Is Dentistry Finally Entering the 21st Century?

Story at-a-glance -

  • While entrenched pro-mercury interests claim amalgams are necessary as an inexpensive option, once the environmental cost of the mercury is taken into account, an amalgam filling is much more expensive than a composite filling – up to $87 more
  • Consumers for Dental Choice has changed the paradigm in the amalgam battle, but the old amalgam habit is hard to break. The landmark economics The Real Cost of Dental Mercury study tells us why: Dentists who use amalgam are not paying the price of the environmental havoc they are wreaking. Instead, they are passing on that cost to taxpayers who foot the clean-up bill
  • The track record of Consumers for Dental Choice shows the organization is both effective and efficient in its charge to end the use of dental mercury worldwide – from breaking down the gag rule upheld by state dental boards (which did not permit dentists to disclose that “silver fillings” contained toxic mercury), to organizing and partnering with mercury-free dentistry groups around the world in a formidable effort to make sure amalgams are included in the final mercury treaty session in Geneva in January 2013

By Dr. Mercola

Dentists who use mercury fillings claim that amalgam is safe because it's been used for 150 years. More accurately, dental amalgam is a Civil War relic, hardly a point in its favor. It is no better, nor safer, than other discarded medical practices like bleeding patients, administering calomel, and performing surgery with unwashed hands.

In fact, amalgam poses a whole swarm of problems at every stage of its lifecycle, including…

  • Releasing mercury during production: Mercury is released into the environment when amalgam is manufactured.
  • Endangering dental professionals: Dentists, dental hygienists, dental assistants, and dental office staff are exposed to mercury during and after amalgam preparation.
  • Deceiving dental patients: Most dental patients are not informed that amalgam is 50 percent mercury – many are told that amalgams are "silver fillings."
  • Damaging healthy tooth structure: To place an amalgam, a significant amount of healthy tooth matter must be removed – permanently damaging the tooth structure.
  • Exposing patients to mercury: Amalgam continues to release mercury after it is implanted in your body, and can even cross the placenta to reach unborn babies.
  • Fracturing teeth: Amalgam expands and contracts over time, leading to cracked teeth and hefty dental bills.
  • Polluting the environment: Sooner or later, most of the mercury from amalgam ends up in air, soil, and water via numerous unsound pathways.
  • Contaminating fish: Once in the environment, amalgam can convert to methylmercury, contaminate fish, and wind up on your dinner plate.

The Shameful Past of the State Dental Boards

Amalgam simply has no place in 21st century dentistry.

Yet, a decade ago, as our century dawned, amalgam was riding high. Three powerful institutional forces combined, if not conspired, to keep primacy for amalgam in American dentistry.

One was in state government (the state dental boards), another in the federal government (the U.S. Food and Drug Administration, or FDA), and the third, a private monopoly (the American Dental Association, or ADA).

The dental boards actually enforced a gag rule that prohibited American dentists from discussing mercury with their patients; in turn, FDA adamantly refused to do its legal duty to issue a rule on amalgam that would have undone the mercury secret; while the role of the ADA – with its gigantic PAC funds – was to keep much of Congress and many state legislatures in its hip pocket. Charlie Brown called these three forces – state dental boards, FDA, ADA – the "Iron Triangle."

Consumers for Dental Choice Turns the Tide

Led by Consumers for Dental Choice, our cause unwound amalgam's primacy a step at a time. First to go was the notorious gag rule: ordering dentists to stop telling the truth ran afoul of their Constitutional right of free speech. Once dentists and lawyers like Charlie stood up to the state dental boards, the gag rule wilted. Next Consumers for Dental Choice started working to inform consumers that amalgam is mercury. Their efforts led to some states adopting "fact sheet" laws mandating that dentists provide consumers information about amalgam.

Then came the challenge to the FDA: Charlie's lawsuit, naming the great grassroots group Moms Against Mercury as lead plaintiff, insisted that FDA must issue a rule on amalgam – a duty it had been dodging for 30 years. The federal judge ordered the FDA to comply with the law by releasing an amalgam rule by the July 2009 deadline. Contrary to the media hype, the FDA's 2009 rule did warn about amalgam use in children and pregnant women:

"The developing neurological systems in fetuses and young children may be more sensitive to the neurotoxic effects of mercury vapor. Very limited to no clinical information is available regarding long-term health outcomes in pregnant women and their developing fetuses, and children under the age of six, including infants who are breastfed."

Unfortunately – and intentionally – the FDA buried this information deep in the rule where it knows consumers and parents won't find it. After multiple petitions for reconsideration, a scientific advisory panel review in 2010 concluded amalgam should not be used in children. After a grassroots uprising, the FDA promised to make an announcement on the amalgam rule by the end of 2011 – but did not. As it has done so adroitly for years, the agency has returned to inaction on amalgam.

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Unprecedented Momentum Toward Mercury-Free Dentistry

Two years ago, as the mercury treaty negotiations loomed, Consumers for Dental Choice started highlighting the environmental harms caused by amalgam. This powerful approach is not only paying off at the mercury treaty sessions – it is shifting the ground under the feet of the pro-mercury dentists in the U.S.

The bastion for amalgam had long been America's dental schools… until now. Citing the upcoming mercury treaty specifically, as well as amalgam's devastating environmental impact, the New York University College of Dentistry announced a new amalgam policy to its students in July: NYU College of Dentistry has decided it will no longer recommend dental amalgam as the primary posterior tooth restorative… it will no longer require students to perform competency examinations for amalgam restorations… and it will no longer allow amalgam use in its own clinics unless students obtain faculty permission for specific cases. NYU and its faculty should be saluted for taking this visionary step to protect our environment from mercury.

Like NYU, communities around the U.S. are speaking out against dental mercury pollution. For example:

  • When Ohio cities demanded variances to allow them to dump wastewater with unsafe levels of mercury into Lake Erie, no one was talking about holding the pro-mercury dentists who released the mercury responsible… until Consumers for Dental Choice entered the picture. Its Ohio chapter organized comments and testimony for public hearings that called attention to the source of over half of mercury in wastewater: dental amalgam.
  • Citizens for a Better Spring Hill is a group of residents fighting to stop the construction of a mercury-emitting crematory in their Tennessee community. Consumers are increasingly aware that crematories emit significant amounts of mercury from amalgam fillings – atmospheric emissions from amalgam burden us with 50-70 tons of mercury pollution every year. And they are fighting hard to protect their children from this unnecessary mercury exposure.

Is Dentistry Finally Entering the 21st Century?

Thanks to the work of Consumers for Dental Choice and its allies, mercury-free dentistry is now starting to flourish in the United States. Probably half of America's dentists have stopped using amalgam altogether.

I am honored to be invited to speak to the International Academy of Biological Dentistry & Medicine (IABDM) about mercury at its annual meeting on October 20, 2012, in the Washington D.C. suburb of Tyson's Corner, Virginia. This entire conference will be a great opportunity for health professionals to learn how to get their patients healthy – and keep them healthy. I look forward to this speaking opportunity.

Uniting to Defeat Mercury Fillings on the International Front

Mercury-free dentistry was once dismissed as mere dreaming, but now the goal of ending dental mercury on our planet is within sight worldwide.

Two years ago, Consumers for Dental Choice – led by Charlie Brown – faced the most amazing opportunity: the nations of the world would be drafting an environmental treaty to address all forms of mercury – mercury mining, mercury storage, mercury waste, mercury air emissions, mercury processes, as well as mercury products. Every nation would send representatives to five sessions, spread over three years. There, the world would wrestle with designing solutions to the global mercury pollution crisis.

The challenge was awesome. How to organize on a worldwide level so that all nations agree to address amalgam in the treaty? How to frame amalgam as an environmental issue that needs to be addressed in an environmental treaty (other environmental laws exempt amalgam because it is classified as health issue)? How to gain needed support from the world's leading environmental organizations?

Consumers for Dental Choice met that challenge.

With the treaty's first round of talks fast approaching, early in 2010 – and at the suggestion of Michael Bender of the Mercury Policy Project – leaders of environmental, social justice, and dental groups assembled under a unified umbrella coalition, the World Alliance for Mercury-Free Dentistry. At its first meeting, the leaders elected Charlie Brown president of the coalition. Charlie recruited a talented team of regional vice presidents and country chapter leaders – dentists, environmentalists, professors, physicians, international policy specialists, and non-profit leaders – from every region of the world from Africa to Europe to Asia to Australia to the Americas. From the first session through the fourth session, 2010-2012, the World Alliance for Mercury-Free Dentistry has gone toe-to-toe with the pro-mercury World Dental Federation at the mercury treaty sessions.

Making Progress at the Mercury Treaty Negotiations

The treaty process moved forward, and with it, the cause of mercury-free dentistry. Those fighting for mercury-free dentistrystood alone at the first session, in Stockholm in June 2010. But the coalition reached out and build alliances, with environmental groups, with medical societies, and consumer groups. At the second treaty session in Japan, the third in Kenya, and the fourth in Uruguay, our side outflanked, outworked, and outpointed the opposition.

Consumers for Dental Choice's team just got back from the fourth treaty session. While their opponent was trying to turn the treaty session into a never-ending debate on health, Consumers for Dental Choice and its World Alliance allies succeeded in keeping amalgam in the draft treaty by emphasizing the known environmental harms caused by amalgam and offering practical solutions. They distributed the landmark economics report The Real Cost of Dental Mercury1 to delegates. This report shows that an amalgam filling can cost up to $87 more than a composite filling once the environmental cost of each material is taken into account.

As a result of this environmental strategy, support from government officials and influential organizations from around the world continues to grow.

Consumers for Dental Choice and its World Alliance colleagues have laid the groundwork for future success at the final mercury treaty session in Geneva in January 2013. There, the decision about amalgam (and virtually all other major treaty decisions), will be made. The challenge is great, but I believe we have found the right organization to lead us.

Bringing Change to the World Health Organization

In addition to their work at the treaty sessions, Consumers for Dental Choice, the World Alliance team, and their allies achieved a major breakthrough with the World Health Organization (WHO). It appeared that WHO's traditional opposition to mercury-free dentistry would prevail when WHO staff released a paper in 2010 promoting amalgam as the "material of choice." But Michael Bender and Charlie Brown organized a worldwide protest that highlighted the glaring errors in the paper and called for an investigation.

Their efforts succeeded; WHO withdrew the paper.

In the wake of this worldwide protest, WHO released its final report on amalgam.2 In a turn-around, WHO commits itself to "facilitate the work for a switch in use of dental materials" away from amalgam. The new WHO report concludes that "for many reasons restorative materials alternative to dental amalgam are desirable." The report describes three of these reasons in detail, determining that amalgam:

  • Raises "general health concerns"
  • Releases a "significant amount of mercury" into the environment
  • "Materials alternative to dental amalgam are available" – citing many studies indicating that such alternatives are superior to amalgam

Perhaps most importantly, WHO now acknowledges that "Alternative restorative materials of sufficient quality are available for use in the deciduous [baby] dentition of children," the population whose developing neurological systems are most susceptible to the neurotoxic effects of dental mercury. There is no longer any excuse for subjecting this most vulnerable population to dental mercury exposure.

Organizing the Regions

While Consumers for Dental Choice is making a significant impact on the international scene, their work is also turning the tide toward mercury-free dentistry in individual regions and nations all around the world:

Africa: In 2011, Consumers for Dental Choice partnered with a non-profit group from the Ivory Coast, Jeunes Volontaires pour l'Environnement (Young Volunteers for the Environment), to launch the Amalgam-Free Africa Campaign.

In a series of well-received workshops and other, press events in different African countries, the team was able to educate governments and the public about the dangers of dental mercury and the range of mercury-free alternatives. In response to opponents' claims that mercury-free dentistry cannot be done in developing countries, they produced an excellent documentary on the feasibility – and the necessity – of mercury-free dentistry in Africa.

Thanks to the efforts of the Amalgam-Free Africa Campaign, the African region now vocally supports the phase-out of amalgam.

Australia: When the Australian government appeared to pose the most serious obstacle at treaty sessions, Consumers for Dental Choice launched an intense Australian campaign.

The volunteer force of dentists, dental patients, and a dental assistant that they organized held meetings with their government and started a major letter-writing campaign that was joined by 27 Australian health and environmental organizations. The new Australians for Mercury-Free Dentistry continues to monitor and reach out to the Australian government. Thanks to these efforts, Australia now supports addressing amalgam in the treaty.

Asia: Consumers for Dental Choice continues to work closely with a number of Asian non-profit allies like the Environment and Social Development Organization on a range of projects: from providing financial and media support for a national conference on mercury-free dentistry… to sponsoring scientists to attend meetings with government officials… to working with a major Asian environmental organization to approach national dental associations... to university campus programs… to petitioning governments.

Europe: In Europe, Consumers for Dental Choice has equally exciting news. The European Union hired a consultant to advise it on what to do about amalgam. The World Alliance for Mercury-Free Dentistry teamed with the well-regarded European Environmental Bureau (an environmental coalition of NGOs) and the excellent French group, Non Au Mercure Dentaire, to submit information and to testify.

The consultant now recommends a total phase-out of amalgam in the 27 nations of the E.U. – for the same environmental reasons our team has been explaining. Much work remains to be done here (a consultant's report can be adopted or discarded), but the World Alliance for Mercury-Free Dentistry is already mobilizing forces for that battle.

The Americas: The existence of that treaty is creating momentum to end amalgam at home in the Americas as well, but more on that to come in the coming week…

Did You Know?

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How You Can Help Put an End to Mercury Fillings

I wish to urge health professionals and consumers alike to support Consumers for Dental Choice during Mercury-Free Dentistry Week. They have changed the paradigm in the amalgam battle, but the old amalgam habit is hard to break. The landmark economics The Real Cost of Dental Mercury study tells us why: dentists who use amalgam are not paying the price of the environmental havoc they are wreaking. Instead, they are passing on that cost to taxpayers who foot the clean-up bill.

It's time for change… and Consumers for Dental Choice can make it happen.

We've shown you the track record of Consumers for Dental Choice, and how their strategy is working, in the U.S. and worldwide. Now is the time for you to consider contributing what you can to this great cause – by aiding an organization that will use your gift wisely for the good of us all.

Will you please consider a tax-deductible 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 Checks can be mailed to:

Consumers for Dental Choice
316 F St., N.E., Suite 210
Washington DC 20002

Please contribute what you can in honor of Mercury-Free Dentistry Week.

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