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Public Health Group Adopts Contradictory Positions on Mercury

Story at-a-glance -

  • The American Public Health Association (APHA) recently pulled an about-face on their long held recognition of dental amalgam as a source of mercury pollution and environmental harm. A preliminary vote endorses the continued use of dental amalgam and, contrary to numerous studies, claims that amalgam’s contribution to environmental mercury contamination is “minimal”
  • The chief sponsor and endorser of the APHA resolution is the American Dental Association (ADA), a former patent-holder and primary defender of amalgam. The ADA helped draft the current resolution, which could be used to derail worldwide efforts to curtail use of dental amalgam to protect against devastating ecological damage caused by mercury pollution
  • Dental amalgam is a primitive, polluting product—an antiquated remnant from the Civil War era—which is composed of about 50 percent mercury, a well-known toxin capable of wreaking significant damage to ecology, wildlife, and human health
  • Dentists are the number one purchaser of mercury in the US and the number one polluter of mercury into municipal waste water

By Dr. Mercola

A preliminary vote endorsing the continued use of dental amalgam has put the spotlight on the American Public Health Association (APHA), since it has long recognized the harm to the environment and public health of mercury releases.

The importance of APHA getting it right on the issue of dental mercury cannot be overstated, and this latest about-face has many scratching their heads, wondering how they could get it so wrong...

The Association is the only progressive multi-disciplinary organization dedicated to public health in the US, representing more than 60,000 health care workers. It has been an important organization for the validation of many of our environmental health resolutions over the last 20 years.

Its influence can also be felt internationally. As one of the largest public health associations it has great influence within the World Federation of Public Health Associations, so its position on this issue will be viewed as a broad pronouncement about what is good for the public's health not just within the United States, but also abroad.

All of this makes APHA's recent policy statement, reported by DentistryIQ1, so profoundly disturbing:

"The American Dental Association supports the American Public Health Association's recent policy statement affirming that dental amalgam is safe and effective in treating dental cavities."

The APHA policy notes that amalgam's contribution to environmental mercury contamination is minimal, and that limiting or curtailing its availability could have negative health consequences, particularly in low-income areas, the featured article reports.

Members are urging the association to reconcile its contradictory positions before a final vote on the resolution early next year. But let's be clear, if this resolution passes, it will keep dentistry firmly lodged in the proverbial stone age; put countless people's health at risk (especially the poor and already underprivileged); and perpetuate significant environmental destruction.

Dental schools such as the New York University College of Dentistry, which recently decided to stop recommending mercury amalgam fillings as the default route of treatment, may have to ditch such notions and return to teaching the barbaric use of neurotoxic mercury rather than modern alternatives.

ADA's Active Effort to Avoid Pollution Control Regulation

Dental amalgam is a primitive, polluting product — an antiquated remnant from the Civil War era — which is composed of about 50 percent mercury, a well-known neurotoxin. Once released into the environment, dental mercury converts to methylmercury and contaminates fish, which are the largest dietary source of mercury in the U.S.

The environmental impact of dental mercury simply cannot be overlooked.

The chief sponsor and endorser of the APHA resolution is the American Dental Association (ADA), a former patent-holder of amalgam that represents one faction of dentistry. Known for its midnight deal-making2 — such as with the U.S. Environmental Protection Agency (EPA) in 2008 in avoiding pollution control regulation -- the ADA appears on the verge of pulling off a similar stunt again.

Appearing at the APHA meeting last month, resolution in hand, ADA lobbyists presented a sequence of falsehoods to APHA leaders in the resolution they helped draft. The resolution claims that mercury fillings' contribution to overall mercury pollution is "negligible" — when in reality, dentists are the number one purchaser of mercury in America for product use and the number one polluter of mercury into municipal waste water.

Will APHA, Like the ADA, Continue to Ignore the Science?

Contrary to ADA claims, a recent report from the World Health Organization3 (WHO) states that the amount of dental mercury entering the environment is "significant." And contrary to APHA's recommendation that "dental professionals continue the use of dental amalgam as a restorative material," the WHO report calls for a "phasing-down" of dental amalgam use. It even says "WHO will facilitate the work for a switch in use of dental materials." WHO noted the following three reasons for the new position:

  1. Amalgam releases a "significant amount of mercury" into the environment, including the atmosphere, surface water, groundwater, and soil. WHO reported:
  2. "When released from dental amalgam use into the environment through these pathways, mercury is transported globally and deposited. Mercury releases may then enter the human food chain especially via fish consumption."

  3. WHO determines that amalgam raises "general health concerns": While the report acknowledged that a few dental trade groups still believe amalgam is safe for all, the WHO report reached a very different conclusion: "Amalgam has been associated with general health concerns." The report observed:
  4. "According to the Norwegian Dental Biomaterials Adverse Reaction Unit, the majority of cases of side-effects of dental filling materials are linked with dental amalgam."

  5. WHO concluded "materials alternative to dental amalgam are available" and cited studies indicating they are superior to amalgam. For example, WHO said "recent data suggest that RBCs [resin-based composites] perform equally well" as amalgam. And dental restorative materials have a higher survival rate, says WHO, citing a study finding that 95 percent of dental restorative materials and 92 percent of amalgams survive after 4 years.
  6. In particular, WHO explained 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. Perhaps more important than the survival of the filling, WHO asserted that:

    "Adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself."

