Amalgam, Mercury & the Developing Brain

One argument you hear some dentists make in defense of amalgam is that it’s a sturdier, stronger and more forgiving material to work with. They may point to studies such as the one recently published in the European Journal of Paediatric Dentistry, which found that amalgam fillings were less prone to failure than composite (by a little) or glass ionomer (by a lot).

But to focus on this issue completely sidesteps the fact that amalgam is 50% mercury. And that mercury is a known neurotoxin, with no safe level of exposure. And that mercury vapor is constantly released from these fillings only to be methylated in the mouth and elsewhere in the body. And that this is happening mere inches from the brain.

Now consider that the human brain is not fully developed until a person is in their mid-20s. Does it seem wise to put this material into the mouths of children or even teens?

human brain development

Heavy metal toxicity, notes DAMS, has been linked to a many neurological and behavioral problems in children, including:

  • Depression.
  • Anxiety.
  • Obsessive/compulsive disorders.
  • Mood disorders.
  • Schizophrenia.
  • Cognitive impairments.
  • ADHD.
  • Autism.
  • Seizures.

A 2014 study in the Journal of Toxicological Sciences looked at the relationship between neurobehavioral changes and changes of gene expression in response to a variety of mercury exposures. “Since the developing brain is extremely vulnerable to mercury toxicity,” wrote the researchers, “the repeated exposure of fetuses and neonates to Hg0 affects neurobehavioral functions.”

The results of the present study also indicate that an increase in the number of altered genes in the brain may be involved in the emergence of neurobehavioral effects, which may be associated with the concentration of mercury in the brain. An increase in the number of genes with altered expression levels implies that changes have occurred in the internal environment of the brain, which may be closely associated with the emergence of neurotoxicity.

A 2011 study in the Current Problems in Pediatric and Adolescent Health Care explains that chronic mercury exposure is problematic at any growth stage.

Because important systems are still differentiating and growing, children have unique susceptibilities not seen in adults—and critical time windows for those susceptibilities. The critical times are preconception, gestation, and postnatal. More than 1 system can be susceptible and different pathology may occur depending on the dose and timing of exposure. The fetus and infant are especially vulnerable to mercury exposures. Of special interest is the development of the central nervous system. With the formation of neuronal cells and the subsequent stages of development, the central nervous system is created. Damage of the nervous system caused by mercury is likely to be permanent. Neurotoxic effects can result from prenatal or early postnatal exposure.

Mercury from amalgam fillings is just one of the largest sources of exposure. Even if the child never has such fillings, they – like all of us – are still affected by mercury pollution from dental offices (mercury entering the water supply) and crematorium emissions. This is above and beyond other industrial pollution and mercury in seafood.

Is it any wonder rates of childhood neurological conditions have skyrocketed?

Fortunately, there are safe and durable alternatives to amalgam when fillings are called for. And there’s an even better alternative to those: a truly comprehensive preventive approach so that fillings are never needed at all.

Dental Mercury Amalgam: The Saga Continues

In Woodstock, Georgia, a whole neighborhood was put on alert recently, after as much as a pint of mercury was discovered in the basement of a home there.

A pint of mercury?!

“They couldn’t tell me where it came from. They said they’ve had it for a long time, a number of years,” EPA coordinator Stephen Ball said. “Some teens were at the house and discovered the mercury and accidentally spilled it.”

One of the teens attends Ace Academy in Canton, and someone at school noticed mercury in the teen’s hair.

The school tested negative for mercury contamination. Not so the home. Others in the area were being tested as this story hit the air late last month.

hgThe EPA took this seriously because mercury is serious business. There is no known “safe” level of exposure. A potent neurotoxin, mercury has been linked to a broad range of environmental and human health concerns, including autoimmune disorders, neurological disorders, cardiovascular problems and “enigmatic” conditions such as CFS, MCS and fibromyalgia.

Of course, a jar full of mercury isn’t the most usual source of exposure for most people. That would be so-called “silver” amalgams, which are actually about 50% mercury. For those with multiple amalgam fillings, up to 90% of their total mercury exposure may come from what’s packed in their teeth.

