dental (mercury) amalgam (aka 'silver fillings')

Several holistic and health-conscious U.S. Senators announced today that they are supporting legislation that would ban table salt since "it consists of 50% chlorine, a poisonous gas." Water will also be banned because it is two-thirds hydrogen, a highly flammable gas, and one-third oxygen, known to be essential to combustion. (Just kidding, of course. Even our most scientifically illiterate legislators wouldn't be so foolish as to ban salt and water....or would they?)

...dentists who purport to treat health problems by ripping out fillings are putting their own economic interests ahead of their patients' welfare.*

An amalgam is a mixture or blend. An amalgam used in many dental fillings is called by some mercury amalgam because mercury is its main component (about 50%). Many people want to ban mercury amalgam and many people have had all mercury amalgam removed from their pearly whites because mercury is a known poison. The other ingredients in mercury amalgam include silver, copper, tin, molybdenum, and perhaps a little zinc. Small traces of these elements may be floating freely in amalgam, but not enough to worry about. Nor should there be worry about the mercury, though a poison, that is also in the amalgam.

Former California congresswoman Diane Watson's beliefs about mercury amalgam are typical of those who want to ban it. "Dental amalgam contains approximately 50 percent mercury, a highly toxic element...and therefore poses health risks." To back up her beliefs, she sponsored H. R. 4163, the Mercury in Dental Filling Disclosure and Prohibition Act. 

Where is the science to back up the concerns of those who think the mercury in dental fillings is a serious health hazard? Totally lacking, according to Leon Jaroff  who took Watson to task in Time magazine. Jaroff wrote:

Watson, who like too many other members of Congress, is, to put it kindly, scientifically unsophisticated. The mercury in amalgam, it turns out, is not free, but mixed with silver, tin, and copper, metals to which it bonds chemically to form a crystalline metallic — and safe — alloy. An obvious analogy, says Dr. Robert Baratz, president of the National Council against Health Fraud, can be made with water, a chemical combination of hydrogen, a gas that can explode, and oxygen, which supports combustion. Yet, like those in water, amalgam's components are tightly bonded to each other. "Saying that amalgam will poison you," Baratz insists, "is like saying that drinking water will make you explode and burst into flames."

The mercury scare took off in 1985 with the publication of It's All in Your Head by Hal Huggins (d. 2014), a Colorado dentist who was convinced that just about everything that ails anybody is due to the mercury in amalgam fillings. Huggins was known to his followers as the Elder Statesman of Holistic Dentistry. (Those calling their craft holistic, biological, or natural dentistry are a hodgepodge of dentists opposed to mercury amalgam, root canal treatments, fluoridation of water, and sometimes allying themselves with beliefs in chi and meridians [imaginary pathways of subtle energy] and promoting belief in something they call the Meridian Tooth Chart).

The television program "60 Minutes" gave the anti-amalgam movement a big boost with a segment in 1990 entitled "Poison in Your Mouth." The program was called Toxic Television by Dr. Stephen Barrett:

More than half a century ago, Orson Welles panicked his radio audience by reporting that Martians had invaded New Jersey. On December 23, 1990, CBS-TV's "60 Minutes" achieved a similar effect by announcing that toxins have invaded the American mouth. There was, however, a big difference. Welles' broadcast was intended to be entertaining. The "60 Minutes" broadcast, narrated by veteran reporter Morley Safer, was intended to alarm—to persuade its audience that the mercury in dental fillings is a poison. It was the most irresponsible report on a health topic ever broadcast on network television.

....the minuscule amount of mercury the body absorbs from amalgams is far below the level that exerts any adverse health effect. One study found that people with symptoms they related to amalgam fillings did not have significant mercury levels. The study compared ten symptomatic patients and eight patients with no reported health complaints. The symptom group had neither a higher estimated daily uptake of inhaled mercury vapor, nor a higher mercury concentration in blood and urine than in the control group. The amounts of mercury detected by the tests were trivial. Some studies have shown that the problems patients attribute to amalgam restorations are psychosomatic in nature and have been exacerbated greatly by information from the media or from a dentist.

