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Amalgam debate..

pcsol at del.this.co.uk pcsol at del.this.co.uk
Tue Aug 3 08:42:04 EST 1999


This is my reply to an EMAIL on the Amalgam issue -
any takers?

Remember main group for reply:  alt.health.dental-amalgam

R wrote:
> 
> >
> >
> > > My advice to you is this:
> > > 1) Don't confuse elemental mercury with mercury amalgam.   Elemental
> > >     mercury is toxic; amalgam is not.  Can amalgams leak elemental
> > >     mercury?   Yes, they can, but the leakage is so minute that the
> > > danger
> > >     is non-existent.   Pseudo-scientific claims to the contrary have
> > > usually
> > >     been based on faulty use of mercury detection instruments.
> >
> > the WHO would beg to differ, placing Amalgam as #1 source for
> > mercury on average..
> 
> I've been around the block on this claim many times over the past
> thirteen years.  So far I haven't seen a single documented claim that
> wasn't based on faulty analysis.   And sad to say, the proponents of

Nonsense. Ive "been round the block" too. Originally the ADA/dental
industry
claimed that *no* mercury leaked from Amalgam - it was such research
that
compelled them more recently to accept that *some* mercury leaks 
- they have changed their line to "ok, but only a little".
This implies that the ADA accept research that you dismiss as
faulty..

ie:-
Svare et al., "The Effect of dental amalgams on Hg levels in expired
air", Journal of dental research (1981) - The first paper to establish
unequivocally that Hg comes out of amalgams.


> amalgam toxicity claims continue to cite such documents even when
> it's been shown that the respective researches used equipment and/or
> methods that simply aren't valid.    If there's been something new
> published in the past few years, I'd appreciate citations.  I'll check

Much research nowadays is "politicised" - ie. Research
influenced/funded
by the dental industry tends to come out with low figures, whereas 
research from independant toxicologists (and yes, of course "anti
amalgamists") tends to produce higher figures..

> them out when I have time and send you my comments.   Please note
> that I'm asking you for COMPLETE documentation which details
> the precise methods and instruments used to develop raw data.  And
> also a description of the statistical analysis used to arrive at conclusions
> like the one below:

> > World Health Organization Figures (World Health Organization,
> > Environmental Health Criteria 118: Inorganic Mercury, Geneva, 1991.)
> > The World Health Organization has calculated the average human
> > daily dose of mercury from various sources is:
> > Dental amalgam = 3.0-17.0 ug/day (Hg vapor)
> > Fish and Seafood = 2.3 ug/day (methylmercury)
> > Other food = 0.3 ug/day(inorganic Hg)
> > Air & Water = Negligible traces   (NOTE ug = Micrograms)

Ok, the above was based on an "average" analysis of available
peer-reviewed research data.

> > > 2) While decrying amalgam as a restorative substance, you better take a
> > >      look at the alternatives.  Acrylic composites are known
> > > pulp-killers and
> > >      the practice of replacing amalgam with composite usually culminates
> > >
> > >      in a root canal procedure  and crownwork if not extraction and
> > > dentures.

Whenever someone trots out the "composites are bad too" line,
I smell a rat. So what? The primary question is whether Amalgam
is safe, not whether composites are safe. 
Anyway, research data indicates that any volatile hydrocarbon
type toxins that Composites might leak are toxic at 
(broadly) milligram levels, rather than microgram levels
that Mercury dangerous at. Furthermore any such compounds
that do come out drop rapidly in level one they "set",
within a day or so. Conversly Amalgams leak Mercury slowly
over a very long time - and Mercury is a cumulative toxin.
Remember that Mercury is the most toxic non-radioactive element 
known to man. Toxicologists have long regarded it as particularly 
dangerous  because its effects at low-levels are so insidious & 
hard to detect.

> > My own & most of the other people I directly know who have gone down
> > this
> > path have not had problems, above what you might expect - after all,
> > rotten
> > teeth are rotten teeth, Amalgam or not..
> 
> No, "rotten" teeth aren't necessarily rotten teeth.   Amalgam restorations
> often last several decades without complications, and they can be easily
> replaced by another amalgam restoration which could easily last another
> two decades.  By contrast, acrylic composites have an extremely short
> life expectancy on occlusal surfaces.   Owing to their high coefficient of
> expansion, a large composite restoration can create stresses within a
> tooth that cause minute (harmful) cracks.   And the base resins used
> *often* cause pulpal problems leading to endodontics and/or extraction.
> This is well documented in the endodontic literature.

Amalgam is indeed an "easy" material to work with, demanding
low skill levels for tolerable results. By contrast Composites
and other materials are "technique sensitive" - more time &
skill is required for good placement - *particularly* in
a tooth that once contained Amalgam because so much of the 
tooth needs to be removed to form a plug for the Amalgam.
Also the presence of Hg ions has the short term local effect 
of killing off bacteria - however that poses immediate
questions about systemic effects of those same ions..

> > This is mud that is easy to sling, but proves nothing.
> > Some of the "Anti amalgamists" are top notch scientists (WHO
> > consultants, etc) with a good solid scientific history before they took
> > up sides the Amalgam issue.
> 
> Name a few.

There are many research papers that indicate (directly or indirectly)
Amalgam could be harmful - often published by scientists who
do not regard themselves as be "anti amalgam" at all.
But if you want a few names..
-------------------------------
Vimy and Lorscheider, "Evaluation of the safety issue of Hg release
from dental fillings", FASEB Journal (1993)

Nylander and Berglund, "Does Hg from amalgam restorations constitute
a health hazard?", Science of the Total Environment (1990)

Goerging, Galloway, Clarkson, Lorscheider, Berlin and Rowland,
"Toxicity Assessment of Hg Vapor from Dental Amalgams", Fundemental
and Appled Toxicology (1992)

Clarkson and Friberg, Biological monitoring of Toxic Metals (Plenum
Press 1988)

Svare et al., "The Effect of dental amalgams on Hg levels in expired
air", Journal of dental research (1981) - The first paper to establish
unequivocally that Hg comes out of amalgams.

Vimy and Lorscheider, "Whole-body imaging of the distribution of Hg
released from dental fillings into monkey tissues", FASEB Journal 
(1990)

Vasken Aposhian, "Urinary Hg after administration of 2,3-
dimercaptopropane-1-sulfonic acid (DMSA): correlation with dental
amalgam", FASEB Journal (1992)

Friberg and Nylander, "Hg Concentrations in the human brain and
kidneys in relation to exposure from dental amalgam fillings",
Swedish Dental Journal (1987)

Woods and Echeverria, "Urinary porphyrin profiles as a biomarker of Hg
exposure: studies on dentists with occupational exposure to Hg",
Journal of Toxicology and Environmental Health (1993)

Vimy and Lorscheider, "Mercury from dental "silver" tooth Eillings
impairs sheep kidney Eunction", (1991)

Eggleston and Nylander, "Correlation of dental amalgam with Hg in
Brain tissue", Journal of Prosthetic Dentistry (1987)

David Eggleston, "Effect of dental amalgam and nickel alloys on
T-lymphocytes: Preliminary report", Journal of Prosthetic Dentistry 
(1987)

Summers, Vimy and Lorscheider, "Hg released from dental "silver"
fillings provokes an increase in Hg and antibiotic-resistant bacteria
in oral and intestinal flora of primates", Antimicrobial Agents and
Chemotherapy (1993)

Vimy and Lorscheider, "Maternal-fetal distribution of Hg released from
dental amalgam fillings", (1990)

Gustav Drasch, "Hg burden of human fetal and infant tissues",
European Journal of Paediatrics (1994)

Fritz Lorscheider, `ADP-ribosylation of brain neuronal proteins is
altered by in vitro and in vivo exposure to inorganic Hg",
Journal of Neurochemistry (1994)

Markesbery and Ehmann, "Trace element imbalances in isolated
subcellular fractions of Alzheimer's diseased brains", Brain Research
(1990)

Markesbery and Ehmann, "Regional brain trace element studies in
Alzheimer's disease neurotoxicology", (1988)

Boyd Haley, "HgEDTA complex inhibits GTP interactions with the E-site
of brain beta-tubulin", Journal of Toxicology and Applied Pharmacology
(1993)


> >
> > The evidence is there - but unfortunately the dental
> > industry has learnt lessons from other industrys with similar problems
> > (tobacco,asbestos,GM foods, etc) and is rather good at spewing out
> > rhetoric similar to that above.
> 
> Exactly the opposite.  The anti-amalgam quackery rose to a fevor pitch
> in the USA in the 80's before consumer agencies finally took action.  The
> publishers of "Consumer Reports" in the USA was instrumental in

Is this the same consumer reports that told us 10 years ago
"passive smoking was harmless", and later reversed that position?
They should stick to evaluating fridges..

> getting officials to examine the scam long before the ADA got involved.
> The ADA was reluctant to speak out on the issue because of political

This is utter rubbish. The ADA have been unequivocal in 
attacking virtually *anyone* (credible scientist or otherwise)
who dares to question Amalgam safty - right from in inception
in the 19th century, through the debates in the 30's, right up
to date. By the way, the average daily release figures calculated
by Dr Stock (10ug/Hg vapour day for a mouth full of Amalgam)
were broadly backed up by later research (see WHO figures above).
This is amazing given the primitive nature of the equiptment
he used. 
At the time, Stock was vilified by the ADA for daring
to suggest *any* mercury at all leaks from Amalgam.
They have never apologised to him.