Despite the known risks and abundant research showing the hazard mercury amalgam presents to human health, agencies like the FDA and organizations like the ADA continue to insist that amalgam is “safe.” In fact, the FDA reinforced the point earlier this year:

After another of its customary multi-year stalls on politically fraught issues, FDA in January substantially denied three five-year-old petitions seeking to rid American dentistry of mercury-based dental amalgams that have been scientifically linked to kidney damage and neurological disabilities and diseases like multiple sclerosis and Alzheimer’s.
The link is especially strong in children, neonates, and placental transfer to fetuses, and comes primarily from chewing with amalgam-filled teeth and, to a lesser degree, from eating fish.

Throughout patients’ lifetimes, these fillings release mercury vapor that is absorbed through the lungs and oral mucosa, according to studies submitted with the petitions—documentation FDA essentially dismisses as “not new.”

As it did in 2009 when it classified amalgam as Class II (safe and effective), FDA in January again defied the statutory approval standard for medical devices and drugs—production by manufacturers of substantial clinical evidence of safety and effectiveness.

Instead, the agency again stood by its unseen political directors, who in turn harken to the third-biggest-spending health professionals’ lobby, the strongly pro-amalgam American Dental Association. The association, in turn, answers to the estimated 30% of practicing dentists who still use amalgam because it is cheaper and easier than safer substitutes and who reasonably fear liability lawsuits from amalgam’s ill effects.

Sound familiar?

There is one positive in this, though, as the agency did agree to some changes to their amalgam webpage that make it clearer that amalgam contains mercury and acknowledge at least some health concerns.

It’s something, but as one of the attorneys involved noted, it’s not enough.

The agency, he said, “continues to allow the American people to be poisoned by their mercury fillings despite the scientifically demonstrated risks. Despite the shift of many countries away from mercury fillings, it appears that the FDA believes that the human mouth is a safe place to store mercury.”

New EPA Rule Aims to Keep Dental Mercury Out of the Environment

no dental mercury amalgamReady for some good news?

At long last, the EPA has proposed its rule to limit mercury discharges from dental offices. The agency estimates that it will prevent 8.8 tons of metal – half of which is mercury – from from polluting our water supply.

This is a very big deal, for there are about 160,000 dentists in the US who either use or remove amalgam, “almost all of whom discharge their wastewater exclusively to [Publicly Owned Treatment Works].”

Studies show about half the mercury that enters Publicly Owned Treatment Works (POTWs) comes from dental offices. Mercury from amalgam can then make its way into the environment in a number of ways, including through discharge to water bodies. Contact with some microorganisms can help create methylmercury, a highly toxic form of mercury that builds up in fish, shellfish and fish-eating animals.

That would include us. It’s one way those of us who never get a so-called “silver” filling are affected by dental mercury, as well. By reducing mercury discharges, we all win.

So how does the EPA propose we put an end to this pollution? Dentists would be required to use amalgam separators, a technology that catches and traps the mercury before it goes down the drain. (Of course, if it’s still being put in your teeth…) Twelve states already mandate them. We’ve used them in our office for years.

“This is a common sense rule that calls for capturing mercury at a relatively low cost before it is dispersed into the POTW,” said Kenneth J. Kopocis, deputy assistant administrator for EPA’s Office of Water. “The rule would strengthen human health protection by requiring removals based on the use of a technology and practices that approximately 40 percent of dentists across the country already employ thanks to the ADA and our state and local partners.”

Even so, we still have a lot of work to do to create a mercury-free future. Even with the new rule, mercury amalgams will still exist. Untold numbers are already in the mouths of patients. Some dentists continue to place them. Some patients still agree to them.

More, as Charlie Brown of Consumers for Dental Choice notes,

Separators cannot stop dental mercury from reaching the environment via other pathways, such as the cremation of human bodies containing amalgam. So what’s the best way to stop dental mercury pollution? Stop using mercury amalgam dental fillings.