The U.S. Food and Drug Administration reviewed the best available scientific evidence to determine whether the low levels of mercury vapor associated with dental amalgam fillings are a cause for concern:

Based on this evidence, FDA considers dental amalgam fillings safe for adults and children ages 6 and above. The amount of mercury measured in the bodies of people with dental amalgam fillings is well below levels associated with adverse health effects. Even in adults and children ages 6 and above who have fifteen or more amalgam surfaces, mercury exposure due to dental amalgam fillings has been found to be far below the lowest levels associated with harm. Clinical studies in adults and children ages 6 and above have also found no link between dental amalgam fillings and health problems.

The U.S. Department of Health and Human Services says "there is scant evidence that the health of a vast majority of people with amalgam is compromised." The American Dental Association  (ADA) claims that "there currently appears to be no justification for discontinuing the use of dental amalgam." The amalgam opponents think the ADA is part of a conspiracy to hide the real dangers of the alloy. The ADA position is not based on economics but on science. According to my dentist, dentists in California are advised not to comply with a patient's request to have all his or her "mercury" fillings removed. Removing "mercury" fillings and using plastics to refill them would be a good way to make money, since there are many people who are convinced that their fillings are causing all their health problems. Dentists are advised not to do the work because there is not sufficient scientific evidence to back up the fear that fillings are poisoning people.

Watson and others wanting to ban amalgam fillings counter the arguments for the safety of amalgam by noting that:

According to certain scientific studies, Health Canada, and the Agency for Toxic Substances and Disease Registry of the Public Health Service of the Department of Health and Human Services, children and pregnant women are at particular risk for exposure to mercury contained in dental amalgam.

According to the Agency for Toxic Substances and Disease Registry, the mercury from amalgam goes through the placenta of pregnant women and through the breast milk of lactating women, giving rise to health risks to an unborn child or a baby.

The Environmental Protection Agency considers removed amalgam filling and extracted teeth containing amalgam material to be hazardous waste.

The use of mercury in any product being put into the body is opposed by many health groups, such as the American Public Health Association, the California Medical Association, and Health Care Without Harm.*

Health Canada specifically states:

...current evidence does not indicate that dental amalgam is causing illness in the general population.

....A total ban on amalgam is not considered justified. Neither is the removal of sound amalgam fillings in patients who have no indication of adverse health effects attributable to mercury exposure.

Health Canada does warn, however, that "whenever possible, amalgam fillings should not be placed in or removed from the teeth of pregnant women." Health Canada does not explain why it gives this warning. The FDA has this to say about the data regarding pregnant women and amalgam fillings:

There is limited clinical information about the potential effects of dental amalgam fillings on pregnant women and their developing fetuses, and on children under the age of 6, including breastfed infants. However, the estimated amount of mercury in breast milk attributable to dental amalgam is low and falls well below general levels for oral intake that the Environmental Protection Agency (EPA) considers safe. FDA concludes that the existing data support a finding that infants are not at risk for adverse health effects from the breast milk of women exposed to mercury vapor from dental amalgam. The estimated daily dose of mercury vapor in children under age 6 with dental amalgams is also expected to be at or below levels that the EPA and the Centers for Disease Control and Prevention (CDC) consider safe. Pregnant or nursing mothers and parents with young children should talk with their dentists if they have concerns about dental amalgam.

If you are concerned about being exposed to mercury from amalgam fillings you already have in place, be advised that a very small amount of mercury vapor will be released when the fillings are removed.

Dr. Oz "Investigates" the Dangers of "Mercury" Fillings

I put 'investigates' in scare quotes because Oz abuses the term in his program on the dangers of dental fillings. The blurb for the Oz episode on fillings reads:

From memory loss to mood swings, could your toxic teeth be to blame for your health problems? Mercury fillings are banned in some countries. Should you consider having your mercury fillings removed? Dr. Oz investigates.

