(2):82-7, 1995

94. Boyd, N. D., H. Benediktsson, M. J. Vimy, D. E. Hooper, And F. L. Lorscheider. Am. J. Physiol. 261 (Regulatory Integrative Comp. Physiol. 30): R1010-R1014, 1991

95. Summers AO, Wireman J., Vimy MJ., Lorscheider Fl., Marshal B., Levy Sb., Bennet S., Billard L. J. Of Anti-Microbial Agents And Chemotherapy 37[4]:825-34 April 1993

96. Brunker P Rother D Sedlmeier R Klein J Mattes R Altenbuchner J Mol Gen Genet (1996 Jun 12) 251(3):307-15

97. Williams MV Environ Mol Mutagen (1996) 27(1):30-3

98. Malmström C., Hansson M., Nylander M., Conference on Trace Elements in Health and DIsease. Stockholm May 25-1992

99. Till et al. Zahnarztl. Welt/reform 1978:87;1130-1134.

100. Sikorski R et al .Women in dental surgeries: reproductive hazards in occupational exposure to metallic mercury. Int Arch Occup Environ Health (1987) 59(6):551-7

101. Rowland AS et al The effect of occupational exposure to mercury vapour on the fertility of female dental assistants Occup Environ Med (1994 Jan) 51(1):28-34

102. Shapiro et al Lancet 8282:1147-50. 1982

103. BBC Panorama 1994

104. Nylander et al.Fourth international symposium Epidemiology in Occupational Health.,Como Italy Sept 1985

105. Joel Butler " Neuropsychological Dysfunctioning Associated with the Dental Office Environment". Professor of Psychology at the University of North Texas.

106. Echeverria, D; et al Neurotoxicology and Teratology. 17(2):161-168, 1995.

107. Gonzalez-Ramirez, D. Et al.. J Pharmacol Exp Therap. 272:264-274,1995

108. Skare: Scand J Work Environ Health (1990 Oct) 16(5):340-7

109. J. Can.. Dent 1994 Special Report

110. Long-Term Mercury Excretion in Urine After Removal of Amalgam Fillings. Bergerow, J; Zander, D; Freier, I; Dunemann, L Int Arch Occup Environ Health, 66(3):209-212, 1994.

111. Mercury in Saliva and Feces After Removal of Amalgam Fillings. Bjorkman, L; Sandborgh-Englund, G; Ekstrand, J. Toxicol Appl Pharmacol, 144(1):156-162,May 1997.

112. Nilsson B, Nilsson B. Mercury in dental practice. I. The working environment of dental personnel and thier exposure to mercury vapor. Swed Dent J 1986a;10:1-14.

