By Dr. Mercola
With Consumers for Dental Choice
- Dental amalgam emits mercury vapor after it is implanted in your mouth. This mercury is bioaccumulative and endangers your health in many ways.
- Mercury impairs its own elimination mechanism by inhibiting the manufacturing of glutathione--an amino acid that acts as your body's main heavy metal detox agent.
- Vulnerable populations – such as children, especially unborn ones, hypersensitive individuals, and people with kidney impairments – are known to be particularly susceptible to the toxic effects of dental mercury.
- Safe alternatives to amalgam include resin composite, glass ionomers, and atraumatic restorative treatment (ART).
Dr. Dave Simone works with Consumers for Dental Choice to fight amalgam because he fully appreciates how deviating amalgam fillings can be to your health. Dental amalgam emits mercury vapor even after it is placed in your mouth. This mercury is bioaccumulative and endangers your health in many ways, which we'll review below.
I urge you to watch the interview I did with Dr. Simone in its entirety, or at least read through the transcript, as he covers far more than what this summary contains. For example, he explains how mercury actually inhibits its own elimination mechanism:
"[Y]ou make glutathione in the mitochondria of your cells. It's one of your 20 amino acids. Glutathione is your heavy metal detox amino acid. It grabs on to mercury, finds its way to your large intestine… you excrete mercury that way… [But] mercury inhibits the manufacturing of glutathione, so mercury stops its own elimination mechanism. [Hence] it bioaccumulates in your body. It also affects the Krebs cycle. So you're not producing ATP, your energy source."
Amalgam Endangers Your Neurological Health
The mercury in amalgam is a neurotoxin – and pro-mercury dentists are placing it an inch from your brain!
Vulnerable populations – such as children, especially unborn ones, hypersensitive individuals, and people with kidney impairments – are known to be particularly susceptible to the neurotoxic effects of dental mercury.
That is why the U.S. Food and Drug Administration's advisory panel on dental amalgam in December 2010 warned against the use of amalgam in vulnerable populations and insisted that FDA had a duty to disclose amalgam's risks to parents and consumers. As panelist Dr. Suresh Kotagal – a pediatric neurologist at the Mayo Clinic – summed it up, there is "no place for mercury in children." The FDA panelists are not alone. Other countries are already working to protect vulnerable populations, especially children, from exposure to amalgam.
- The 47 nations of the Council of Europe just passed a resolution calling on the nations to start "restricting or prohibiting the use of amalgams as dental fillings,"1 explaining that "amalgams are the prime source of exposure to mercury for developed countries, also affecting embryos, fetuses (through the placenta) and children (through breastfeeding).
- Exposure to mercury can seriously affect the health of both patients and dental professionals, and early exposure to low doses of mercury (during pregnancy and through breastfeeding) increases the risk of a decrease in the intelligence quotient (IQ) among children.… According to the World Health Organization in 2005, certain studies show that mercury may have no threshold below which some adverse effects do not occur."2
- Australia's National Health & Medical Research Council (NHMRC) says amalgam should be avoided in pregnant women, nursing mothers, children, and people with kidney disease.3 As the government of the state of Queensland explains,
"Amalgam is now generally avoided for filling children's teeth. Growing children tend to be more sensitive to the effects of exposure to any chemical substance in their environment… High level exposure to mercury (which is present in silver fillings) may affect the kidneys. Therefore, the NHMRC, suggest people with kidney disease may be more concerned than others to minimize exposure to mercury."4
- Health Canada directed its dentists to stop using amalgam in children, pregnant women, and people with impaired kidney function – way back in 1996.5
Amalgam Endangers Your Reproductive Health
It is known that the mercury from amalgam can cause reproductive harm – dental mercury even crosses the placenta and accumulates in unborn babies. Due to mercury exposure from amalgam in the workplace, dental workers – including dentists, dental hygienists, and dental assistants – are at particular risk for suffering reproductive harm. Studies have shown that dental workers have elevated systemic mercury levels.6 Many of these dental workers are women of child-bearing age, which makes them particularly susceptible to the occupational hazards associated with handling mercury.