Note that the blurb refers to "mercury fillings," even though the proper term is 'amalgam' or 'alloy' and the fillings contain other metals as well. The American Dental Association (ADA) thinks Oz went overboard in making his case against dental amalgam, which "is considered a safe, affordable and durable material that has been used to restore the teeth of more than 100 million Americans." According to the Consumer Health Digest, Oz's "investigation" of amalgam fillings "mentioned the ADA's viewpoint but denied the group's offer to provide credible experts for the discussion."

The program featured appearances by two mercury-free dentists, a woman who claimed to have suffered from amalgam toxicity, and a demonstration purporting to show that brushing the teeth releases toxic levels of mercury vapor within the mouth. During the demonstration, Oz reached into a sealed box to brush the teeth of a mouth model that contained amalgam fillings and an instrument detected mercury vapor within the box.

The ADA issued a press release in response to Oz's "investigation," in which it condemned Oz's "reliance on sensationalism while ignoring sound science."

The demonstration on the Dr. Oz Show related to brushing amalgam fillings in a synthetic mouth model and measuring vapor does not simulate real world conditions in the mouth. For example, the mouth model is in a closed, dry environment, yet people have saliva in their mouths. The water protein barrier in the mouth reduces vapor activity. The amount of vapor released from amalgam fillings is so small it’s in the billionths of a single ounce. A noted researcher calculated that it would take nearly 300 amalgam fillings in real life for even the most sensitive person to exhibit symptoms.

Oz is not alone in misleading people about the dangers of mercury vapor from amalgam fillings. Wildlife documentarian Steve Kroschel has lately turned his attention to natural cancer cures and the dangers of mercury in amalgam fillings. Check out this trailer for "The Beautiful Truth." Nice title but, as they say, you shouldn't judge a film by its title.

The Cochrane Collaboration metastudy comparing composite resin fillings to amalgam fillings for permanent or adult posterior teeth concluded:

There is low-quality evidence to suggest that resin composites lead to higher failure rates and risk of secondary caries than amalgam restorations. This review reinforces the benefit of amalgam restorations and the results are particularly useful in parts of the world where amalgam is still the material of choice to restore posterior teeth with proximal caries. The review found insufficient evidence to support or refute any adverse effects associated with amalgam or composite restorations. However, emerging research is highlighting issues around genetic susceptibility to mercury. The decision for a global phase-down of amalgam (Minamata Convention on Mercury) will restrict the future use of amalgam. (emphasis added)

In other words, even though the preponderance of the evidence is in favor of amalgam as both safe and effective, it is likely that in the Minamata Convention on Mercury amalgam will be lumped together with toxic fish, coal-fired power stations, and mining that uses mercury to separate gold from ore-bearing rock. Amalgam will probably be banned worldwide, along with thimerosal in vaccines, as part of the worldwide effort to reduce mercury poisoning. At least 140 countries have signed the Minamata Convention on Mercury, including the United States.

further reading

Dental amalgam or resin composite fillings? "Dental amalgam has a 150-year proven track record of as one of the safest, most durable and least expensive materials used to a fill a cavity. Ongoing scientific studies conducted over the past 100 years continue to show that amalgam is not harmful."

National Council Against Health Fraud Position Paper on Amalgam Fillings "The amount of mercury released from installed amalgam and absorbed by the body is minuscule. Mercury is found in the earth’s crust and is ubiquitous in the environment. Thus, even without amalgam fillings, everyone has small but measurable blood and urine levels. Amalgam fillings may raise these levels slightly, but this has no practical or clinical significance"

EPA: Mercury in Dental Amalgam "Since the 1990s, several federal agencies have reviewed the scientific literature looking for links between dental amalgam and health problems. According to the Centers for Disease Control and Prevention (CDC), there is little scientific evidence that the health of the vast majority of people with dental amalgam is compromised, nor that removing amalgam fillings has any beneficial effect on health."

The Mercury Amalgam Scam: How Anti-Amalgamists Swindle People Stephen Barrett, M.D.

"Holistic Dentistry": A Brief Overview Stephen Barrett, M.D. William T. Jarvis, Ph.D.

Last updated 12-Dec-2014