A Response to the NHMRC Position Statement 2002 "Dental Amalgam - filling you in" by Dr Robert Gammal BDS FACNEM(dent) Dr Gammal is founder and past president of the Australasian Society of Oral Medicine and Toxicology (ASOMAT), which was created with the intent to bring to public and professional awareness the science and the dangers associated with mercury from dental amalgam. In August 1997 the NHMRC withdrew its policy statement on the safety of dental amalgam. At that time they held the view that Dental amalgam is an excellent material for repairing decayed teeth and for many applications, it is still preferable to the alternatives.  The position statement was withdrawn because the comments made by the NHMRC did not reflect the content of the only reference which was used to justify their position.  At that stage the whole of Australia's policy on the safety of amalgam was written on one A4 sheet of paper.  It was not authored and it was not a part of a larger document or report.  In fact there was no record of any committee who put it together. Australia did not have a policy statement for the five years that it took for the NHMRC to arrive at their current position. During that time they created a working party to examine the scientific research and reflect on the submissions (over 40) that had been given to them. The working party made their report in February 1999.  In that report they state Dental amalgam is still a desirable direct restorative material from a cost and longevity perspective and is the material of choice in certain clinical situations where its properties are superior to alternative materials.  This is almost the exact statement used in the previous position paper, but now we are supposed to think that amalgam is acceptable because it is cheaper than the alternatives. Incredibly, they also state that amalgam should not be used in children, pregnant women and people with kidney diseases.   Clearly the NHMRC believe that mechanics and cost are of greater concern than the potential of being poisoned by the third most toxic substance known to man.  This is in stark contrast to the position taken by other reputable governments such as Sweden, Germany, Canada and California. The working party also suggested that Australia should conduct its own risk assessment on the dangers of mercury from dental amalgam.  One of the comments in the executive summary of this Risk Assessment (No 8) is that removal of amalgam will allow a reduction of the body burden of mercury to a level experienced prior to amalgam placement. The full NHMRC position statement can be found at http://www.nhmrc.gov.au   Think About It: The only place that dental amalgam can be stored safely and legally is in the mouth of a living person! Everywhere else it is TOXIC WASTE!
NHMRC Statements				Robert Gammal Comments
What is the issue?				(there is a glossary at the end of this table)
1..... mercury, a substance that at high levels can be harmful to human health.				At high levels mercury IS harmful to human health.   In fact at low levels mercury is harmful to human health. At low, CONTINUOUS exposure, mercury accumulates in the body.  The brain and nervous system are major areas of concern for the accumulation of mercury.  Mercury is Neurotoxic! In fact,  ALL levels of mercury are harmfull to ALL living organisms! The ATSDR list mercury as the third most toxic substance known to man, after Arsenic and Lead. Unlike Lead though, mercury is liquid at room temperature and vaporises atroom temperature and is thus more commonly bio- available than lead or arsenic.
2. Media stories and websites have fuelled these concern but they are sometimes based on inaccurate information.				2)  Many websites and media stories actually present accurate and scientifically referenced information. Try out: http://emporium.turnpike.net/P/PDHA/mercury/asr1.htm http://www.hugnet.com/ http://www.algonet.se/~leif/yfVIM90a.html http://www.altcorp.com/ http://www.algonet.se/~leif/AmFAQigr.html It is a shame that the NHMRC tries to invalidate the mass of scientific research which disagrees with their position.
3. Repeated worldwide reviews of the scientific evidence have been unable to link the use of dental amalgam directly with ill health1,2.				3)  Repeated World Wide Reviews   - How curious that we are not told the NHMRC Working Party have acknowledged that no studies have been done which test the proposition that amalgams are safe.  So what are these reviews looking at? The references used here to support this statement are reviews of the literature.  Reviews Of The Literature Are Just Reviews.  They Are Not Scientific  Studies.  It is incomprehensible that such an august body as the NHMRC should rely on reports as references to their statements. The references used: 1. ADA Council on Scientific Affairs. Dental amalgam: update on safety concerns. Journal of the American Dental Association. 1998 129:494-503. It is well known that the AmDA is the greatest proponent on the safety of amalgam.  The Journal of the American Dental Association rates as one of the least scientific journals in the world. [i] The American, like the Australian, Dental Association is a trade organisation - it is NOT a scientific organisation. How many people know the American Dental Association owns patents on widely used amalgam formulations and yet at the same time asserts the alleged safety of amalgams? Is this a conflict of interest? US Pat.4,018,600Waterstrat April 1977 US Pat. 4,078,921Waterstrat March 14 1977 2. World Health Organization. Consensus statement on dental amalgam, 7 March 1997. Geneva: WHO, 1999. This was an unofficial report from a subcommittee of dental personnel. The World Health Organization have clearly stated that it should not be used to suggest that it was their official position, and have in fact distanced themselves from this supposed consensus statement. It is curious that NHMRC is willing to cite an unofficial document yet ignores an official one (World Health Organization Criteria 118,  published in 1991 with full ownership by the WHO), which states clearly that  dental amalgam is the greatest source of mercury to the general population - in the order of 3 - 17 times greater than all other sources combined (including fish and other sea food). In Criteria 118 they also stated clearly that for mercury vapour a specific 'no-observed-effects-level' (NOEL) cannot be established, meaning that NO level of mercury vapour that can be considered harmless has been found.   WHO also stated "There are at present no suitable indicator media that will reflect concentrations of inorganic mercury in the critical organs, the brain or kidneys, under different exposure situations". For further insight into the lack of research on the safety of amalgams see the comments made by Dr Boyd Haley (Prof Chemistry, University of Kentucky): Dr. Haley Rebuts the American Dental Association Position on Mercury Amalgam Safety 23 May 2001 The Honorable Dan Burton Chairman Committee on Government Reform U.S. House of Representatives Washington, D.C. Issued late in 1997, the FDI World Dental Federation and the World Health Organization consensus statement on dental amalgam stated "No controlled studies have been published demonstrating systemic adverse effects from amalgam restorations. My first comment would be to question "who staffed these committees and what percentage were connected to the ADA though the NIDCR or the FDA dental materials branch or other relationships?" We appear to have the foxes guarding the henhouse! Then I would again point out that "absence of proof is not proof of absence". I would then ask have any controlled studies been done and if not, why not? If the ADA dentists insist on placing amalgams in the mouth, are they not required to show it is safe, not the other way around? Should not the ADA and others concerned push to require the FDA to prove amalgams are safe instead of totally ducking this issue. Go to the FDA dental materials web-site and try to find any evaluation of amalgam safety---you will not succeed. The dental branch of the FDA refuses to do a safety study on amalgams and this is shame on our government. Dr Haley's website is http://www.altcorp.com On 9 August 2002, The Court of Appeal, in California, issued a ruling that should have a dramatic impact on the dental amalgam mercury controversy. [Consumer Cause v. Smilecare, 91 Cal. App. 4th 454 (200 1), B 147727]     Bio Probe Vol 19 Issue 2 March 2003, make the following points. Previously, the defenders of amalgam mercury have always been successful with their position that the safety of the material, although it is known to be a strong poison, has been established by 150 years of use and the consensus opinions of an "alphabet soup" of committees. The second important point is the insistence of the Court and the Attorney General that determination of the issue be decided by formal and proper "Risk Assessment." Previously, defendants have relied on the contention that it has not been proven that dental amalgam mercury causes any one of several 'named' diseases, such as Multiple Sclerosis (MS) or Alzheimer's Disease (AD). Mercury is a poison, similar to lead or arsenic. Nobody declares that lead or arsenic are not poisonous because it has not been proven that they cause MS or AD! Human risk from exposures to lead or arsenic are determined by Risk Assessment. Exposure to mercury should be addressed the same way. The Court agreed. The end result was that on 7 January 2003, the Superior Court in San Francisco approved the final language for warnings on dental amalgam mercury that are required under California's Proposition 65: "NOTICE TO PATIENTS. PROPOSITION 65: Warning on dental amalgam, used in many dental fillings, causes exposure to mercury, a chemical known to the state of California to cause birth defects or other reproductive harm.
Can mercury from fillings enter the body?