Few dental workers employed by pro-mercury dentists are given protective garb or air masks to minimize their exposure to mercury. Many dental workers are not even aware of the risks of occupational mercury exposure. As a result, dental workers have reported serious health problems – especially reproductive failures and birth defects caused by amalgam in the workplace.7 Interestingly, both the American Dental Association and the amalgam sellers have admitted that amalgam endangers dental workers, and attempted to profit from it.
- In a brochure on occupational health in dental offices, the American Dental Association (ADA) explains that:
"Exposure to mercury is a potential hazard for anyone in the dental profession who handles mercury or mercury-containing compounds….Office spaces may be contaminated with mercury from leaky amalgam capsules and from the lingering effects of spillage. High speed handpieces and ultrasonic compactors that vaporize mercury can lead to unsuspected inhalation." The brochure goes on to list the symptoms of dental mercury exposure, including "[g]rowing irritability, mood swings, and appetite loss…insomnia…tremors or numbness in the fingers…" But "[w]aiting for these symptoms to appear is far too late."
According to the ADA brochure, the solution is for dentists to buy an annual subscription to the ADA Mercury Testing Service for $75.00 per employee.
- An advertisement from Henry Schein Inc., the leading amalgam seller, explains that amalgam's "toxic vapor is quickly absorbed and accumulated within your body's system, giving proven, long-term harmful side effects." The flyer urges dentists to "protect yourself now from the harmful effects of mercury vapor" by purchasing new amalgam storage containers for $60.99 or $26.49.
Of course, the most effective – albeit perhaps less profitable – solution is to prevent dental workers from being exposed to this unnecessary source of mercury in the first place.
Amalgam Endangers Environmental Health
Even if you do not have amalgam in your mouth, your health is still at risk from amalgam. Amalgam leaches into the environment via multiple pathways, polluting our water via dental clinic releases and human waste; our air via cremation, dental clinic emissions, sludge incineration, and respiration; and our land via landfills, burials, and fertilizer. Once in the environment, dental mercury converts to its even more toxic form, methylmercury, and becomes a major source of mercury in the fish people and other animals eat.
The environmental health effects of amalgam are well known, and have recently been reiterated by the United States Environmental Protection Agency: brain damage and neurological problems, especially for children and the unborn babies of pregnant women.
Amalgam Endangers Your Oral Health
In addition to all the neurological, reproductive, and environmental harm caused by amalgam, it turns out that amalgam even endangers oral health. It is well known that placing amalgam requires the removal of a significant amount of healthy tooth matter. This removal, in turn, weakens overall tooth structure, which increases the need for future dental work.8 On top of that, amalgam fillings, which expand and contract over time, can crack teeth and create the need for still more dental work.9
Superior modern alternatives preserve healthy tooth structure and actually strengthen teeth, leading to better oral health and less extensive dental work over the long-term.10
"These tooth-friendly features of resin-based composites make them preferable to amalgam, which has provided an invaluable service but which, we believe, now should be considered outdated for use in operative dentistry," concluded a recent study of composite use.11
Additionally, the mercury in amalgams can interact with other metals in your mouth, such as gold fillings and crowns, causing an increased rate of reduction and oxidation that results in overall higher levels of toxicity. The other challenge is the electric current generated by having two dissimilar metals in your mouth, which essentially creates a battery that has more current than the circuits in your brain. This current has actually been given a name and is called biogalvanism.
The Alternatives to Amalgam
Far from being an essential dental product with no viable alternatives, amalgam is interchangeable with many other filling materials – including resin composites and glass ionomers – which have rendered amalgam completely unnecessary for any clinical situation. In fact, the mercury-free alternatives are so advanced that entire nations, such as the Scandinavian countries, have stopped the use of amalgam.12 Already, about half of U.S. dentists are mercury-free and 77 percent of consumers who are told that amalgam contains mercury choose mercury-free alternatives.13
One of the most popular alternatives to amalgam is resin composite. Resin composite is made of a type of plastic reinforced with powdered glass. It is already common throughout the U.S. and the rest of the developed world, offering notable improvements over amalgam, as it:
- Is environmentally-safe: Composite, which contains no mercury, does not pollute the environment. This saves taxpayers from paying the costs of cleaning up dental mercury pollution in our water, air, and land – and the costs of health problems associated with mercury pollution.