The report also included mention of the known toxic effects of mercury exposure, stating:

"Mercury is highly toxic and harmful to health. Approximately 80 percent of inhaled mercury vapor is absorbed in the blood through the lungs, causing damage to lungs, kidneys and the nervous, digestive, respiratory and immune systems. Health effects from excessive mercury exposure include tremors, impaired vision and hearing, paralysis, insomnia, emotional instability, developmental deficits during fetal development, and attention deficit and developmental delays during childhood."

What is the True Cost of Dental Amalgam?

Equally missing in the APHA resolution is any mention of amalgam's true cost, when environmental expenses are factored. The price of amalgam is lower than its main alternative, composite, solely because the polluters, the pro-mercury dentists, are not paying for the externalized impacts they cause. As an authoritative economics study4 shows that when the environmental costs of amalgam are totaled, amalgam's true costs are as much as $77 per filling more than composite.

In addition to the World Health Organization, a recent report created by the BIO Intelligence Service (BIO) for the European Commission5 recommends phasing out dental amalgam and mercury in button cell batteries by 2018 in order to protect the environment from continued devastating harm. According to the authors, dental amalgam is "a significant contributor to overall EU environmental emissions of mercury from human activities." The situation is identical in the US.

The report, titled: Study on the Potential for Reducing Mercury Pollution from Dental Amalgams and Batteries6, highlights the extensive ecological harm caused by dental mercury, and the subsequent health impact on wildlife and humans:

"The current levels of mercury pollution in the EU are such that all the EU population is exposed to mercury above the natural background level and certain population groups such as high-level fish consumers, women of childbearing age and children are subject to high risk levels, principally due to their high exposure and/or high vulnerability to mercury in the form of methylmercury, which is ingested through the diet.

This presents a risk of negative impacts on health, in particular affecting the nervous system and diminishing intellectual capacity.

There are also environmental risks, for example the disturbance of microbiological activity in soils and harm to wildlife populations. The effects of mercury releases on the integrity of the ecosystem are substantial. Various species, especially eagles, loons, kingfishers, ospreys, ibises, river otters, mink and others that rely on fish for a large part of their diet, have been observed to suffer adverse health and/or behavioral effects.

Observed disorders such as effects on the muscles and nervous system, reduced or altered mating habits, ability to reproduce, raise offspring, catch food and avoid predators have been demonstrated to affect individual animal viability and overall population stability. According to calculations based on the critical load concept, more than 70 percent of the European ecosystem area is estimated to be at risk today due to mercury, with critical loads of mercury exceeded in large parts of western, central and southern Europe."

World-Wide, Governments are Calling for the Phase Out of Amalgam

As an organization based in the United States, Consumers for Dental Choice has worked to educate its own government about dental mercury pollution and the many mercury-free alternatives to amalgam. In March of last year, their diligence paid off, as the U.S. government, in its official submission to UNEP's mercury treaty negotiations, called for both the "eventual phase out" of amalgam and prompt "phase down" steps, including many of our recommendations, such as:

  • "Educating patients and parents"
  • "Protecting children and fetuses" 
  • "Training of dental professionals on the environmental impacts of mercury in dental amalgams"

From a government whose device regulator (FDA) had previously refused to educate the public about amalgam's mercury content or take any steps to protect vulnerable populations, it was a welcome – even spectacular – development for the cause of mercury-free dentistry. Other governments from around the world quickly joined the push for mercury-free dentistry, including the Arab League, the African region, the Council of Europe, and numerous other developing nations.

ADA's Self Serving Interests Coming to Light

Despite all this progress, the ADA still succeeded in ramming the resolution through APHA, claiming that it was a 'late breaker" issue that warranted fast tracking, overcoming objections that it be withdrawn. Opponents argued that nothing had occurred since the resolution deadline (2/15/12) to justify "late breaking" status7 — and instead the resolution should be resubmitted through the normal policy next year where it would be more fully vetted.

Objection to the resolution inside APHA was fierce, with opposition expressed at both the public hearing and the Governing Council meeting. Both the Environment, Occupational, and Maternal and Child Health sections urged a No vote. But the ADA political machine won the day, crowing afterwards that APHA resolution (that the ADA helped draft) "further vindicates the ADA's own long-standing and scientifically based policy."

ADA's self-serving interests are now only beginning to come to light as more APHA members become better informed.

In addition, some believe the ADA is now using APHA's resolution as a way to derail the global WHO's new policy to "phase down" amalgam — and influence negotiators who are considering incorporating the WHO policy into a global legally binding treaty on mercury8 when they meet for the final time in Geneva in mid-January. We knew the World Dental Federation was determined to protect amalgam to the bitter end... let's hope APHA doesn't give them the "ace" they need to eliminate dental mercury from the negotiations.

Join the Campaign for Mercury-Free Dentistry!

APHA still has time to undo its mistake. The final decision does not come until February. Consumers for Dental Choice leads the battle for mercury-free dentistry both in the US and worldwide. Its financial needs are greater than ever, so we ask for your help! 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 here. 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.