For the 10th consecutive year, we now celebrate our annual Mercury Awareness and Mercury-Free Dentistry Week. With us again is Charlie Brown, executive director of Consumers for Dental Choice and former attorney general for West Virginia.
As in previous years, during this week of August 23 through 29, 2020, we will double your donations to Consumers for Dental Choice, matching it dollar for dollar up to $150,000. I’m committed to doing this annual fundraiser because eliminating dental mercury is such an important effort for both human and environmental health.
Over 20 years ago, Brown committed his life to this advocacy, to help improve the lives of millions of people, and your generous donations are what allow him to continue this crucial humanitarian work.
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He’s made great progress this past year, which he details in this interview. You will be delighted to know your past donations have been put to good use, and it is thanks to you that this stellar nonprofit group has been able to have such a sustained impact.
This has in part been accomplished through the founding of the World Alliance for Mercury-Free Dentistry, a coalition of nonprofit groups from all over the world, which elected Charlie Brown as its president. As explained by Brown:
“We were able to go nationally to international. We were able to shift from dream to reality and the international successes have come one after another. Those that read our stuff have seen that. Eight countries just in the past year have either ended amalgam totally or have announced a specific phase-out date.
The push-back on the United States is huge. The U.S. Food and Drug Administration knows it's way behind and that's why, under our unrelenting pressure, they reopened the FDA rule [on dental amalgam]. We certainly see a different approach from the FDA now than the silence, which has been deafening, for so many years.”
International Progress
Internationally, the World Alliance for Mercury-Free Dentistry’s success in including amalgam as a plank at the Minamata Convention on Mercury — a global treaty to protect human health and the environment from the adverse effects of mercury signed in 2013 that went into effect in 2017 — has led to actions by governments across the world. Notably, the 27-nation European Union in 2018 banned dental amalgam in children under 15 and in pregnant or breastfeeding women.
Health Canada also passed guidelines years ago against the use of amalgam in children, pregnant women and in those with kidney disease but, regrettably, Health Canada seems to have lost interest in using its own guidelines.
Ten governments have gone further and implemented either immediate bans or a precise phase-out date. In the past year, the Philippines, Ireland, Nepal, Slovakia, Finland, New Caledonia, Moldova and the Czech Republic have all joined Norway and Sweden in the winner’s circle.
It gets better: At the third Conference of the Parties of the Minamata Convention in Geneva in November 2019, all Parties to the treaty (well over 100 countries, including the U.S. and Canada) were instructed to redouble efforts and accelerate the phase-down of amalgam.
To facilitate the global phase-out of amalgam, the World Alliance for Mercury-Free Dentistry helped create centers to coordinate the implementation of mercury-free dentistry in each region. There’s the Asian Center for Environmental Health in Bangladesh, the European Center for Environmental Medicine in Berlin, the African Center for Environmental Health in the Ivory Coast, and the Latin American Center for Environmental Health in Uruguay.
A specialized campaign is tailored to the island states in the Caribbean, the Pacific and the Indian Ocean. All of this is coordinated by Consumers for Dental Choice, which serves as Secretariat to the World Alliance. The ultimate goal of the Minamata Convention is the total ban on amalgam everywhere.
“We are nonstop implementing and I make it my point to do that by finding the best environmental group leaders to implement the program on the ground. None of this can be done by me showing up in the country. I do go to many countries, but we show up to work with an excellent team on the ground of experienced people who do their job and know how to win.”
Progress in the US
Following these international successes, the Chicago Declaration to End Mercury Use in the Dental Industry was created in the U.S. The declaration was signed by 50 organizations, including the Sierra Club, Clean Water Action, Greenpeace and Learning Disabilities Association of America. With these signatories onboard, the FDA finally sat up and took notice.
“We were able to meet with the FDA director for the center for devices. They agreed to reopen the rule. They had full hearings in November of 2019,” Brown says.
“We brought a team of 16 experts, city and county commissioners, professors, a former dean of a dental school, the National Medical Association representative, the Children's Environmental Health Foundation, Connecticut Coalition for Environmental Justice, four different lawyers, each with a different legal angle on this and so on.