- Preserves healthy tooth structure, because, unlike amalgam, it does not require the removal of significant amounts of healthy tooth matter. Over the long term, composite preserves healthy tooth structure and actually strengthens teeth, leading to better oral health and less extensive dental work over the long-term.
- Is long-lasting: While some claim that amalgam fillings last longer than composite fillings, the science reveals this claim to be baseless. The latest studies show that composite not only lasts as long as amalgam, but actually has a higher overall survival rate.14
A lesser known alternative is increasingly making mercury-free dentistry possible even in the rural areas of developing countries. Atraumatic restorative treatment (also called alternative restorative treatment or ART) is a mercury-free restorative technique that has been demonstrated a success in a diverse array of countries around the world, including Tanzania, India, Brazil, Zimbabwe, Turkey, South Africa, Thailand, Canada. Panama, Ecuador, Syria, Hong Kong, Mexico, Sri Lanka, Chile, Nigeria, China, Uruguay, Peru, and the United States.
ART relies on adhesive materials for the filling (instead of amalgam) and uses only hand instruments to place the filling. ART is endorsed by the World Health Organization as "a perfect alternative treatment approach."15 According to WHO,
"The WHO Oral Health Program (ORH) believes ART is one of the most suitable caries controlling approaches for use in primary oral health care programs and therefore the continuation of the global promotion of ART is one of its major objectives."16
ART offers countless benefits to dental patients:
- ART is environmentally-safe: Unlike amalgam, the glass ionomers used in ART do not contain mercury. Substituting ART restorations for amalgam protects the environment from this major source of mercury pollution.
- ART is low-cost: While amalgam requires electricity and clinic equipment that makes the costs prohibitively expensive for many patients, ART uses only inexpensive materials and hand instruments that do not require electricity. As a result, ART restorations only cost half as much as amalgam restorations according to the Pan American Health Organization.17
- ART increases access to dental care: Amalgam is inaccessible to many disadvantaged people because it requires a dental clinic, a dentist, and typically a painful procedure. As a result, the World Health Organization has long recognized that "the majority of the world's population still suffers from untreated dental decay. The main reason for this is the continued dependency on traditional approaches to oral health care," such as the use of amalgam. ART increases access to dentistry by eliminating the barriers posed by amalgam:
First, the hand instruments used to perform ART do not require electricity and are portable. This easily allows ART to be performed in schools to treat schoolchildren, in patients' homes to treat individuals with disabilities and senior citizens who might have difficulty obtaining transportation to a clinic, and in rural areas without electricity to treat children in developing countries.
Second, the ART procedure is so simple to learn that ART can be performed by non-dentists as well as dentists, a valuable advantage in countries and regions that have a shortage of dentists.18
Third, ART is virtually painless and requires no anesthesia, which increases the likelihood that patients – especially children – will seek or cooperate with dental care in the first place.19
- ART is superior dental care: Not only does ART preserve the healthy tooth structure that must be drilled out and destroyed in order to place an amalgam restoration,20 but countless studies have shown that ART restorations have a longevity comparable – and even superior – to amalgam.21 For example, according to leading atraumatic restorative treatment researcher Dr. Prathip Phantumvanit of Thailand in an interview with Dental Tribune,
"When we compared the results with amalgam, we found that ART restorations were more successful than amalgam up to eight years of follow-up… we believe that ART will be an alternative to amalgam restoration especially in the primary teeth, whose life span is less than ten years."22
What You Need to Know about Amalgam Removal and Replacement
If you have amalgam in your teeth, removal and replacement with a safer material should be on the top of your list—especially if you are planning a future pregnancy. However, please do NOT make the mistake of having your amalgam fillings removed by a dentist who is not properly trained in safe amalgam removal. Doing so could expose you to tremendous health risks, due to the large amounts of mercury vapor being released during the removal process. So please, avoid making the same mistake I did 20 years ago when I had all my amalgams removed. My dentist at the time was a competent dentist. However, he was clueless about mercury toxicity and used no precautions.
As result I suffered kidney damage. It was a very expensive and health damaging mistake.
