Dental Mercury Exposure Q&A

Questions & Answers
Dental Amalgams & Mercury Exposure

What is Mercury? Is it toxic?
Mercury is a naturally occurring liquid heavy metal at room temperature.
The elemental symbol for mercury is Hg.
Mercury exists in three forms:

1. metallic, or pure mercury (example: thermometers)
2. inorganic mercury which is composed of a compound of one or more other elements with mercury (example: dental amalgam and mercuric chloride used in disinfectants and pesticides)
3. organic mercury which is a type of mercury formed by microorganisms (example: methyl mercury found in some fish)

All forms of mercury are very toxic. In fact, it is the most toxic natural occurring non-radioactive substance on earth!

How can I be exposed to Mercury?
Your mercury exposure can be categorized into three types:

1. by handling or touching
2. by ingesting or swallowing
3. by inhaling or breathing

What is dental amalgam?
Dental amalgam is a mixture of 50% metallic mercury, 35% silver, 9% tin, 6% copper and trace amounts of zinc. When amalgam is initially mixed, it is soft and pliable enabling it to be placed and condensed into the hole or preparation of the tooth after the removal of decay.

Why is dental amalgam used?
The American Dental Association (ADA) and the Food and Drug Administration (FDA) endorse the use of dental amalgam because of its low cost, ease of placement, strength, durability and because mercury is bacteriostatic.

What factors contribute to the seriousness of my exposure to Mercury?
There are many factors to consider regarding your mercury exposure. (See above, “What is Mercury” for an explanation of the three mercury forms.) Factors include the form of the mercury, the route or type of exposure, the amount of exposure, the duration of the exposure, your age, your sex, your health condition or status at the time of exposure, your genetics, and your diet.

With respect to dental amalgam, 80% of mercury vapor inhaled from amalgam fillings enters your bloodstream and is distributed to your organs and brain. When exposed through ingestion, however, this systemic distribution occurs at a lower rate of 10-40%.

What is the history of dental amalgam?
The first report of mercury being used to fill decayed teeth was in 7th Century China. During the middle ages, alchemists played with different concoctions of mercury with various other metals. By the 1800’s mercury and silver amalgamation was gaining acceptance throughout Europe as a low-cost alternative to gold fillings or the removal, extraction, of the tooth.

Edward Crawcour and his nephew, Moses Crawcour, brought dental amalgam to America from Europe in 1833. They used an exceedingly inferior compound and did not excavate or remove the decay from the tooth before its placement. This resulted in poor treatment outcomes thus casting dark suspicion on dental amalgam use. The controversy not only centered on poor compounding and lack of agreement or adherence to sound treatment protocols but on the health risks associated with the chief component of dental amalgam – mercury. With increased ease of handling and placement, coupled with its low cost, unqualified and/or unscrupulous practitioners arose putting financial stress on ethical professionals. The American Society of Dental Surgeons, the dental organization of the period, declared dental amalgam use to be unsafe and required its members to sign a pledge promising to abstain from its use. In dissent, a group of dentists allied in support of the use of dental amalgam – and so began the “first amalgam war.” The American Society of Dental Surgeons fell into disfavor and disbanded. The amalgam proponents further organized and convened, forming the American Dental Association (ADA) in 1859. It was during this period that dental amalgam was accepted by this newly formed ADA as a low cost, satisfactory restorative material. It is salient to point out that the ADA owned two patents on dental amalgam, although it has been reported that the organization received no royalties. A question is raised as to the possibility that the leadership or members of the ADA may have had a financial interest in the fate of dental amalgam.

In 1895, Dr. G.V. Black, the “Father of Modern Dentistry” developed the “ideal composition” of dental amalgam that is still used today with only minor modifications. The controversy did not end with its general acceptance by the ADA and most dentists.

The “second amalgam war” began in 1926 by a renowned inorganic chemist, Professor Alfred E. Stock. Contracting mercury poisoning while conducting experiments in 1923, he realized the significant health threat from mercury exposure. Following his recovery from the ill effects, he went on to publish more than 50 papers on mercury use, exposure, toxicity and poisoning – to include the grave health risks associated with dental amalgam. He firmly believed that mercury in amalgam leads to illness and its removal allows for complete recovery. Interestingly, in 1928, the ADA took over safety testing of dental amalgam from the National Bureau of Standards, a Federal agency.

The third, and what may be the final amalgam war, began in the late 1970’s and is still raging today. Mounting scientific evidence has challenged the traditional dental paradigm of the ADA that dental amalgam is safe. Numerous research investigations have demonstrated the clear threat dental amalgam poses to our health and the environment. On July 28, 2009, the Food and Drug Administration, in conjunction with the ADA, issued a “final” ruling on dental amalgam safety.1 They acknowledged the toxicity of mercury; however, they declared restorative and economic benefits outweigh inherent risks. In contrast to this ruling, the World Health Organization’s (WHO) policy paper on Mercury in health Care stated, “recent studies suggest that mercury may have no threshold below which some adverse effects do not occur.” 2 In another study WHO confirmed mercury vapor from amalgam fillings as being the greatest source of exposure in non-industrialized settings, exceeding risk standards set for food and air.3 The WHO fact sheet updated January, 2016 concludes the need to work on developing measures to “phase down” use of amalgam fillings.4

How can Mercury from my amalgam fillings enter my body?
Let us consider the “life cycle” of an amalgam filling.
All filling materials will have a life cycle:

1. filling placement
2. functional lifespan
3. filling removal and replacement due to filling failure or because it is no longer structurally sound

Risk of mercury exposure varies with each of these three life cycle points and are as follows:

1. filling placement – the amalgam filling component ingredients are first mixed and then inserted into the prepared tooth and carved or shaped while still pliable. The placement and shaping process invariably results in mercury coming into contact with mucous membranes with filling fragments falling to the back of the throat and being swallowed by the patient. Utilization of a rubber dam could be used to minimize this risk but would not be beneficial in mitigating mercury vapor risks. Higher concentrations of mercury vapor are released until the amalgam hardens or chemically sets.
2. functional lifespan – during the functional lifespan of an amalgam filling mercury vapor is continually released. This point has apparently not been fully appreciated by those who claim dental amalgams are safe. Because they believe exposure to small amounts of mercury is acceptable, they tend to discount the fact that small amounts can cumulatively build up in the organs and brain and become a significant health problem. The amount of exposure depends on the number, age, condition and the amount of abrasion the amalgam fillings experience. In most cases, the period of this exposure can be measured in decades.
3. filling removal – removal of dental amalgam is the period of greatest mercury exposure risk. To remove these fillings, a high-speed drill is employed to grind out the filling. Unless safe amalgam removal protocol is used mercury will come in contact with mucous membranes, fragments will be swallowed and mercury vapor will be inhaled.

How can dental amalgam affect my health?
Mercury can damage the brain/nervous system, lungs, liver, immune system and kidneys. It can cause a myriad of illness and disease, causing tremors, loss of sight and hearing, muscle in coordination, paralysis, sensory deficits, personality changes to include nervousness, irritability, shyness and memory problems, dementia and insomnia. It can damage the mucous membranes of the mouth; irritate the airways and lungs causing a burning sensation and cough. Other exposure effects are nausea, vomiting, diarrhea, high blood pressure, increased heart rate, cardiomyopathy and loss of kidney function. Exposure can cause developmental defects and deficits in children. Our knowledge of the etiologies and pathogenesis of many common diseases remain incomplete. Given the vast complexity of the human organism and what is known of the dauntingly complex interrelationships that exist between systems of the body, chronic exposure to mercury could plausibly lead to serious diseases that, rather than being manifest as acute symptoms, could present a much more insidious progression, such as Alzheimer’s and Parkinson’s Disease.

I have amalgam fillings which need to be removed, What do I do?
The potential for greatest exposure to mercury exists in the placement and/or removal of dental amalgams. First, it is important not to accept inherent health risks by allowing amalgam fillings to be used as a restorative. Elect to have composite, porcelain or gold placed as an alternative. Also, if you have amalgam fillings that must be removed, insist on a stringent safe amalgam removal protocol. This involves using a rubber dam, nasal oxygen hood, and drapes. If these supplies and equipment are not used, find a dentist that does use them. Your health is too important.

How does my body remove mercury?
Most of the mercury eliminated from the body is through the gastrointestinal tract. This natural action is accomplished through a process known as chelation. Chelation just means that a chemical substance binds to the mercury enabling the body to remove it. These chemical substances are sulfur-containing amino acids or combinations of linked amino acids that form proteins. Usually, these amino acids and proteins are the necessary enzymes essential for metabolism, but since they are also chelating agents, mercury exposure depletes the sulfur-containing amino acids and proteins causing nutritional deficiencies, weakened immune system and consequently disease and physical breakdown.

The most important naturally occurring chelating substance in our bodies is glutathione. The liver has the highest concentration of glutathione, but the elimination process can take place in all tissue. Essentially, the glutathione-bound mercury is excreted by the bowel through the bile. Kidneys will also excrete a small percentage and are very sensitive to mercury. It is significant to note that as glutathione-bound mercury is moved through the intestine and colon some of the gut bacteria will convert it into methylmercury, the most toxic form of mercury, which may be reabsorbed into the bloodstream and cross the blood-brain barrier – trapping the mercury in the body.

Are there other detoxification methods or chelating agents?
Yes. There are doctor prescribed chelating drugs and nutritional supplements used individually, or in combination, which are effective in mercury detoxification. The common characteristic of each of these chelating agents is they all contain Sulphur.

There are three different prescribed routes:

1. DMSA (Dimercaptosuccinic acid) an oral drug
2. DMPS (2, 3–Dimercapto–1 –propane sulfonic acid) an intravenous drug
3. Nutritional Supplements such as:
4. L-glutathione
5. Alpha-liponic acid
6. Amino acids
7. N-acetyl cysteine
8. Multiple vitamins
9. Vitamin C
10. minerals

Is there a medical test to determine exposure to Mercury?
Testing can determine if you have been exposed but not where, how much or if damage has occurred. Testing may include fecal, urine, blood, saliva and hair analysis. Of these, fecal testing is the most reliable evaluation of your recent exposure, how much may have accumulated in your tissues and your ability to chelate (bind) and remove mercury. It has been reported there is a direct correlation between the number of dental amalgam fillings and the amount of glutathione-bound mercury found in the fecal metals test. Amounts can be ten times higher in those with the amalgam fillings than with those not having amalgam fillings.

What do I do next?
Call (813) 908-2444 for your FREE dental consult to discuss your particular dental situation. Establish a personal plan for your dental and medical fitness.