Is there an ongoing controversy surrounding amalgam/mercury/silver fillings?
Yes, there is, and this controversy predates the founding of the American Dental Association (ADA) back in the 1800s. The ADA continues to stand by its affirmation that mercury fillings are 100% safe for use in the human mouth. The material is, however, classified as a controlled / restricted material both before putting it into your mouth and after it is taken out of your mouth. In fact, the EPA regulates dental mercury waste as a “hazardous material” and imposes serious fines if not properly handled. The ADA has recently changed their previous stance that no mercury evaporates (off gasses) from the mercury / amalgam fillings once they are safely placed in the mouth of the patient. The ADA current stance is that minute amounts of mercury vapor do indeed escape from the mercury fillings, but that the amount is so small it poses no negative health risk. Under substantial pressure as a result of a 2006 lawsuit, the FDA has also recently changed its stance regarding mercury fillings. It now cautions the use of mercury / amalgam filling usage in pregnant / breast-feeding women, children, and those who have a higher risk of mercury poisoning.
It is our position that if there is any question as to a dental material possibly having a significant negative impact on a person’s health, we should avoid using that material until all questions have been satisfactorily answered. Patients often come to us requesting that they have their mercury / amalgam fillings removed and replaced with non-metal, tooth-colored materials. We offer these procedures as requested by a patient or as necessary when decay is present in an already existing mercury / amalgam filling.
Toxicity of Metals in Dentistry:
Fundamental studies on biological effects of dental metals–nickel dissolution, toxicity and distribution in cultured cells
Epithelium-fibroblast co-culture for assessing mucosal irritancy of metals used in dentistry
Toxicity of metal ions used in dental alloys: a study in the yeast Saccharomyces cerevisiae.
Adverse Health Effects of Palladium
What precautions do you take when removing amalgam/mercury/silver fillings?
We feel it is very important to safeguard everyone involved, The ADA has indicated that mercury vapor continuously evaporates from silver / amalgam fillings, and we know that drilling on these fillings can release even greater amounts of mercury vapor and particles. We have implemented IAOMT (International Academy of Oral Medicine and toxicology), www.IAOMT.org, recommended protocols to protect patients and staff members when working on teeth containing amalgam/mercury/silver fillings, and are constantly seeking additional ways to improve our protocols.
Currently we utilize the following precautions: rubber dam application, high power vacuum suctions – one over the tooth and one over the patient, continuous water irrigation over the surgical area, nose mask (to deliver fresh, clean air to the patient for breathing), and room air filters. Our practice also uses mercury separators to protect the environment’s water supply.
What materials do you use instead of amalgam/mercury/silver?
Short answer: “non-metal,” tooth colored filling materials.
Long answer: it is a chemically bonded (glued), light cured (hardened), glass composite resin (tooth colored) filling material that may contain slight amounts of metal oxides so they are visible on x-rays. There are many different types of this material. We use products that we believe to be the most hypo-allergenic for the greatest number of people and last the longest – best for the most people. If a patient is extremely chemically / environmentally sensitive, they may choose to utilize a compatibility test to determine which material their body would have the best reaction to.
Amalgam / Mercury / Silver Filling Replacement:
If you choose to have your amalgam replaced we will provide this service using the safety precautions consistent with recommendations of the IAOMT. However, we would never recommend to any patient that they replace their amalgam fillings. As a patient, this is your decision to make, and yours alone. In addition to the safety precautions, we do all we can to structurally strengthen the tooth. The new resin composite restoration, helps to avoid future cracks and fractures. In some cases, when a great deal of tooth structure has been lost, we will recommend a ceramic / porcelain on-lay or crown.
The beneficial effect of amalgam replacement on health in patients with autoimmunity.
Neuro Endocrinol Lett. 2004 Jun;25(3):211-8.
The Institute of Dental Research 1st Medical Faculty Charles University and General University Hospital, Prague, Czech Republic. firstname.lastname@example.org
Patients with certain autoimmune and allergic diseases, such as systemic lupus, multiple sclerosis, autoimmune thyroiditis or atopic eczema, often show increased lymphocyte stimulation by low doses of inorganic mercury in vitro. The patients often report clinical metal hypersensitivity, especially to nickel.
OBJECTIVE AND METHODS:
In this study we examined the health impact of amalgam replacement in mercury-allergic patients with autoimmunity. The suitability of MELISA, an optimized lymphocyte stimulation test, for the selection of susceptible patients and monitoring of sensitization was also examined. Amalgam fillings were replaced with composites and ceramic materials. Follow-up health status and lymphocyte reactivity were assessed and evaluated half a year or later following amalgam removal.
Results of lymphocyte reactivity measured with MELISA indicate that in vitro reactivity after the replacement of dental amalgam decreased significantly to inorganic mercury, silver, organic mercury and lead. Out of 35 patients, 25 patients (71%) showed improvement of health. The remaining patients exhibited either unchanged health (6 patients, 17%) or worsening of symptoms (4 patients, 11%). The highest rate of improvement was observed in patients with multiple sclerosis, the lowest rate was noted in patients with eczema. The initial mercury-specific lymphocyte reactivity was significantly higher in the responder group, than in the non-responders, whose health was not improved by amalgam removal. All patients with health improvement after amalgam replacement showed reduced proliferation to inorganic mercury in follow-up MELISA. In vitro responses to phenylmercury and nickel did not differ between the groups.
Mercury-containing amalgam may be an important risk factor for patients with autoimmune diseases.