Research has shown that if you do not take proper safety precautions during the removal process, mercury levels in your blood can rise three to four-fold, which may result in acute toxicity. Hence, it's extremely important to find a biological dentist that is trained in properly removing mercury fillings. Some things that need to be done to keep you (and your dentist) safe during the procedure include:
- Providing you with an alternative air source and instructing you not to breathe through your mouth
- Using a cold-water spray to minimize mercury vapors
- Putting a rubber dam in your mouth so you don't swallow or inhale any toxins
- Using a high-volume evacuator near the tooth at all times to evacuate the mercury vapor
- Washing your mouth out immediately after the fillings have been removed (the dentist should also change gloves after the removal)
- Immediately cleaning your protective wear and face once the fillings are removed
- Using room air purifiers
For a complete description of how to safely remove mercury amalgam, see this PDF created by the International Academy of Oral Medicine and Toxicology (IAOMT). Dr. Simone also discusses the proper procedure in the featured interview. Here are several sources to help you locate a dentist trained in biological dentistry:
- Consumers for Dental Choice's Campaign for Mercury-Free Dentistry
- IAOMT's database
- International Academy of Biological Dentistry and Medicine
- The Holistic Dental Association
I also highly recommend getting healthy BEFORE having your fillings removed, as you want your detoxification mechanisms optimized prior to removal. To remove mercury that has already accumulated in your body, review my Mercury Detoxification Protocol, which details the things you can do right now to help rid your body of this toxin. If your mercury levels are seriously elevated, you should work with a knowledgeable health care practitioner to help you through the detoxification process.
Consumers for Dental Choice is Fighting to Protect Your Health
Consumers for Dental Choice is the leading U.S. consumer organization focused on protecting our health by eliminating dental mercury. Led by executive director Charlie Brown, Consumers for Dental Choice has tackled this health threat at every level:
- At the state and local level, Consumers for Dental Choice has made significant progress in getting out the word about amalgam's health risks. Their efforts resulted in laws requiring dentists to distribute fact sheets warning patients that amalgam can cause neurological and reproductive harm in California, New Hampshire, Maine, and Philadelphia. Dental offices in California are required to post signs warning that "Dental Amalgam, used in many dental fillings, causes exposure to mercury, a chemical known to the state of California to cause birth defects or other reproductive harm." Most recently, Consumers for Dental Choice won resolutions recognizing the health threat of dental mercury from the California cities of Costa Mesa and Santa Ana. 23
- At the national level, Consumers for Dental Choice has led the battle to convince the U.S. Food and Drug Administration to address the amalgam threat. First petitioning, then suing the Food and Drug Administration for failing to develop a rule to regulate amalgam, Consumers for Dental Choice's lawsuit resulted in a federal judge ordering FDA to develop an amalgam rule and a federal magistrate overseeing a re-writing of FDA's website. When the FDA then refused to even order product labeling in its rule, Consumers for Dental Choice unleashed "unprecedented consumer-level pressure," according to the trade press. "No final rule in FDA's modern history, or perhaps ever, has attracted this kind of organized opposition." FDA is now reconsidering its amalgam rule and says it will address concerns about vulnerable populations – children, unborn babies of pregnant women, people with kidney impairments, and hypersensitive individuals.
- At the international level, Consumers for Dental Choice is ensuring that the World Mercury Treaty, which is currently being negotiated, addresses amalgam. Thanks to their efforts, the U.S. government now supports both the "eventual phase out" of amalgam and prompt "phase down" steps, including "educating patients and parents," "protecting children and fetuses," and "training of dental professionals on the environmental impacts of mercury in dental amalgams." With amalgam increasingly being dumped in developing countries, Consumers for Dental Choice continues to fight especially hard to protect these disadvantaged children from amalgam and to ensure their access to mercury-free alternatives like ART restorations.
Charlie Brown, who runs Consumers for Dental Choice, is headed to Nairobi in October to lead a worldwide delegation participating in the world mercury treaty negotiations. With him will be a team of dentists, consumers, attorneys, and scientists fighting to get amalgam into that treaty. With the world deciding whether we continue allowing mercury in children's mouths, much is at stake. Here's what you can do in your nation or state:
Americans: Our #1 problem is the Food and Drug Administration, which has partnered with the American Dental Association to cover up the mercury, to make you think you are getting silver instead of mercury in your mouth. The FDA intentionally conceals the warnings about amalgam deep in its regulation -- so parents will never see them. On its website, the FDA gives dentists the green light to continue to deceive consumers with the term "silver fillings"
"Americans are ready for the end of amalgam." This was the theme of the testimony to the U.S. Department of State on August 18 by former West Virginia state Senator Charlotte Pritt. Yes, Americans are ready. But FDA is not. So let's send them a message.
Nine months ago, FDA scientists advised the agency to disclose the mercury to all patients and parents, and to stop amalgam for children and pregnant women. Yet FDA sits – sits actually in the pocket of the American Dental Association – ignoring its own scientists.
Please write the Director of FDA's Center for Devices, Jeff Shuren, email@example.com Ask Dr Shuren why FDA continues to ignore the scientists and covers up the mercury from American parents and consumers. Ask when FDA is going to get in step with the world on mercury.
Dr. Jeff Shuren, Director
Center for Devices, U.S. Food & Drug Admin.
10903 New Hampshire Ave.
WO66-5431, Room 5442
Silver Spring, MD 20993-0002
Californians: Dr. Shuren is coming to San Francisco for a "town meeting" on September 22. We urge Northern Californians to attend. It will go from 8 am to 12 noon, at the Embassy Suites Hotel, San Francisco Airport (telephone 650.589.3400)
In Southern California, Consumers for Dental Choice is organizing a city-by-city attack on amalgam --- and needs volunteers. If you wish to help with the grassroots work of organizing for city council hearings, gathering petitions, and telephoning, volunteer by writing firstname.lastname@example.org
Australians: Your government, Aussies, is now in last place on the mercury treaty, asking the world to throw in the towel instead of working to phase out dental mercury. A great new group has started, Australians for Mercury-Free Dentistry, led by dentist Lisa Matriste and consumer activist Anna Priest. We urge you to go to its website and join: http://www.mercuryfreedentistry.com.au/
Folks worldwide: If you aren't on that list, there's plenty to do – for example, Dominique Bally, an outstanding young advocate from the Ivory Coast, runs the Amalgam-Free Africa Campaign. If you want to help somewhere, anywhere, and there's nothing on the list above for you, write Charlie Brown, email@example.com
Consumers for Dental Choice is working to protect your health – and the health of your children – all around the world. Charged with this important mission at state and local, national, and international levels, Consumers for Dental Choice would appreciate your help!Dr. Mercola Recommends...Every "Like" Helps Support This Cause
Please consider a donation to Consumers for Dental Choice, a 501(c)(3) non-profit organization dedicated to advocating mercury-free dentistry.
Donations can be made online at http://www.toxicteeth.org/donate.cfm. Checks can be mailed to:
Consumers for Dental Choice
316 F St., N.E., Suite 210
Washington DC 20002
Also, for timely updates and information, please join Consumers for Dental Choice on Facebook.
Thank you for supporting mercury-free dentistry!
- 1 Parliamentary Assembly of the Council of Europe, Resolution 1816 (2011), available at http://assembly.coe.int/nw/xml/XRef/Xref-XML2HTML-en.asp?fileid=17999&lang=en
- 2 Social, Health and Family Affairs Committee of the Parliamentary Assembly of the Council of Europe, Report: Health Hazards of Heavy Metals and Other Metals (12 May 2011), available at http://assembly.coe.int/Main.asp?link=/Documents/WorkingDocs/Doc11/EDOC12613.htm
- 3 National Health & Medical Research Council, Dental Amalgam – Filling You In (2002),
- 4 The State of Queensland (Australia), Consent Information – Patient Copy, Dental Fillings
- 5 Health Canada, The Safety of Dental Amalgam
- 6 Marcelo Tomás de Oliveira et. al., Effects from Exposure to Dental Amalgam on Systemic Mercury Levels in Patients and Dental School Students, Photomedicine and Laser Surgery (October 2010, Vol. 28, No. S2: S-111-S-114)
- 7 See Mercury Policy Project, Neurotoxic Effects of Mercury in Dental Nurses (7 September 2006)
- 8 Terry L. Meyers, When less is more -- Technology increases minimally invasive procedures, Dental Economics (explaining that "with the resins and composites developed over the past 30 years, we don't have to remove nearly as much tooth structure as we did when using amalgam. Before these new materials with their bonding capacity came along, in some cases dentists had to take out the whole back side of the tooth to get enough amalgam in there to work.").