1.Very small amounts of mercury are released from the surface of dental amalgam fillings, mainly as mercury vapour.				1) There is no known level of mercury vapour which is regarded as SAFE (a no-observable-effects-level [NOEL] has never been demonstrated). To date there is not one agency in the world including the USEPA, FDA, and ATSDR nor the NHMRC who have shown a safe minimum level of mercury vapour.  The use of the words "very small amounts" implies a harmless nonexistant level.  Health Canada attacked the Canadian Dental Association for making similar comments: Canadian Dental Association: Q. Is the mercury which is released from fillings absorbed into the body? A. Yes, but in extremely small amounts, i.e. in MILLIONTHS of a gram (this is very small amount, 0.000001 grams.) Dr Tobin's Response: "This answer is rather condescending and insulting to the intelligence of readers. By emphasizing only how small a microgram is it implies that a microgram of toxic material could not be harmful. What is significant is not now many zeroes there are in a microgram, but how many micrograms of mercury are released by and compared to the number of micrograms required to cause illness. The fact is that a level of only one hundred millionths of a gram (only 0.0001 gram) of mercury per gram of Creatinine in urine is considered to indicate clinical mercury poisoning." Mercury is released continuously from amalgam, mainly in the form of mercury vapour, which is considered one of the most toxic and most bioavailable forms.  80% of inhaled vapour is absorbed through the lungs. [ii] Early symptoms of low-level mercury poisoning are characterised by sub-clinical (no clinical symptoms are visible) neurological (effecting the nervous system) symptoms.  It is nonsense to think the dental profession does not know this. Even the New York State Dental Journal (1979) state: The symptoms of mercury poisoning from chronic inhalation develop gradually and thus, may be difficult to notice. With the exception of tremor, the symptoms may be ignored by the victim or attributed to other causes. This lack of awareness is particularly likely in the case of erethism, a condition characterized by; irritability, outbursts of temper, excitability, shyness, resentment of criticism, headache, fatigue, and indecision.
2 .....In this way, some mercury can reach the rest of the body and accumulate in certain organs, particularly the kidneys.				2) Mercury is a cumulative toxin.  It accumulates and stays in the body.  Although highest levels are found in the kidneys, the other main organ for the accumulation of mercury is the brain.  Mercury readily crosses the blood brain barrier and remains in the brain.  Mercury is neurotoxic.  Its most widely known damage is thus in the central and peripheral nervous systems.  Alzheimer's Disease and many other serious neurological diseases are strongly related to mercurylxii . The mention of mad hatters in the NHMRC article (point 3 of what are the health effects?)  must surely indicate that this information is known to the NHMRC.
3. However, the mercury levels involved are very low, so the amount of mercury absorbed into the body is very small.				3) This statement ignores the toxicity of mercury. For example a speck of plutonium is small but it will kill within a few days. To say that mercury vapour levels are low without taking into account its toxicity is, at best, misleading and at worst, deceiving. Research has shown that over 80% of the inhaled mercury vapour is absorbed into the body via the lungs. Where is the NHMRC's evidence that small levels of mercury vapour are safe when ATSDR lists mercury vapour as one of the most toxic substances known to man? Interestingly, Canada Health (the Canadian equivalent of the NHMRC) have fully endorsed the 1995 Richardson report [iii] which clearly indicates that 1  Filling  in  Toddlers;  1  Filling  in  Children;  3  Fillings  in  Teens; 4  Fillings  in  Adults  and Seniors provides the equivalent amount of mercury which the USEPA has set as its Tolerable Daily Intake-TDI .  More fillings will of course result in exceeding these TDI levels. Intra-oral mercury vapour levels  are reported in the order of 200 times greater than that accepted by the ATSDR . The ATSDR MRL for inhalation exposure to metallic mercury vapour is 2x105 mg Hg/m3 ( 0.02 mcg Hg/m3) and the MRL for chronic inhalation exposure to metallic mercury vapour is 1.4x105 mg Hg/m3 (0.014 mcg Hg/m3). These standards are both well below (by more than 5000 times) exposure levels to mercury vapour that have been well documented to emanate from amalgam dental fillings, even in the absence of stimulation. [iv] Mercury vapour concentrations in the mouth of someone with amalgam fillings have been shown to be between 30 and 150mcg/m3. [v] , [vi] , [vii] , [viii] , [ix] , [x] , [xi] , [xii] , [xiii]
4. The amount of mercury released from fillings is greatest when fillings are being inserted or removed.				4)   The amount released during insertion or removal is significant and although the increase in mercury exposure is only transient, it can be more than enough to top the balance of people who are already sensitized and poisoned by mercury.  This is really an added insult to the already overloaded patient because mercury is released continuously from amalgam for the ENTIRE LIFE of the amalgam. For this reason it is critical that correct removal procedures be followed and in fact that no amalgam should ever be placed in teeth. Apart from insertion and removal, eating, chewing, grinding, and drinking hot drinks will cause an increased release of mercury from amalgam.  After such stimulation the levels remain elevated for up to 90 minutes. [xiv] , [xv]
What is dental amalgam?				go to top of page
1. ....generally made up of mercury, silver and tin with small amounts of copper and zinc.				1) Even here the NHMRC cannot openly acknowledge that the bulk of a dental amalgam, is mercury, (about 50% of it in fact), with the rest being made up of all the other materials. Half of every amalgam filling is mercury, which continually leaks out and vaporizes over the ENTIRE LIFE of a filling. The ONLY way not to be exposed from this source is to not have amalgam fillings. Research has clearly shown that the mercury levels in people without amalgams, or who have had their amalgams removed, are significantly lower than those people WITH amalgams in their mouths. WHO in 1991 stated clearly that dental amalgam is the greatest single source of dietary mercury to the general population.
2. The use of amalgam for dental work is declining.....				2) ANY use of amalgams represents a deliberate use of a material which is known to be the major source of mercury vapour exposure in human beings. Current dental materials technology is such that there is not one use for amalgams which cannot be satisfied by the clinically competent use of other and better alternatives. In 2003, the Swedish Government stated that; "With reference to the fact that mercury is a multipotent toxin with effects on several levels of the biochemical dynamics of the cell, amalgam must be considered to be an unsuitable material for dental restoration. This is especially true since fully adequate and less toxic alternatives are available."
What are the health effects?				go to top of page
1. High levels of mercury are harmful to human health. ......, producing signs such as mood swings, memory loss and development of tremors.				1) This statement is factually wrong because it is, in fact, low levels of mercury vapour which will produce signs such as mood swings, memory loss and development of tremors.  These are the early symptoms of low-level long term mercury poisoning - NOT the late ones, and they are not the symptoms seen in high level mercury poisoning.  High level poisoning is accompanied with rapid kidney failure.
2. In rare cases, a person may be allergic to mercury.				2) Peer reviewed published research has reported allergy levels of 5%‑8% (Rudner,) 27% (Djerrasi & Berova),  2%‑10.8 % (White & Brandt),  31%, 27%, 32%, 39% (Miller et al), 11.3% (Brun),  9.6 % (Nebenfuher et al), 13% (Sato et al)  [xvi] , [xvii] , [xviii] , [xix] , [xx] , [xxi]   These are NOT small figures.  Assuming that only half of the Australian population have amalgam fillings we could conservatively expect that between  475,000 and  3,705,000 people are sick as a direct result of allergy to amalgam. In the past the ADA have made allegations that less than one percent of the population is allergic to mercury.  They have never been able to substantiate this claim with any references. The AMerican Dental Association have now reviewed this figure and claim that 3% of the population is 'allergic' to amalgam. Even Caulk Co, the manufacturers of the Dispersalloy brand of amalgam, warn: "Allergic reactions that may occur in previously exposed persons include dermatitis, encephalitis, and death. Unfortunately true allergy is only one of the immune effects of mercury Ð there are many others. [xxii] , [xxiii]
3. The phrase 'mad as a hatter' came about because the hat makers of the 19th century were exposed to high levels of mercury,.......				3) Dental personnel are exposed to exceptionally high levels of mercury vapour.  Evidence exists which shows significant health problems in dentists and dental nurses.  Dentists have one of the highest suicide rates of any profession. [xxiv] Dentists also have twice the rate of Glioblastoma (a type of brain cancer) than the rest of the population. [xxv] The authors of this study also state In the group of dental personnel, the effect of their own amalgam fillings on mercury concentrations....was as important as their occupational exposure to mercury. Dentists also show evidence of subtle pre-clinical changes in behaviour associated with mercury exposure: functions related to complex attention, psychomotor task, mood. [xxvi] , [xxvii] Shapiro, et al. and Ship II, et al.   reported the relation between cumulative exposure to mercury and chronic health impairment. Of 298 dentists, 30% of the high mercury dentists had polyneuropathies. No polyneuropathies were detected in the control group. The high mercury group had mild visuographic dysfunction;  they also had more symptom- distress than did the control group. [xxviii] There are many studies demonstrating that female dental personnel suffer dramatically from exposure to mercury in the dental environment. One such states: Female dentists had a higher rate of spontaneous abortions then a control of female medical personnel or the rest of the population.  The Peri-Natal Mortality Rate for the female dentists was significantly higher than for the rest of the population  - 19.5 / 1000 as compared to 7.5 / 1000 [xxix] Unfortunately the problem does not stop with the dental nurse but is passed on to the offspring: "rates of spontaneous abortion or non-congenital abnormalities in children during this period, were higher in respondents exposed to high levels of mercury in the dental environment than those exposed to low levels". This is published in the Journal of the American Dental Association Vol 122 August 1991.  It was written by Irwin Mandel DDS., Assoc. Dean for Research School of Dental and Oral Surgery Colombia University New York. Another study reported a high frequency of adverse events of pregnancy among dental staff and learning deficit disorders in children of mothers having been exposed to mercury. [xxx] The United States Environmental Protection Agency stated: Women chronically exposed to mercury vapour experienced increased frequencies of menstrual disturbances and spontaneous abortions. A high mortality rate was observed among infants born to women who displayed symptoms of mercury poisoning. [xxxi]
Is dental amalgam likely to affect me?
1. Different people have different tolerances to chemicals in the environment; however, in the opinion of the World Health Organization the levels of mercury exposure from amalgam fillings do not affect general health.				1) There has never been a level of mercury exposure set which is regarded as safe. A NOEL for mercury does not exist!  What is their reference for this comment?  Authoritative bodies such as the American NIH and even the NHMRC inquiry acknowledged that there were no studies which even looked at the issue.
2. ..... There is no reliable evidence that people with such fillings have a greater risk of ill health than people without amalgam.				2) The Absence of Evidence is NOT Evidence of Absence.  This is particularly pertinent when, as mentioned above, it has been acknowledged that virtually no studies have been done which even look at this issue.
3. A very small number of people may experience local side effects due to an allergic reaction to dental amalgam, causing irritation in the tissues surrounding the tooth.  However these local effects appear quickly, and can be recognised and treated.				3) The chances of any dentist recognising mercury allergy if it presented are extremely low. No training is given in this area, nor is it written about or discussed. Again, no reference is given to support this assertion. The fact is that any problems experienced are likely to be presented to a medical practitioner who is also very unlikely to recognise it as a low level mercury toxicity problem. Local reactions DO NOT necessarily appear quickly and the only 'treatment' is to remove the caue. ie. remove the amalgam. Local reactions are NOT the only affect on the immune system.  See www.melisa.org to gain an understanding of how mercury and other heavy metals can instigate a variety of auto immune diseases. The medical profession, as well as the dental profession, are also almost certainly unaware that mercury from amalgam has been shown to cause an increase in mercury-resistant and antibiotic-resistant bacteria in the human body [xxxii] .  Antibiotic resistance has become a major medical public health concern and limits the effectiveness of antimicrobials.  The authors of the research which showed this noted that since dental amalgam is a greater source of mercury exposure for humans than any other non-occupational source (including food), it is likely that dental amalgam mercury is a selective agent which increases the prevalence of plasmid-associated mercury and antibiotic resistances in the oral and intestinal bacteria of humans. Caulk Co., the manufacturers of Dispersalloy, state in the MSDS for this product:  Exposure to mercury may cause irritation to skin, eyes, respiratory tract and mucous membrane. In individual cases, hypersensitivity reactions, allergies, or electrochemically caused local reactions have been observed. Due to electrochemical processes, the lichen planus of the mucosa may develop. Mercury may also be a skin sensitizer, pulmonary sensitizer, nephrotoxin and neurotoxin......Allergic reactions that may occur in previously exposed persons include dermatitis, encephalitis, and death.
Putting the issue in perspective
1. Of the mercury found in the body, less is likely to have come from dental amalgam than from other sources.				1)  This statement is blatantly false! It has neither a reference nor any credibility. WHO Criteria 118 - Environmental Mercury 1991 Between 3-17 times more mercury is absorbed from dental amalgam as compared to all other sources combined including seafood. ATSDR  Elemental Mercury and Inorganic Mercury Compounds: Human Health Aspects (No 50) - Exposure to elemental mercury by the general population and in occupational settings is primarily through inhaling mercury vapours/fumes. Dental amalgam constitutes a potentially significant source of exposure to elemental mercury, with estimates of daily intake from amalgam restorations ranging from 1 to 27 µg/day.... This ATSDR quote is from the very document used by the NHMRC in this pamphlet - Reference No 3. Professor Drasch, Professor of Forensic Medicine at Munich, says:  Hg found in tissues of individuals with amalgam fillings derive mainly from these fillings and not from other theoretically possible sources.xliii   (Hg is the Scientific notation for mercury.)
2. Mercury is present at low levels in our environment as a naturally occurring element in air, water and food.				2) Again the use of the words low levels, without any quantification and without any particular reference.  This would imply that the same low levels exist in the environment as in a mouth full of amalgam filled teeth. Mercury vapour levels in the mouth can be quantified and usually far exceed environmental levels. Just because mercury is a 'natural' element and it IS found in nature, does NOT make it safe.  Arsenic, lead, plutonium, uranium and many other NATURAL substances are deadly.
3. Mercury in food, particularly in fish, is often in a form that can be easily absorbed by the body (in contrast to the mercury in dental amalgam).				3) There is no doubt that organic forms of mercury are readily absorbed.  This has been known for years.  It is amazing that the NHMRC suggest that elemental mercury (that which comes from amalgam) is not readily absorbed, particularly when they are referencing their position with the ATSDR paper which clearly states the opposite of what they are saying:  For elemental mercury, the main route of exposure is by inhalation, and 80% of inhaled mercury is retained......Elemental mercury is lipid soluble and easily pene­trates biological membranes, including the bloodÐbrain barrier. Metabolism of mercury compounds to other forms of mercury can occur within the tissues of the body. It has been known for some time that mercury can be converted to organic mercury in the intestinal tract of human beings. [xxxiii] , [xxxiv]   More recently a study has been published which demonstrates that elemental mercury from dental amalgam can be converted in the mouth to organic mercury.  The authors conclude: Our results are compatible with the hypothesis that amalgam fillings may be a continuous source of organic mercury, which is more toxic than inorganic mercury, and almost completely absorbed by the human intestine. [xxxv]
4. The use of dental amalgam has been recommended to be phased out in Scandinavia and other parts of Europe, once satisfactory alternative materials become available. The reason for this was mainly concern over the release of toxic substances into the environment rather than concern about potential health effects for the individual.				4) This statement borders on the incredible suggesting that human beings are in some way separate from the environment.  Especially in terms of mercury derived from dental amalgam, it is the human being who is the first in line of the environment.  See reference xxxix in the next section. Why is it that the environment should be protected if not for the sake of preserving life and health of all sentient beings who live on this planet? The truth is that mercury from dental amalgam is a MAJOR source of mercury to the environment.
Mercury and the environment
1 Human activities since the start of the industrial age (eg mining, burning of fossil fuels and solid waste incineration) have resulted in additional release of mercury into the environment3.....  As mercury moves up the food chain it becomes more concentrated.				1) This is the only place in the pamphlet that cites the ATSDR document.  The rest of the ATSDR document seems to have been ignored. It has been known for many years that crematoria release huge amounts of mercury into the environment.  Estimates indicate that each chimney releases about 11Kg mercury per year. [xxxvi] , [xxxvii] , [xxxviii]   If the NHMRC are so concerned about the environment why have they still not imposed a requirement that all crematoria use mercury collection devices.  Surely this must be regarded as industrial exposure with environmental and health risks.  Mercury released from amalgam in living people is also a major concern: These results demonstrate that humans, especially in populated areas, can be a significant source of mercury pollutants. As a consequence of mercury release, bacteria may acquire mercury resistance, as well as resistance to other microbial agents. [xxxix]
2. Dental amalgam adds to the level of mercury in the environment when wastes from dental offices are not disposed of properly, and through cremation, which vapourises the mercury in amalgam fillings (although mercury vapour collectors are now often used at crematoriums to prevent this)				2)  Dental offices are significant contributors of mercury into the environment.  Why has the NHMRC not set guidelines for the compulsory use of mercury separators in dental surgeries?  It is a shame that they forgot to mention that once the human is no longer alive the amalgam in the mouth of that dead human is a serious TOXIC WASTE.
Pregnancy
1  During pregnancy, placement of new amalgam fillings or removal of old ones is not recommended, because the level of mercury in the blood tends to rise briefly in these situations. The mercury can cross the placenta and enter the bloodstream of the fetus4,5.				1) There is no doubt that placement and removal of amalgam produce high levels of mercury but low levels of mercury are released from amalgam continuously. The levels of mercury in the foetus and new born are directly proportional to the number of amalgams in the mother s mouth.  These results came from autopsy studies on foetus and new born children many of whom died from Sudden Infant Death Syndrome. [xl] , [xli] Women of child bearing age and younger should not have amalgam in their mouths! Studies on sheep have shown that the mercury is stored in all parts of the body of the foetus including the developing central nervous system and pituitary gland. [xlii] The authors state: "We conclude that Hg released from dental amalgam tooth fillings will begin to selectively accumulate in maternal and fetal tissues soon after amalgam placement. .... Amalgam restorations are a source of continuous Hg exposure to both mother and fetus. In view of the experimental evidence presented herein, continued employment of dental amalgam as a tooth restorative material in pregnant women and children should be reconsidered." Another study states: ... inorganic mercury found in tissues of people with amalgam fillings, derive mainly from these fillings and not from other theoretically possible sources. [xliii]
2  There is no scientific evidence of any link between amalgam use and birth defects or stillbirths. However, current thinking is that it is better to avoid dental work involving amalgam when possible during pregnancy, unless the effects of avoiding treatment could cause greater problems, eg the loss of a natural tooth.				2)  This statement is sadly incorrect and misleading. [xliv] , [xlv] , [xlvi] , [xlvii] , [xlviii] , [xlix] , [l] , [li]   It is clear that mercury is embryotoxic, teratogenic and mutagenic.  The dates of these references make it abundantly clear that this information has been around for a very long time.  Lets also look again at what Caulk Co say about their amalgam product side effects: The use of amalgam is contraindicated: In proximal or occlusal contact to dissimilar metal restorations. In patients with severe renal deficiency. In patients with known allergies to amalgam. For retrograde or endodontic filling. As a filling material for cast crown. In children 6 and under. In expectant mothers. Caulk Co go on to say: Intrauterine exposure may result in tremors and involuntary movements in the infants. Mercury is excreted in breast milk. Paternal reproductive effects and effects on fertility have been reported in male rats following repeated inhalation exposures. Ivoclar (another amalgam manufacturer) go further and contraindicate the use of amalgam in pregnant and lactating women. More recent studies indicate that: Mercury vapor released from the amalgam fillings in pregnant rats was distributed to maternal and fetal organs in dose‑dependent amounts of the amalgam fillings. [lii] In studies on animal offspring in utero exposed to mercury vapor, behavioral changes, such as radial arm maze, morris maze and lever‑press durations, are observed when the levels of mercury vapor exceed the threshold limit value. [liii]
Breastfeeding				go to top of page
Women who are breastfeeding should also avoid having amalgam fillings inserted or removed, because mercury can be passed to the baby through breast milk.        Of course, there are some situations during pregnancy or breastfeeding where dental work using amalgam might be necessary, and there is no scientific evidence that this will cause harm.				Again it is well known that mercury in all forms will be carried through the breast milk to the developing infant. The higher Hg burden of infants' tissues from mothers with dental amalgam, as reported previously, must be explained (1) by a prenatal transfer of Hg from the mother's fillings through the placenta to the fetus, followed by a  redistribution of this Hg in the body of the newborn, and ( 2) an  additional burden via breast milk. [liv] Of course there is a high level of exposure to mercury during placement or removal of amalgam BUT there is also a high level of mercury in the breast milk directly from the amalgam which is already present in the mother's mouth. It would thus be advisable for all women of child bearing age and younger not to have amalgam in their mouths to start with. Intrauterine exposure may result in tremors and involuntary movements in the infants. Mercury is excreted in breast milk. [lv]
Children
Amalgam is now generally avoided for filling children's teeth. Growing children tend to be more sensitive to the effects of exposure to any chemical substance in their environment. Several of the new tooth‑coloured materials are suitable for use where cavities are small, as they often are in children.				Amalgam is still being used in many, if not most, school dental services throughout Australia.  Amalgam is still used by the majority of paediatric dentists. Amalgam restoration of deciduous (milk) teeth is still being taught at most university dental schools. Amalgam is routinely placed in children's teeth in dental surgeries throughout Australia partly because the dental authorities still promote the false notion that there is no suitable alternative for large cavities.  Suitable alternatives have been available for many years! Why continue exposing  the most sensitive members of the population to one of the most toxic substances known to man?
Kidney disease
Because high levels of mercury exposure may affect the kidneys, people with kidney disease may be more concerned than others to minimise exposure to mercury.				As mentioned earlier, High Level Mercury Poisoning is accompanied with Kidney Failure. Low levels of mercury will have a dramatic effect on kidney filtration function.  Severe Renal Dysfunction is cited by Caulk Co. as a contraindication (ie not recommended). Ivoclar go much further in their contraindications! They say their amalgam is not only contraindicated for patients with severe renal deficiency but for all patients suffering from a reduced kidney function. Sheep studies have found a 50% reduction in kidney filtration rates after the placement of dental amalgam fillings. [lvi]
				No reference is made in the NHMRC pamphlet about the effects of mercury in relation to: Health effects on dental personnel [lvii] , [lviii] , [lix] , [lx] , [lxi] Central nervous system - so numerous it would fill pages just to give all references Mercury causing identical changes in the brain as is found in the brain of Alzheimer's Disease [lxii]   Intelligence in children [lxiii] Periodontal disease [lxiv] Immune function [lxv] , [lxvi] Auto Immune Diseases [lxvii] , [lxviii] , [lxix] Endocrine function [lxx]
Should amalgam fillings be replaced?
1   There is no support in the scientific literature for the idea that the mercury released from amalgam fillings is harmful to an individual's health.				1) Mercury from dental amalgam is a cumulative poison.  The longer you are exposed to it, the more will accumulate in your body!  Mercury may not cause a specific disease, but it does cause mercury poisoning, which IS characterised in the largest array of diseases and syndromes known. Mercury released from dental amalgam fillings is mainly in the form of vapour and as mentioned previously, 80% of inhaled mercury enters the blood and the body.  Again from the ATSDR document (reference 3 of the NHMRC pamphlet) available at http://www.who.int/pcs/cicad/summaries/cicad_50.html:   "Neurological and behavioural disorders in humans have been observed following inhalation of elemental mercury vapour, ingestion or dermal application of inorganic mercury-containing medicinal products, such as teething powders, ointments, and laxatives, and ingestion of contaminated food. A broad range of symptoms has been reported, and these symptoms are qualitatively similar, irrespective of the mercury compound to which one is exposed. Specific neurotoxic symptoms include tremors, emotional lability, insomnia, memory loss, neuromuscular changes, headaches, polyneuropathy, and performance deficits in tests of cognitive and motor function. Although improvement in most neurological dysfunctions has been observed upon removal of persons from the source of exposure, some changes may be irreversible. Acrodynia and photophobia have been reported in children exposed to excessive levels of metallic mercury vapours and/or inorganic mercury compounds. As with many effects, there is great variability in the susceptibility of humans to the neuro­toxic effects of mercury.   The primary effect of long-term oral exposure to low amounts of inorganic mercury compounds is renal damage. Inorganic forms of mercury have also been associated with immunological effects in both humans and susceptible strains of laboratory rodents, and an antibody-mediated nephrotic syndrome has been demonstrated through a variety of exposure scenarios." [lxxi]
2  There is no scientific evidence showing that general symptoms are relieved by the removal of amalgam restorations 2				2) The NHMRC statement is clearly incorrect.  There is ample evidence which suggests that removing dental amalgam will reduce the body burden of mercury to pre-amalgam levels.  In fact as part of creating their 2002 document the NHMRC called for their own new risk assessment ot be done.  It is clearly stated in section 8 of the executive summary of the Risk Assessment conducted on behalf of the NHMRC. “Amalgam removal has been shown to be effective in reducing mercury levels to the levels of those in people without amalgam fillings.” The first step to detoxify anyone is to first remove them from the source of the poison!
3. In fact, there are disadvantages to having amalgam fillings replaced ‑ replacement can be expensive; it almost always causes more of the natural tooth to be lost; and, mercury levels in the body rise immediately after amalgam fillings are replaced due to the manipulation of the amalgam. Alternative materials such as gold, ceramics or composite resins (plastics) require more of the tooth to be removed. Composite resins are also more prone to wear so they usually do not last as long as amalgam fillings.				3) It seems that the NHMRC need to take further advice on the material aspects of dental amalgam. Dr. Harold Loe, the Director of the National Institute of Dental Research (NIDR),  stated in the September, 1993 edition of "Dental Products Report": "That first filling is a critical step in the life of a tooth. Using amalgam for the first filling requires removing a lot of the tooth substance, not only diseased tooth substance but healthy tooth substance as well. So, in making the undercut you sacrifice a lot, and this results in a weakened tooth. The next thing you know the tooth breaks off, and you need a crown. Then you need to repair the crown...and so it continues to the stage where there is no more to repair and you pull the tooth. With the first filling you should do something that can either restore the tooth or retain more healthy tooth substance. Use new materials-composites or materials you can bond to the surface without undercuts. You can do this with little removal of the tooth substance so that the core of the tooth is still there."
4  If you decide to have amalgam fillings replaced, your exposure to mercury can be reduced by using a rubber shielding device called a 'dental dam' and having extra suction during the removal. Dentists can also cut away, rather than drill out the amalgam filling, to help reduce exposure to mercury. Check that your dentist uses these measures before undertaking dental amalgam procedures.				4) If a rubber dam should be used during removal, why does the NHMRC not recommend it be used during placement when it says that mercury exposure is highest during removal AND placement? How does the NHMRC recommend that patients protect themselves from the continuing mercury vapour exposure which occurs 24 hours per day, 7 days per week, Or from the spikes in mercury vapour release, which can last up to 90 minutes, whenever someone eats or has a hot drink? Amalgam removal protocols have been in place for many years but are routinely ignored by the dental profession.  I would like to know what the NHMRC considers to be sufficient protection.  Why does the NHMRC NOT advise dentists to use similar protective measures when they work daily with amalgam?
5   The decision to replace amalgam fillings is an individual one, and you should make it in consultation with your dentist. If you feel that you need further information after reading this leaflet and talking to your dentist, it may be a good idea to seek a second opinion.				5)  All patients have the right to be fully informed about any material or device which is to be implanted into their bodies.  Without full information it is not possible to make informed decisions.  In this regard the advice given in this statement by the NHMRC is misleading rather than informative as the NHMRC does not cite any alternate sources of information. Most dentists are unaware of the dangers that they place themselves, their staff and their patients in when using amalgam.  Most dentists are themselves seriously affected by the mercury from amalgam. These effects include an impairment of cognitive understanding.  It is like setting the fox to gaurd the chickens.
Further information
Further information on the effects of amalgam fillings and their benefits and disadvantages can be found on the World Health Organization website http://www.who.int/ncd/orh				Also see the submission presented to the NHMRC by ASOMAT 1998 (www.asomat.org) Instead of the URL presented here, I would suggest that you just go to the home page of the WHO and start your own search on amalgam and mercury. Further information is available at many web sites and from many organisations.   Many are listed on the 'links' page.
Source References
1.         ADA Council on Scientific Affairs. Dental amalgam: update on safety concerns. journal of the American Dental Association. 1998 129:494-503. 2.         World Health Organization. Consensus statement on dental amalgam, 7 March 1997. Geneva: WHO, 1999. 3.         ATSDR. Toxicological Profile for Mercury. U.S. Department of Health & Human Services, 1999. 4.         Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment. Statement on the Toxicity of Dental Amalgam. Department of Health, United Kingdom, December 1997. 5.         Ad Hoc Working Group. Dental Amalgam. A report with reference to the Medical Devices Directive 93/42/EEC. European Commission, 1998.				No 3 ATSDR  is the only reference used here which has any scientific credibility.  As demonstrated above, this one reference alone disagrees with many of the statements made by the NHMRC. The Australian and the American Dental Associations are NOT scientific organisations but trade organisations.    The objectivity of the publications of the dental associations on this issue is, unfortunately, quite suspect. The World Health Organization Consensus statement on dental amalgam,   7 March 1997, is without an author and has never been endorsed by the WHO.  In fact it is a document written in conjunction with the FDI - another dental trade organisation. In the words of Dr Boyd Haley: "Issued late in 1997, the FDI World Dental Federation and the World Health Organization consensus statement on dental amalgam stated "No controlled studies have been published demonstrating systemic adverse effects from amalgam restorations." My first comment would be to question "who staffed these committees and what percentage were connected to the ADA though the NIDCR or the FDA dental materials branch or other relationships?" We appear to have the foxes guarding the henhouse! Then I would again point out that "absence of proof is not proof of absence". I would then ask have any controlled studies been done and if not, why not? Interestingly, no mention is made of the position statement of Canada Health 1996: Dentists should provide their patients with sufficient information to make an informed choice regarding the material used to fill their teeth, including information on the risks and benefits of the material and suitable alternatives.
The advantages and disadvantages of dental amalgam
In many respects, amalgam is an excellent filling material, because:      It is reasonably priced.       It is highly durable - apart from gold and some of the new ceramics, amalgam is the best material for teeth that are subject to considerable force during chewing and therefore a lot of wear (such as molars). Any replacement weakens the natural tooth that is being filled, so the longer a filling lasts, the better.        It is pliable when first mixed and can be moulded into a tooth cavity - reducing the amount of natural tooth that needs to be removed in order to fit the filling.				The reality is that many dentists, particularly those who no longer use amalgams, would disagree completely with that statement. The newest composite resins have properties which make them a more than adequate alternative, and in a number of respects a much better alternative, especially in the area of minimal tooth preparation and bonding to undermined tooth structure. Evidence exists that teeth can be cracked by amalgams, presumably due to expansion of the amalgam over time. Many dentists would assert that there are no situations at all, ever, which cannot be dealt with using non-mercury based alternatives. One of the main difficulties here is that amalgams are relatively easy to use but the alternatives are more technique sensitive and require a higher skill level to manage correctly.  This is surely a compelling argument to increase skills through better teaching at the undergraduate level and at the post graduate level,  rather than dumbing down to the lowest common denominator. Dr. Harold Loe, the Director of the National Institute of Dental Research (NIDR), wrote in the September, 1993 edition of "Dental Products Report": "That first filling is a critical step in the life of a tooth. Using amalgam for the first filling requires removing a lot of the tooth substance, not only diseased tooth substance but healthy tooth substance as well. So, in making the undercut you sacrifice a lot, and this results in a weakened tooth. The next thing you know the tooth breaks off, and you need a crown. Then you need to repair the crown...and so it continues to the stage where there is no more to repair and you pull the tooth. With the first filling you should do something that can either restore the tooth or retain more healthy tooth substance. Use new materials-composites or materials you can bond to the surface without undercuts. You can do this with little removal of the tooth substance so that the core of the tooth is still there."  In 1995 the editor-in-chief of Quintessence  (Volume 26, Number 3,1995), Dr Richard Simonsen wrote: Amalgam should never be used as a restorative material in paediatric dentistry. Amalgam should never be used as a first time restorative material.    Why?   Because better alternatives are available.  Move Over Amalgam - At Last Another fact is that research has clearly shown that when amalgams are placed in teeth as fillings, then within a relatively short time, weeks not months, mercury which was present in the amalgam can be detected in virtually every other part of the body Ð brain, kidney, lungs, heart, etc. [lxxii] , [lxxiii] It has been conceded in dental articles that if amalgam was introduced today, as a new material, it would have no hope at all of passing safety requirements and as such would have no hope of being introduced onto the market due to the high levels of mercury released. The only reason amalgam is still available is that it was grandfathered in and not subject to the same health standards as newer materials. With today's knowledge how can this situation still be acceptable? Alternatives to amalgam have been around for a long time.  Why is the NHMRC still endorsing its use today?
Glossary
ADA		Australian Dental Association
AmDA		American Dental Association
ASOMAT		Australasian Society of Oral Medicine and Toxicology
ATSDR		Agency for Toxic Substances and Disease Registry.  It is a branch of the United States Environmental Protection Agency
FDA		Food and Drug Administration (USA)
mcg Hg/m3		micrograms of mercury vapour per cubic meter
Micromercurialism		long-term, low-level mercury poisoning.  As from dental amalgam
Mercury Organic		mercury atom combined with other atoms to form an organic compound
Mercury Inorganic		this is the same as elemental mercury.  It is the metallic form
MSDS		Material Safety Data Sheet
MRL		Maximum Recommended Level
NHMRC		National Health & Medical Research Council
NOEL			No Observable Effects Level
paediatric dentistry			Dentistry for children
TDI			Tolerable Daily Intake
WHO			World Health Organization
USEPA			United States Environmental Protection Agency