If you haven’t already done so, sign the Consumer for Dental Choice’s petition that calls on Secretary of State John Kerry to help bring the FDA in line with State Department policy now that the US has signed the global mercury treaty known as the Minamata Convention. Please take a moment to sign and share it through social media or email. The petition is available here.

When It Comes to Fillings, “Silver” Is Not So Much Silver

A silver filling sounds a little like a piece of bling put in your mouth, right? But a more truthful name for it is “mercury filling.” The amalgam – a mixture of metals – such fillings are made of is actually about 50% mercury, a known neurotoxin.

Despite the dangers, false labeling and euphemistic language have made it possible for dental patients to be put at risk unawares. This month, a new Zogby poll for Consumers for Dental Choice reported that 57% of Americans do not know that mercury is the main ingredient in amalgams. This isn’t so surprising when you consider that only 11% said their dentist had informed them about what their “silver” fillings would be made of.

Think about it: 89% of people were not granted the right of informed consent – the right to say yea or nay to a particular treatment once they are explained its risks and benefits.

And it gets worse. Americans making under $50,000/year are three times less likely to be told by their dentist that their amalgam fillings contain mercury. And a miniscule 6% of African-Americans report getting this critical information.

mercury amalgam fillings in molarsWomen are also less likely to be informed than men – a fact which has some scary implications. For women of childbearing age, it’s not just her own health that’s at stake but that of any children she may conceive once the fillings have been placed. Children may experience tremors, vision and hearing impairments, developmental delays, autism… the list goes on.

Decisions about your health or your child’s health shouldn’t just be handed over to your dentist, however educated and well-intentioned he or she may be. You deserve to have all the information possible before you make a decision.

Unfortunately, the report found that 63% of patients do not believe that their dentists give them enough information about alternative restorative materials such as composite.

The American Dental Association (ADA) and the FDA do not require dentists to talk to their patients about mercury, so dentists do not have legal incentives to make mercury dangers well-known. Moreover,

The FDA’s willingness to allow the dental industry to use the term “silver fillings” and blatantly misrepresent a product that’s primarily mercury has measurably misled Americans. As a policy, it flies in the face of one of the agency’s primary reasons for being: to protect consumers by preventing companies from misbranding and mislabeling heath care products.

Because of this, 55% of Americans would like to see governmental legislation that would require dentists to inform their patients.

For now, you often have to educate yourself. A few excellent sources of information on the health effects of mercury amalgam fillings:

TAKE ACTION!: Consumers for Dental Choice has launched a petition drive to get Secretary of State John Kerry to help bring the FDA in line with State Department policy since the US signed the global mercury treaty known as the Minamata Convention. Please take a moment to sign and share it through social media or email. The petition is available here.

Image by Enzo Carretta

Reducing Toxins in the Dental Office

Mercury is the key ingredient in so-called “silver” amalgam fillings and a known neurotoxin. Despite that, about 75% of all new fillings are made of the stuff, as the ADA continues to insist that it’s perfectly safe. Evidence, however, shows that mercury from dental amalgam may play a role in numerous neurological, endocrine and autoimmune disorders.

This isn’t just a concern for patients. Dental workers are at risk, as well.

1385682_846092542070992_3574722680187190476_nYes, dentists – who, every day, with every patient, year after year, can be exposed to an incredible variety of toxins, ranging from bacteria and other pathogenic (disease-causing) microbes to x-ray radiation, toxic chemicals and heavy metals.

Due to constant exposures to mercury – as well as radiation and chemicals – research has found that dentists have a higher-than-average risk of some cancers (brain, skin and reproductive). Other studies have shown higher rates of suicide and divorce among dentists. Could those be fueled by mercury, as well? Notable symptoms of what was historically called Mad Hatter’s Disease – a condition caused by hat-makers’ prolonged exposure to the mercury used in their trade – include mental confusion, emotional disturbances, pathological shyness and irritability.

There are many potential points of mercury exposure in a conventional dental office, putting both patients and dental workers alike at risk.

Amalgam comes in measured capsules that have to be shaken, then broken into a dappen dish. Inevitably, no matter how carefully it’s done, some is bound to spill. Without proper precautions, some of this will contaminate the air and some may enter the office plumbing and its journey through waste water into the environment. There are waste capsules and scrap amalgam to deal with. If existing amalgams are removed, both mercury vapor and particulate are released.

Imagine working in that environment all day, every day.

It’s why practices like ours go to such lengths to practice mercury-safe dentistry, doing all we can to minimize exposure. You can learn more about proper safety measures here, here and here.

As mentioned, radiation is another major threat to dental workers’ health. While there are standard safety regulations to minimize exposure – the Texas guidelines run over a 100 pages – the fact remains that older equipment used for making x-rays on film emits much more radiation than newer, digital machines. Some have estimated the difference in exposure to be as much as 90% less in digital. Older equipment is also more prone to leakage, providing an even bigger dose of radiation to the dentist and office staff.

Another benefit of digital over film: As we noted before, going digital means we don’t have to keep harsh, noxious chemicals in the office for processing the images. And when we do take images, it’s only when required for proper diagnosis or evaluation of a condition. We believe the risks of radiation are enough that x-rays should never be “routine.”

After all, the most fundamental concept in the healing arts is to first, do no harm…

“Mercury-Free” vs. “Mercury-Safe”

Dr. Tom McGuire on the difference between “mercury-free” and “mercury-safe” dentistry:

Strictly speaking, the term “Mercury Free” refers to dentists who do not put amalgam fillings in their patients’ teeth. This term was first used over 40 years ago by dentists who wanted to distinguish themselves from other dentists who believed that mercury amalgams were safe and continued to use them.

However, the term Mercury Free wasn’t a truly accurate description because even dentists who didn’t put in amalgam fillings still had to remove them – and the removal process released excessive and unnecessary amounts of toxic mercury vapor. But while being Mercury Free was a good beginning – it solved only part of the problem.

Over time, dentists who were Mercury Free developed protocols and equipment that allowed them to dramatically minimize a patient’s exposure to mercury during the amalgam removal process. In effect, using these protocols meant that their practices were not just Mercury (amalgam) Free – but also were now Mercury Safe – yet they erroneously continued to only use the term Mercury Free to describe themselves. But times have changed and the term “Mercury Free” is not only inadequate but confusing and misleading!

Today it is no longer enough for a dentist who is both Mercury (amalgam) Free and Mercury Safe to just promote his or her practice as being Mercury Free. Why? Recently a survey showed that 52% of general dentists no longer use amalgam and call themselves Mercury Free. But, and this is important for every dental patient to know; not because they were concerned about safely removing them – but mainly because they no longer felt amalgam was a good filling material when compared to the newer composite fillings.

This of course has created a dilemma for patients who believed that dentists who said they were Mercury (amalgam) Free meant they also used protocols to safely remove amalgam fillings. But patients are catching on and now look for dentists who will safely remove their amalgam fillings and now ask this question of the dentist: “Are you both Mercury Free and Mercury Safe?” Bottom line . . . you can’t assume that a dentist who advertises his or her practice as being Mercury – amalgam – Free, is also Mercury Safe – unless you ask!


Safer Amalgam Removal



Did Dental Work Cause Your Disease?

Dr. Hal Huggins was one of the first and most vocal proponents for mercury-free, mercury-safe dentistry in the United States and continues to be a leading figure in identifying toxic dental materials, balancing body chemistry and developing a multi-disciplined approach to reversing autoimmune diseases.

In the series of videos below, Dr. Huggins discusses the impact various dental situations can have on whole body health. It’s a must-see for anyone who has ever wondered whether their complex, chronic health problems may have been aggravated by mercury amalgam fillings or other dental sources of toxins.


Not Just Mercury-Free Dentistry, Mercury-Safe

hg_wasteEarly last month, the global mercury treaty was officially signed in Minimata, Japan.