- 9 Davis MW, Nesbitt WE. The wedge effect: structural design weakness of Class II amalgam. AACD J 1997;13(3):62-8.
- 10 World Health Organization, ART-Atraumatic Restorative Treatment.
- 11 Christopher D. Lynch, Kevin B. Frazier, Robert J. McConnell, Igor R. Blum and Nairn H.F. Wilson, Minimally invasive management of dental caries: Contemporary teaching of posterior resin-based composite placement in U.S. and Canadian dental schools, J Am Denta Assoc 2011; 142; 612-620
- 12 See Bio Intelligence Service/European Commission, Review of the Community Strategy Concerning Mercury (p.229), 4 October 2010
- 13 Zogby poll
- 14 N.J.M. Opdam, E.M. Bronkhorst, B.A.C. Loomans, and M.-C.D.N.J.M. Huysmana, 12-Year Survival of Composite vs. Amalgam Restorations, Journal of Dental Research (October 2010), Vol. 89, 10: pp. 1063-1067.
- 15 World Health Organization, ART-Atraumatic Restorative Treatment.
- 16 WHO, Atraumatic Restorative Treatment (ART) for Tooth Decay: A Global Initiative 1998-2000 (1998).
- 17 Pan American Health Organization, Oral Health of Low Income Children: Procedures for Atraumatic Restorative Treatment (PRAT) (2006) ("The costs of employing the PRAT [procedures for atraumatic restorative treatment] approach for dental caries treatment, including retreatment, are roughly half the cost of amalgam without retreatment.").
- 18 Pan American Health Organization, Oral Health of Low Income Children: Procedures for Atraumatic Restorative Treatment (PRAT) (2006) (The Pan American Health Organization concluded that its "study demonstrated a higher cost-effectiveness of auxiliary personnel in some countries than traditionally trained dentists.")
- 19 Olushola Ibiyemi, Olubunmi Olusola Bankole, and Gbemisola Aderemi Oke, Assessment of Atraumatic Restorative Treatment (ART) on the permanent dentition in a primary care setting in Nigeria, International Dental Journal (2011) (finding that 98 percent of patients "admitted that ART was not painful" and concluding that "One major deterrent to health seeking behavior especially for dental care is fear or perception of pain. This has been supported by the findings of this study in that the vast majority of the participants, even though they claimed they had never visited the dentist expressed immense fear and a wrong notion of what dental treatment experience should be. It is gratifying to note however that in spite of this initial bias, most of them admitted to having a pleasant experience [with ART] compared to this preconceived attitude. Furthermore, they would be willing to receive such treatment [ART] again and would encourage others to patronise the dentist for similar procedures. These observations were also reported in other previous studies conducted in environments with similar socio-demographic characteristics."); Jo E. Frencken, Evolution of the ART approach: highlights and achievements, J Appl Oral Sci. 17 (sp issue): 78-83 (2009) (finding that"a high level of acceptance amongst those treated with ART and an unwillingness to be treated again amongst those in the traditional rotary hand piece group [using amalgam].")
- 20 van Amerongen WE, Rahimtoola S., Is ART really atraumatic?, Community dentistry and oral epidemiology. 1999 Dec; 27(6):431-5 (concluding that "preparations with hand instruments were smaller than those produced with rotary instruments.")
- 21 E.g., Frencken JE, Taifour D and van't Hof MA. Survival of ART and amalgam restorations in permanent teeth after 6.3 years. J Dent Res, 85:622-626 (2006) (concluding "that the restorations produced with the ART approach, with high-viscosity glass ionomer, survived longer than those produced with the traditional approach, with amalgam, in the permanent teeth of young children"); Steffen Mickenautsch, Veerasamy Yengopal and Avijit Banerjee, Atraumatic restorative treatment versus amalgam restoration longevity: a systematic review, Clinical Oral Investigations, Volume 14, Number 3, 233-240 (2009) ("In the permanent dentition, the longevity of ART restorations is equal to or greater than that of equivalent amalgam restorations for up to 6.3 years…").
- 22 Daniel Zimmerman, Interview, Dental Tribune
- 23 Proposition 65 warning