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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