This treaty sets standards specifically designed to protect the environment, including provisions for a phase-down of dental mercury – the main ingredient in “silver” amalgam fillings.

But it doesn’t call for a phase-out, even as half of all mercury pollution can be traced to the dental industry. Some of that is waste improperly disposed of by dental offices. Some is excreted by people. As DAMS executive director Leo Cashman notes in a powerful critique of the treaty,

Between 300 and 400 tons of mercury are used globally in dental amalgam mercury fillings per year. Whether the mercury from dental amalgams accumulates in a person’s body or gets excreted into a toilet and out into the sewage treatment system, dental mercury is going to cause problems somewhere. A treaty that doesn’t deal with the dental amalgam mercury problem in a firm way is an environmental and a health failure.

While a true end to the use of dental mercury worldwide remains elusive, there are practices committed to being not only mercury-free but mercury-safe. That includes our own.

Just one amalgam filling releases as much as 15 micrograms of mercury each and every day. That may not sound like much, but keep in mind that there is no recognized safe level of this potent neurotoxin.

When a person chews, drinks, swallows and breathes, mercury released from dental fillings is absorbed by the lungs and the linings of the digestive system into the bloodstream. As they corrode, mercury fillings release ionized mercury into the saliva, tooth pulp, and gum tissues leading to the digestive system and bloodstream.

In general, some people can tolerate amalgam fillings for a long time; others cannot. If you have amalgam fillings and are experiencing symptoms of mercury exposure – including but not limited to tiredness, anxiety, headaches, and memory loss – you should make an appointment with a qualified biological dentist to be evaluated.

Some have reported significant health improvements upon mercury removal and thorough, supervised detox. However, it is critical that, should you choose to have your amalgams removed, the removal be done safely. If proper protocols are not followed, much greater mercury exposure can occur.

That’s why mercury-free is not enough. Mercury-safe matters – for the health of the patient, the dentist, office staff and the planet.

For starters, good air filters in the operatory are a must. The patient will also be protected by

  • A disposable gown and cap.
  • Covering for eyes and face.
  • An oxygen mask over their nose.

The dentist and dental staff will take similar precautions, wearing filtration masks and disposable clothing, including gloves.

The dentist will then use a rubber dam – essentially a square of rubber or silicone – to isolate the operation area so the filling can be removed in small chunks with use of a drill. The dental dam, along with the use of suction devices and copious amounts of water, helps make sure that the patient does not breathe, swallow or ingest the mercury particles.

A recent study in the Journal of Occupational Method and Toxicology demonstrated just how crucial water and suction are. It found that when both were used, mercury vapor levels were about 4.0 to 19.0 μg/m3. When neither was used, levels jumped as high as 796 μg/m3 – and even higher than that when only suction was used.

Here at Pride Dental, we are committed to improving your health by being both mercury-free and mercury-safe. Along with other conscientious dentists who, every day, follow the IAOMT’s protocols for the safe removal of mercury amalgams, we put the safety of our patients, staff and the environment at the forefront of our mission.


Learn more about IAOMT protocols for safe mercury removal

Learn more about the difference between mercury-free and mercury-safe dentistry

Image via IAOMT

“Silver” Amalgam Fillings Raise Mercury Levels

So called “silver” amalgam fillings are a primary source of mercury exposure – a fact borne out by research just published in the Journal of Occupational Medicine and Toxicology.

Canadian researchers analyzed the relationship between the number of dental amalgam surfaces and urinary mercury levels using data from a large philanthropic chronic disease prevention program in Calgary, Alberta.

The study group included 2,137 people who agreed to have a urinary analysis to determine their mercury levels from September 2010 through February 2013.

Those with amalgam fillings had higher levels of mercury, both under normal conditions and when given DMPS and DMSA (substances that move mercury out of bodily tissues). According to the authors,

Our estimates indicate that an individual with seven or more dental amalgam surfaces has 30% to 50% higher urinary mercury levels than an individual without amalgams. This is consistent with past literature that has identified seven amalgam surfaces as an unsafe level of exposure to mercury vapor. Our analysis suggests that continued use of silver amalgam dental fillings for restorative dentistry is a non-negligible, unnecessary source of mercury exposure considering the availability of composite resin alternatives. [emphasis added]

Could the point be made any more clearly?

You can download a free provisional version of the complete paper here.

You might wonder: How did we get to this situation in the first place, thinking nothing of putting a known neurotoxin in people’s teeth? A quick history of mercury fillings:

Clouding the Mercury Issue with BPA

bpa_freeThere are stickers on plastic bottles, plastic cups, and other dishes that proudly proclaim, “No BPA.” Sometimes, it’s even stamped into the bottom of the dish.

If you’re a parent or have bought products for young people, you’re probably well aware of the message. You probably look for it! And if you pick up a plastic something without this stamp of approval, you put it back without a second thought.

Why? Bisphenol A – famously known as BPA – is a chemical that’s been used in hard plastics and metal containers for over 50 years. It’s also harmful. It gets into our bodies and is linked with developmental, behavioral and reproductive problems in youth, and to cancers in everyone. Most recently, it’s been linked to childhood obesity, insulin resistance and an increased risk developing asthma, and noted as a possible cause of undescended testicles.

Because of its risks, you’d be hard-pressed to find a baby’s bottle made from the noxious chemical anymore. As of last summer (July 17, 2012, to be exact), the FDA banned its use in all baby bottles and sippy cups. It’s still around in plenty of other products, though – including some dental materials.

Specifically, it can be found in some brands of composite resin, which is used both as a sealant and filling material. Consequently, you sometimes hear pro-amalgam dentists offer this as a reason to stick with mercury – a known neurotoxin. (So-called “silver” amalgam fillings are actually 50% mercury.)

So is it really a matter of choosing the lesser of two evils?

Not once you recognize one very simple fact: All amalgam contains mercury; not all resins contain BPA.

Avoiding the use of potentially hazardous materials is one of the hallmarks of biological dentistry. Instead of just using whatever is cheapest or most convenient or easiest to work with, we make a point of choosing only biocompatible materials. By its very nature, BPA is not biocompatible – just as mercury is not biocompatible.

hg_compBPA-free resins have other advantages beyond their being nontoxic. For one, they look better, being tooth-colored and metal-free. Composite fillings also protect the natural integrity of the original tooth because less drilling is needed to prepare it for restoration. Adding strength is the fact that these fillings bond to the teeth.

Even so, some will continue to argue for amalgam because they’re cheaper – and because they’re much less technique-sensitive than composite, a dentist can place them faster, seeing more patients in a workday.

But are they really that much cheaper? Not once you factor in all costs. According to the paper “The Real Cost of Dental Mercury,” once you account for the cost of keeping mercury out of the environment and the benefits to health and society from using nontoxic alternatives, those “cheap” amalgam fillings actually cost anywhere from $60 to $128 more per tooth than “expensive” composite.

Clearly, adverse effects on the environment and society over the whole life cycle of dental amalgam – mercury production, preparation of filling materials, removal of old fillings and placement of new ones, environmental and health impacts from mercury recycling, discharges to wastewater, solid waste disposal, emissions from crematoria and releases from cemeteries – can only be sustainably avoided by phasing out amalgam as a dental restorative material and switching to mercury-free alternatives. Since high quality and cost-effective alternatives – including composites, glass ionomers and “compomers” – are readily available. . .dental amalgam should be phased out.

Dentists who champion amalgam fillings by raising the specter of BPA are, in the words of Dr. Michael D. Flemming, “confusing safety with effectiveness.” Such arguments, he adds, “only serve to further cloud the issues and hamper the development of a comprehensible policy on amalgam use.”

If you need to have a tooth filled, talk to your provider about the best options for you. Of course, the best thing to do is avoid cavities in the first place by maintaining good oral health by regular brushing and flossing and eating whole foods that promote overall health.

BPA label image by Mark Morgan, via Flickr