> fears.   A lawsuit brought by a notorious quack named Hal Huggins
> seeking ADA sponsorship for a bogus treatment program was the "last
> straw", so to speak, and prompted the ADA to get involved.   It's worth
> mentioning, however, that most of the effective actions against anti-
> amalgam quackery have been waged by attorneys and government

In my view Huggins hurt the "anti amalgam" movement by trying
to make money out of his "discovery" that Amalgam could 
be dangerous, and thus gave the dental industry a "get out" 
- they can now accuse *any* scientist (however credible they
previously were) who happens to question amalgam safety of 
"quackery".
It is interesting to note that one of the original usages
of the term "quack" was to attack the first dentists who 
used mercury in fillings in the early 19th century by 
the (then mercury-free) dental association of the time.
Doctors regarded these upstart dentists as reckless 
for implanting a known dangerous toxin, Mercury, in teeth.

> regulators without much assistance from the ADA.   At one point in
> the 80's it was estimated by roughly 30-50% of dentists in the USA
> were using the amalgam scam to literally "scare up" business that
> was unnecessary or poorly advised from the standpoint of their
> patients' health.

How much has the ADA and it members made from implanting 
countless tons of mercury in peoples teeth? How much 
money does the dental industry stand to loose if it is
ever proven that Amalgam is dangerous?

> > Arguments should be grounded on facts..
> 
> Agreed.  Facts and not fallacies.
> 
> > "[The evidence] tells me very succinctly that there is a
> > chronic low-dose exposure to a toxic heavy metal that 80-85 per
> > cent of the industrialised world have implanted in their teeth,
> > and it's a situation of timed-release poisoning."
> >   (Dr Murray Vimy, research scientist and former World
> >   Health Organisation consultant, speaking on BBC Panorama..)
> 
> I've examined all of Vimy's papers published prior to 1995 or
> thereabouts and everyone of them was flawed.   If memory serves
> you'll find an analysis of these flaws in papers by Dr. John Dodes.
> Sorry, I don't have citations handy but they turn up readily in
> bibliographic searches.

I do remember reading an good analysis of Dodes rather 
pathetic critique - by Dagfinn maybe - perhaps someone else could drag
it
out from the AMALGAM archives & post it here?

> > "..I think there is no basis for such a statement... [that
> > amalgam is safe to use for children].... They are definitely
> > particularly vulnerable. We know that if you take a young
> > child - it takes a few years after birth until the brain
> > is developed. We know that the brain in children is much
> > more sensitive than in adults."
> >   (Dr Lars Friberg, Former Chief Adviser to the World
> >   Health Organisation on Mercury safety. speaking on BBC Panorama..)
> 
> Great.   We can agree that children have sensitive brains.

Friberg was for a long time "impartial" on the Amalgam issue,
and his textbooks on toxicology of Mercury were/are regarded
as "standards" - he was/is a very highly regarded Toxicologist.
It is worth noting there is no record of critisism of him 
by the dental industry prior to his later stance on Amalgam.
When someone of his experience sticks his neck out this far,
people should take note.

> > "..there is no safe level of mercury,
> > and no one has
> > actually shown that there is a safe level. I would say
> > mercury is a very toxic substance... I think they
> > [the BDA] are wrong.. [to make such a claim]"
> >   (Dr Lars Friberg, speaking on BBC Panorama..)
> 
> Wrong.   Safe levels can easily be established by looking at the
> epidemiological evidence.

It is quite clear from the quote that he means
that we do not know how low we have do go before
we say "this level is safe", and the BDAs claim
to the contrary is wrong. 
Bear in mind too his first language is Swedish..
 
> > "My own conclusion is that already in individuals with bruxism,
> > [bruxism is habitual grinding of teeth]
> > which is common in the population, exposure may well be compared
> > with industrial exposure that has given rise to effects. Furthermore,
> > despite negative results in epidemiological studies, the statistical
> > power [of these studies] is not high enough to exclude the occurrence
> > of effects in a few percent of the population at still lower
> > exposure levels.
> 
> In other words, he doesn't have any evidence to support his claim.

Of course he has evidence, otherwise he would not be 
saying it. He is saying *epidemiological* evidence is lacking
- but that is true *both* ways..

> Modern science is based on the concept of the null hypothesis.  In
> essence, we expect to see proof that a given claim is true before we
> accept its validity.   By contrast, this individual has asserted a claim
> without evidence and is faulting science for failing to prove that
> his claim is true.   We have lots of anecdotal evidence from lots
> of authorities "proving" that ghosts exist, but we can't prove the
> existence scientifically because the scientific methods at our
> disposal aren't sufficiently powerful.

Typical rhetoric designed to ridicule, rather 
than argument based on fact.
We have hard research evidence indicating Amalgam could be
a problem - I think your metaphor about ghosts holds no water.

> > As amalgam is used so widely already, an effect in
> > a few percent of the exposed population would mean that very
> > large population groups could be affected.
> 
> Yes, perhaps ghosts and gobblins are also affecting a statistically
> small segment of the population -- adding up to many millions.  However,
> there's no evidence to support this notion.   The claim about bruxism,
> for instance, was originally based on a quack study conducted about
> fifteen years ago which used misused a device for monitoring mercury levels
> in industrial environments.   There have been two or three attempts
> to re-establish the claim, but to the best of my knowledge, none of
> the anti-amalgamists has been successful in putting together
> a reproducible study.

Nonsense - the research that indicates bruxism increases Hg leakage 
from the surface of Amalgam remains unchallenged. The only critism
of the device used (gold leaf Jerome meter) fails in this incidence
for simple reasons - whatever dispute/errors that may occur when
trying
to extrapolate the (abviously tiny) amounts of Hg vapour directly
measured by the meter to daily exposures, this is less relevant when
*comparing* 2 figures measured by the same meters, say before/after
abrading Amalgam surfaces. Whatever the absolute figures, we can
show an *increase* in release after bruxism.

> >  The evidence from experimental and human studies at higher exposure
> > levels clearly indicates that mercury from the toxicological point
> > of view is an unsuitable element to use in dentistry. It is my
> > opinion that it is prudent to conclude that mercury from dental
> > amalgam is not safe to use for everyone."
> >   (Dr Lars Friberg, Former Chief Adviser to the World
> >   Health Organisation on Mercury safety. 1995 Symposium report.)
> >
> > "If you have something that's been put in your mouth that
> > you can't dispose of in a waste basket without breaking
> > environmental protection laws,
> 
> He's confusing amalgam with elemental mercury.

He knows what he is talking about..
 
> > there's no point in
> > keeping it around, there's no point in taking that type of
> > risk - there's no point in exposing people to any level of
> > mercury toxicity if you don't have to......
> > .....there is no doubt in my mind that low levels of mercury
> > present in the brain could cause normal cell death, and this
> > could lead to dementia which would be similar to Alzheimer's
> > disease....
> 
> Ghosts and goblins could be responsible for this dementia,
> which may or may not exist, but
> unfortunately, there isn't any evidence.
 
Again, typical rhetoric designed to ridicule, rather 
than argument based on fact.

> > We can't go inside a living human being and look
> > at their brain, so we have to work outside, and do scientific
> > experiments such as we've done. And to the best that we can
> > determine with these experiments, mercury is a time-bomb in
> > the brain, waiting to have an effect.
> 
> Nonsense.  The best evidence has determined that AMALGAM --
> not to be confused with mercury -- is a safe and effective restorative

Amalgam contains Mercury - 50% to be exact - held in a
fairly weak metal-metal bond. This bond is much weaker
than the more normal bonds found in salts - ie. -ve/+ve
ion bonds. Thus Amalgam is prone to corrosion by acids,
for instance..

> material.   It's been used for more than a century without any
> evidence of "dementia".

Have you ever wondered why industrialised countries suffer from
certain chronic illnesses (MS,ME,Alzheimers) that are virtually
absent in other parts of the world? Industrial pollution 
(with Amalgam being a part of that) could be an answer.
The evidence could be there - proving it in the current
political climate is harder..
 
> > If it's not bothering
> > someone when they're young, especially when they age it can
> > turn into something quite disastrous."
> >   (Dr Boyd Haley, Professor of Medicinal Biochemistry,
> >   University of Kentucky. speaking on BBC Panorama..)
> >
> > "The ADA owes no legal duty of care to protect the public from
> > allegedly dangerous products used by dentists…..Dissemination
> > of information relating to the practice of dentistry does not
> > create a duty of care to protect the public from potential
> > injury."
> >   (American Dental Association lawyers.)
> 
> Where did you find this quotation?   Please name the attorneys who
> made the statement and tell me where it appears in print.   The
> reason I'm making this demand is that I personally know the
> person who was in charge of approving or disapproving the use
> of restorative materials during the height ot the amalgam scam
> in the USA (Enid Neidle) and Neidle would deny this claim in a
> heartbeat.

This is an absolute quote from a court case where someone
tried to sue them. In fact the ADA have gotten so annoyed 
about usage of this quote that they decided to issue
rebuttal on their WWW pages - it might still be there..
Again more details are on the AMALGAM group archives..

cheers

ade

---------------------------------------------------------------------
To learn more about the Amalgam safety issue (or lack of) visit:-
  http://i.am/amalgam                       or
  http://ourworld.compuserve.com/homepages/pcsol/homepage.htm

This provides a wide range of information, and also links to
other important sources - The Amalgam FAQ, The BBC Panorama
program summary, the IAOMT homepage, Dr Vimys page, etc.






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