Statement "The Truth About Mercury"
3rd March 1999 http://www.ada.org.au/brochures2/mercury.htm

This document is intended to give the reader a quick overview of the flaws in the statements made by the Australian Dental Association about dental amalgam. Italicized text is the statement made by the Australian Dental Association in their publication called THE TRUTH ABOUT MERCURY. (internet web site: http://www.ada.org.au/brochures2/mercury.htm) It is hoped that the Australian Dental Association will correct the inaccuracies in its statement.

Australian Dental Association write:

What are amalgam fillings made of?

Dental amalgam is an alloy of a number of metals, mainly silver, tin and mercury.

Robert Gammal's Response:

The word 'amalgam' means a mixture of a metal with mercury.

Dental amalgam is NOT an alloy. It is a MIXTURE of an alloy with mercury. The alloy is usually composed of silver, tin, zinc and copper. The alloy is powdered and then mixed in the dental surgery with an equal amount of mercury.

Mercury constitutes about 50% of set amalgam.

Australian Dental Association write:

Is it true that mercury leaks out of fillings?

Advances in testing equipment over the past few years have enabled us to detect very small amounts of mercury released from fillings, especially when fillings are polished or removed.

Robert Gammal's Response:

The World Health Organisation in 1991 (Criteria 118), determined that dental amalgam was the greatest source of mercury to the general population - up to ten times greater than all other sources combined. They also determined that there is NO lower level of mercury vapour at which health effects do not occur.

Although small amounts of mercury are released from amalgam, it is misleading to suggest that this is only at times of polishing and removal of amalgam. Mercury is released all of the time. Most mercury is released from amalgam at the time of insertion of the amalgam into the tooth when it is still soft and unset.

Mercury release is increased by increasing friction (eg chewing gum & grinding teeth), temperature (hot food and drinks) and increased electrical currents (combining amalgam and other metals such as gold in the same mouth creates a battery)

This increased elevation in the release of mercury after stimulation will remain elevated for about 90 minutes.

The use of the term "small amounts", implies no danger. This is quite deceptive as the toxicity of the material determines the danger level. According the US Govt. (ATSDR), mercury is the third most toxic substance known to mankind after arsenic and lead.