And they listened. In fact, the experts at the end of that hearing recommended the FDA break its silence and get the word out that this material is mercury and has some serious health effects.
More so they said, ‘The FDA needs to get much more specific for the vulnerable,’ including children … Here is FDA's chance to catch up. Those who listen, probably say, ‘Well, we've been down this road before. FDA is starting and stopping.’
That's true. But this time we were much readier. We had our camera man there. We videoed every minute of it so they couldn't say ‘this happened’ when it was really something else. We followed up, to the top of the agency, again ... We are interacting with the team.
FDA has now created a team to look at this issue. The Chicago Declaration continued to weigh in as did an expert in environmental justice issues, pointing out the real disparate use of amalgam in children, [especially] children of color and other low income children, Indian reservations, Medicaid, as well as lower income adults — those in prisons, soldiers and sailors, those who are left behind.
We have no excuse. We have no excuse for treating our soldiers and sailors and airmen and Marines this way. We think FDA, this time, is about to turn over a new leaf. If they don't though, we've got a multitude of strategies going on in the states and we've already turned up the heat there.”
Efforts in Maine, Connecticut and Wisconsin Redouble
Brown expects we’ll get a ruling from the FDA by the end of 2020. If not, action within various U.S. states have redoubled. For example, the petition by Consumers for Dental Choice to the Maine dental board resulted, this year, in an official rule that all pro-mercury dentists — those still using amalgam — must provide written disclosure about the mercury in amalgam to all patients, parents or guardians.
The patient must sign this disclosure, acknowledging they understand the risks before having amalgam placed in their teeth. That will undoubtedly cut back usage substantially.
“That's now the law in Maine. We've now headed into Wisconsin. We've headed into Connecticut. We are heading other places to be on the offensive and get disclosures, or in the case of Wisconsin and Connecticut, more than disclosures,” Brown says.
"Connecticut actually requires, mandates, mercury fillings in people on Medicaid. It's just morally, legally outrageous. But we've got a really good partner there and we're going after them.”
Interestingly, Wisconsin actually has a law banning the sale of any product with elemental mercury aimed at children. Brown’s team is focused on applying this law to dental amalgam use, arguing to state officials that the law means use of this mercury product must end in Wisconsin children.
African Region Poised to End Amalgam
On the international level, coming up in 2021 is the fourth Conference of the Parties of the Minamata Convention. The stars of the show could well be the African Region. Its 51 governments sponsored an amalgam phase-out amendment in Geneva last year, and are poised to do the same in Bali, Indonesia, next year. Brown comments:
“They've been wonderful. They are united. They want amalgam to end. They proposed that the third Conference of the Parties to end amalgam, and we got a very good compromise. We didn't have the votes yet to end it, but we are building to have the votes in the 2021 session, which will be in Indonesia, November 2021.
We bring a great team there, but we work through the governments who support us. The entire African governments does. But I think they're going to have a lot of allies. The EU campaign is in high gear and here's where we are with the EU: They have already ended it for amalgam for children, pregnant women and breastfeeding women.
Five of the countries in the Union have ended it, but now they are making the decision whether to phase it out [in all 27 EU nations]. I was at a conference in Brussels in January of 2020. I was the only non-European invited. And the indication from the European Commission is they want to phase this out. They are poised to make a recommendation.
They're a little late because of the [COVID-19] pandemic, but they will make a recommendation. There's the European Commission, European Union and the European Parliament. The three have to agree. It starts with the Commission, and we have a really great campaign.
We work with the European Environmental Bureau [and] the European Center for Environmental Medicine. We also have nonprofit groups that we work with in Spain, Poland and Sweden and so on. And we intend to work, just like we did in 2016, to get the first law passed, which set up the process.
We won that by going to the parliament. This year, under whatever the procedures are for going to parliament, maybe it's all virtual, we will do that. But we intend the European Union to win the campaign in 2020 and get an end date [for amalgam].
We don't know what it will be, but we want to get an end date. And the indications are, we've got the momentum to do that. If we get the European Union and the African region, that's a huge part of the world …”
Asian Successes
We’ve also seen major victories and forward movement across Asia. Indonesia has promised to end amalgam this year, but they’ve already stopped promoting it for public health. Indonesia is the fourth largest country in the world, and its version of Medicaid is far larger than that in the U.S. If they can end the use of amalgam, so can the U.S.