Mercury, although released in small amounts, is in fact stored in the tissues and is a known cumulative poison. Mercury from dental amalgam can be found throughout the body and is principally stored in the Brain, Kidney and Liver.

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Australian Dental Association write:

Is this mercury harmful?

Medical research organizations including the American Food and Drug Administration, the Swedish Medical Research Council and our own National Health and Medical Research Council say that there is no scientific evidence that these tiny amounts of mercury released from dental fillings are a danger to health, apart from those rare cases where some individuals are unusually sensitive to this material. A number of overseas studies indicate there is no increased health risk or shortening of life between groups of people with amalgam fillings and those with none.

Robert Gammal's Response:

This statement is misleading and inaccurate.

1. The Australian National Health and Medical Research Council on the 22nd March 1999 advised that " it would be prudent to avoid placement and replacement of dental amalgam fillings in certain population sub-groups such as pregnant women, children and people with kidney disease." One must now ask, if certain groups are in danger of serious health effects from the mercury from amalgam, than who is it safe for?

2. Again the reference to tiny amounts of mercury are deceptive.

3. Although these organizations may have said that there is no scientific evidence of danger to health all one need do is search Medline to find that mercury in any concentration is a danger to health. It is Neurotoxic, embryotoxic, mutagenic, and cytotoxic in minute amounts. Research now demonstrates that minute amounts of mercury in the brain will cause neurofibrilar tangles which are identical to those found in the brains of Alzheimer's Disease patients.  A faster search is to look at what the manufacturers say about their own material.

4. The study which the Australian Dental Association quote to demonstrate similar morbidity and mortality figures, have in the past been dubbed as "statistically insignificant" by Prof. Lars Frieberg, who at the time was the head of toxicology for the World Health Organisation.

5. The statement "rare cases where some individuals are unusually sensitive to this material" is again misleading and inaccurate. See below

Australian Dental Association write:

Is it true that mercury is in our diet?

Yes. A normal balanced diet contains amount of mercury and we also come into contact with it in our environment and in a number of other products. Sources of mercury in the environment include: industrial processes, batteries, deodorants, nasal sprays and even some vaccines such as flu vaccine.

Robert Gammal's Response:

SO WHAT!  Just because there is mercury in the diet does not make the mercury safe nor does it justify a health care profession implanting the stuff into people's heads every day of the year.  Just because it is found in 'nature' also does not make it safe.  Fluoride, uranium, cadmium and many other materials are also found in nature and also are not safe.

The Australian Dental Association's statement is blatantly mischievous and must surely be a poor advertisement for vaccination! Dental amalgam is the greatest source of mercury to the general population. (WHO Criteria 118). The figures speak for themselves.  Criteria 118 states that the general population ingest mercury from the following sources on an average daily intake;

• Air and Water             0mcg/day
• Other Foods               0.3mcg/day
• Fish and Sea food       2.3mcg/day
• Dental Amalgam          3 - 17mcg/day
• The figure for dental amalgam was revised in 2003 and raised to 27mcg/day

All over-the-counter medicaments, which contain far less than 50% mercury, have now been taken off the United States market by instruction from the FDA.  This does not include some vaccines.

There is absolutely NO health benefit from mercury in our diet. To approach this topic with such a blasé attitude is both unethical, unscientific and dangerous. Perhaps the Australian Dental Association suggests that we are safe to eat fish which is contaminated with mercury.

Australian Dental Association write:

Can you be allergic to the mercury in amalgam?

This is extremely rare. Only 46 cases have been reported throughout the world since 1905. If you are worried, ask your doctor to refer you to a specialist for tests to check if you are allergic. If so, your dentist can use another type of filling for you. Alternatives exist but some can be rather expensive.

Robert Gammal's Response:

In the past the Australian Dental Association have said that less than 1% of the population are allergic to mercury. After being unable to produce a single scientific paper to support this claim, they are now saying "those rare cases where some individuals are unusually sensitive to this material".

Unfortunately the scientific research does not agree. The latest research found that 13% of the population show true allergy to mercury and dental amalgam. Assuming that in Australia only half of the population has amalgam in their mouths, this equates to 700,000 people who are sick as a direct influence of an allergic reaction to amalgam. This does not include the other devastating effects on the immune system, or effects on health, which are independent of the immune system. This number of people who are effected by mercury from amalgam is NOT an insignificant number.  Their comment that the alternatives are expensive is an insult to your choice of health or dollars.  The alternatives are a bargain compared to the disease states caused by the mercury from amalgam.

Australian Dental Association write:

Is it true that Sweden has banned amalgam?

The Swedish Medical Research Council has confirmed the safety of dental amalgam fillings. Sweden has not "banned" amalgam but, because of concerns about a number of chemicals, including mercury, in the environment from a number of sources - not just fillings, they have recommended the phasing out of amalgam over the next few years, provided suitable alternatives can be used.

Robert Gammal's Response:

This statement is again inaccurate and misleading.

1. Although Sweden has not 'banned' the use of amalgam the Swedish government have taken other steps to stop amalgam being placed in their citizens. In their proposition to Parliament on Reformed dental compensation, of 12th March 1998, however, the Government (Social Department) proposes better general compensation for the patients, and also states: " No financial compensation will be given for the placement of amalgam fillings. The compensation for amalgam fillings is abolished. The aim is a total ban of the use of dental amalgam in approximately two years." The changes came into force 1st January 1999.  Sweden has now banned the use of amalgam as have many other countries

2. It is incredible that the Australian Dental Association continue to separate the environment out side of the body to that inside the body. How can mercury from amalgam be dangerous to the external environment and be harmless inside the body. It is important to understand that a filling is really an implant into living tissue.  Perhaps the ADA lives in a world that no one else shares.

Australian Dental Association write:

Should I have my dental amalgam fillings removed?

Unless you are one of those rare individuals who is particularly sensitive to dental amalgam, you will not improve your dental health by having these fillings replaced. Australia's specialist doctors and Health authorities have warned the public that there is no justification for believing that this will cure a range of serious illnesses.

Robert Gammal's Response:

Some of Australia's leading medical experts have claimed safety for amalgam and others have claimed serious health consequences from mercury. Although claiming that amalgam is safe they have not yet been able to present one peer reviewed scientific paper to support their position.

Solid peer reviewed scientific papers have demonstrated that the removal of amalgam leads to a significant reduction in the body's mercury burden. Removal of amalgam is like turning off the taps. All that is happening is that the greatest source of mercury is being removed from the person's body. The reduction in the mercury burden, which follows, may or may not allow improvements to health. No claims have ever been made that mercury from amalgam causes a specific disease. In fact it causes mercury poisoning which presents with many different clinical symptoms. One need only to refer to the Caulk Co.'s Material Safety Data Sheet supplied with its product Dispersalloy, to see the variety of these symptoms.

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