Use of amalgam will cease in three years in the Philippines and in five years in Nepal — they serve as guides for the continent. Vietnam ended amalgam for children and for pregnant and breastfeeding women, and is working on a “road map” for amalgam’s total demise.
Bangladesh ended all use of amalgam for its entire armed forces and their families, and most of its dental schools. They now teach only mercury-free dentistry and have banished the teaching of amalgam from the curriculum. Here is a great success story from the Central African nation of Cameroon, all done at the local level:
“We're seeing all kinds of progress, both huge and on the micro level. The Cameroon Baptist Convention has hospitals all over the country. I've gone to the headquarters and met with the chief medical officer. She's a dentist. She ended amalgam in Cameroon for the entire system 12 years ago. She didn't need us,” Brown says.
“I asked, ‘How did you think of this, Dr. Theresia?’ She replied, ‘I read and read and read, and I [decided], we're going to stop using it.’ And they did. It isn't like you need a high-income country to do this. You need willpower.
The U.S. FDA still needs a little more willpower, but we're working around them as well as right at them. And we're going to see this happen here too … [We’re going to] make sure that whatever guidelines they issue are not going to be ignored because of the American Dental Association trying to sabotage … as they've done before.”
Progress in Two Nations With Massive Populations
What about the two nations with a billion-plus people? Brown has made India a major priority for the World Alliance, partnering with the nation’s leading environmental group on a national campaign, and engaging a “model state” campaign in the eastern India state of Odisha.
The campaign is bearing fruit. The Indian Railway, the largest employer in the world, which employs thousands of dentists for its workers, is ending amalgam use. If the world’s largest employer can end amalgam, it is less complicated for smaller employers to do the same! The World Alliance for Mercury-Free Dentistry also has allies in China.
“It is true they have a law on nonprofit groups that basically doesn't allow us to come in and participate,” Brown says, “but we work through our allies. China recognizes nonprofit groups have a role and environmentalists have a role. They allow them, they respect them.
They listen to them because China knows they've got to do things about the environment. Our partners in China are quite active. China, as you know, is very much top down so we have to convince the government in Beijing, almost exclusively.”
Join the Fight to End Dental Mercury Worldwide
As you can see, significant progress is being made. We’ve come a long way in these past 10 years. With your continued support, we can end the health scourge that is dental mercury, worldwide, thereby improving the health of literally billions of people.
This is the time to show your support. When you donate this week, I'm going to double your contribution, dollar for dollar, up to $150,000. We need to empower dentists who really understand health, and through that understanding provide the type of care that you and your family need and deserve. We need to eliminate this poison, and to do that we need to bring Consumers for Dental Choice across the finish line. We’re almost there.
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Consumers for Dental Choice is a verified 501(c)(3) corporation, which means any donations to this campaign are tax deductible. For many of you, that means you not only can leverage your donation by my doubling any amount you give, but you also can get up to a 40% tax deduction on your donation. It's a win, win, win all around.
Also, if you’re a dentist who is still using amalgam, please consider removing it from your practice immediately. Not only is it harming your patients’ health, dental amalgam is also a significant source of environmental mercury pollution. As explained by Brown:
“There’s no excuse anymore. First, it's a primitive pre-Civil War product that harms. It [requires the removal] of good tooth matter. The alternatives are so much better because they're minimally invasive. They focus on the life of the tooth, not the life of the filling.
The dentists who use amalgam are also putting their own staff at risk … And they are the polluter who's not paying. They are putting this pollution into our environment and saying, ‘We don't want to pay for this. Let the taxpayers pay for the mercury I'm putting in the environment.
Let the funeral director buy equipment [to block mercury emissions] before he does cremation. Let the landlord have the mercury stuck in the pipes. Let the fishermen not fish.’ It is irresponsible and unnecessary.”
Opt for Mercury-Free Dentistry
On the home front, you can help this movement by using only mercury-free dentists. They understand the risks of mercury, refuse to expose their patients and staff to mercury vapors and protect our environment from mercury pollution. How do you find one? Here are several organizations with lists or information: