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BBC TV PANORAMA DOCUMENTARY: Poison in the Mouth
Program transcript, Transmitted on BBC-1, llth July 1994
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(NOTE: TOM MANGOLD is both the BBC REPORTER and VOICE OVER
quoted throught this text..)
VOICE OVER: This is a phial of mercury, a liquid metal and one
of the most poisonous substances known to man. Most people have
metal or amalgam fillings in their mouths, and half the metal in
each filling is made from this stuff. For years dentists have believed
these fillings were safe, but now we know that every time we chew,
brush or grind our teeth, some of the mercury is released as a
vapour and we inhale it.
Panorama has uncovered a growing body of scientific evidence that
shows ominous links between the mercury from our fillings and serious
illnesses. We also reveal an uncomfortable background of complacency
and ignorance within the British dental establishment, and apathy in
govemment, which is helping mask the truth about the dangers of the
poison in your mouth.
(Vision shows men wearing protective suits)
These men are handling old amalgam tooth fillings for recycling.
Once removed, what had lived inside our mouths for years is
suddenly treated as the dangerous poison it's always been.
Mercury is so toxic that at certain levels it drives people mad,
but even the tiniest amounts are regarded as unsafe. At lower
levels - and no one quite knows how low they are - the metal attacks
the brain and the central nervous system, producing symptoms that
indude nervousness and irritability, lack of concentration, loss
of memory and self confidence, mood swings, anxiety, depression,
fatigue and insomnia.
Because there can be other causes for these symptoms, no one has
associated dental amalgam with them. But suddenly the familiar
quicksilver of our youth is beginning to look dirty.
(Vision cuts to interview extract)
DR BOYD HALEY (University of Kentucky) 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, 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.
(Vision cuts to interview extract)
JOHN HUNT (Chief Executive, British Dental Association) The
epidemiological evidence thus far - and every other bit of evidence
ttsat we've seen, not just ourselves but the scientific experts and
the
toxicologists - points to amalgam being as safe as any other material.
(Vision cuts to interview extract)
DR MURRAY VIMY (University of Calgary) Mercury is a poison - there's
no safe level. The World Health Organisation has determined that, and
so how can we continue to implant that into people's teeth?
VOICE OVER: Dentists have been using amalgam for over a century,
convinced of its safety. Mercury is used to bond silver and other
metals together to make a cheap, efficient and durable filling, yet no
one has proven that when the mercury goes into our bodies it is safe.
The dentists have always assumed it was safe because these were no
identifiable side-effects - but dentists may not have been the right
people to look for the subde but dangerous symptoms of low-level
mercury poisoning. Supposing there have been side-effects, but of the
kind only doctors are qualified to recognise? Has the evidence always
been there?
Tonight we examine the new scientific clues that place amalgam firmly
in the dock, on suspicion of causing harm to humans. It's a case where
both sides, believers and non-believers, are fundamentally divided on
even the most basic issues.
Amalgam's most vehement suppon comes fsom the British Dental
Association (BDA), the professional body to which most dentists
belong. They run a service that includes giving their members an
up-to-date scientific advisory service. John Hunt is the Chief
Executive and Peter Gordon the scientific adviser. They do no original
work, but review other studies.
(Vision cuts to interview extract)
BBC REPORTER: Is amalgam safe?
PETER GORDON (Scienc Adviser, BDA): In a word, yes.
BBC REPORTER: No doubt about that at all?
PETER GORDON: No doubt about it at all.
BBC REPORTER: Is there anybody it is not safe for?
PETER GORDON: There may be a small percentage of the population with
an allergy to amalgam, but it really is very, very small - in fact
less than 50 worldwide in the last 100 years.
BBC REPORTER: So it must be 99.9 per cent safe?
PETER GORDON: Yes, in our opinion.
(Vision cuts away from interview)
VOICE OVER: Dr Lars Friberg spoke recently at a German amalgam
conference. He's the world's leading authority on mercury poisoning
and was Chief Adviser to the World Health Organisation on mercury
safety. Until now he's remained studiously neutral in the mercury
debate.
(Vision cuts to interview extract)
BBC REPORTER: Dr Friberg, is there a safe level of mercury?
DR LARS FRIBERG (Consultant, World Health Organisation) No, 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.
BBC REPORTER: So there's no amount, in your opinion, that should
really
go into the body?
DR FRIBERG: I would like to avoid it as Far as possible.
BBC REPORTER: If there is no safe level of mercury, why does the
British Dental Association say there is one?
DR FRIBERG: I don't know, but I think they're wrong.
(Vision cuts away from interview)
VOICE OVER: The first evidence of mercury's joumey into the body came
ten years ago. Dentists had always assumed that mercury stayed inert
in the filling, but scientists discovered that the gleamy new amalgam
inside a polished tooth didn't stay put - it leaked as mercury vapour
and entered the bloodstream.
This is an electron microscope picture of a ten-year-old amalgam
Eilling. Those black holes are where the mercury used to be. In this
filling, some 40 per cent has evaporated in only ten years. So where
did it go, and could it cause harm to humans?
The challenge was taken up in Western Canada by two men from different
disciplines. Their co-operation has produced scientific revelations
which are so damning that they may yet bring about the end of the
very use of dental amalgam. Fritz Lorscheider and Murray Vimy set
about clearing the smoke surrounding the amalgam mystery. Vimy, the
academic dentist and World Health Organisation consultant, and
Lorscheider, Psofessor of Medical Physiology at the University of
Calgary, pioneered a simple but dramatic experiment to show not only
where the missing mercury went, but also that it did do harm when it
got there. Their work shattered the comfortable illusion that mercury
and amalgams were stable and safe. They took a sheep and put fillings
in its teeth containing radioactive mercury, which would show up as
black on X-rays.
(Vision cuts to footage of Dr Vimy looking at an x-ray)
DR VIMY: Here's the outline of the sheep, and this is the jawbone;
here are the two stomachs; this area is the liver; here are the two
kidneys, and this is the transverse colon. So the mercury from the
fillings which were slightly radioactive migrated to these tissues. In
fact it was in all the tissues. The dental profession said: well, it's
a sheep - it chews too much, they grind a lot, they regurgitate their
food - it's not a good example.
BBC REPORTER: So they repeated the work with monkeys, and found that
again the mercury had spread. Furthermore, they discovered that even
small amounts of mercury from amalgams damaged the kidneys of the
sheep.
(Vision cuts to interview extract)
BBC REPORTER: When you look at all the current scientific evidence,
what do you think it's trying to tell you?
DR VIMY: It 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.
(Vision cuts away from interview extract)
VOICE OVER: But animal studies were one thing - what science now
had to prove was chat mercury from fillings in human beings was a
major source of the bodys intake of the metal, and that this mercury
not only accumulated but stayed inside the body's most sensitive
organs.
They cracked that one here, at the University of Arizona.
The university's Department of Molecular and Cellular Biology is
headed by the world-renowned Professor Vasken Aposhian. He used
tablets to draw out mercury in the body's sensitive organs. Students
volunteered to take part.
For over a century, dentists believed that mercury from fillings
didn't even enter the body. But Aposhian's results, published two
years ago, were an astonishing rebuttaL They showed that no less than
two thirds of the mercury in the body came from tooth fillings.
(Vision cuts to interview extract)
PROFESSOR VASKEN APOSHIAN (University of Arizona): I'm worried that
the
amount of mercury coming from dental amalgams that we're putting in
the mouths of young children today might be harmful to them as far as
effecting their learning abilities, their performance abilities. I'd
hate to think that 20 years from now we will have hurt some of these
children when we could have prevented it by proper scientific
research, and that is what we must do now.
VOICE OVER: The professor simply doesn't know if enough mercury from
fillings enters the body to do harm - but nor is he waiting to find
out.
PROFESSOR APOSHIAN: I'd hate to see amalgams in the mouth of my
grandchildren, who are 5 years and 8 years of age now, when there are
better materials, and I think then are better materials now available.
BBC REPORTER: And safer?
PROFESSOR APOSHIAN: And safer.
(Vision cuts to new interview extract)
BBC REPORTER: Are you aware of the work of Professor
Aposhian, Professor of Molecular and Cellular Biology at the
University of Arizona?
PETER GORDON: No.
BBC REPORTER: Not at all?
PETER GORDON: (Shakes head)
BBC REPORTER: Did you know that he had shown that two thirds of
the mercury excreted from the human body comes from dental amalgams?
JOHN HUNT: No, I didn't know that
BBC REPORTER: Isn't this, gentlemen, the kind of document that ought
to
be on your desks?
JOHN HUNT: Yes, I'm surprised that it isn't in the bundle that we have
got, but nevertheless I think that if it were, and if you produced it,
we would have had a look at it, and asked our experts to have a look
at it, and reviewed the sciencific methodology and the interpretation
of the findings. We need to have a look at these papers and certainly
routinely we do - this one we appear to have missed.
(Vision cuts away from interview)
VOICE OVER: Now even more ominous evidence has been uncovered, this
time about the dangers of amalgam mercury in the most vulnerable and
sensitive organ of all. It was a dentist in Los Angeles who first
discovered from his examination of bodies in the mortuary that mercury
from dental amalgam travels to the brain, and the more fillings, the
more it accumulates.
Dr David Eggieston is a dentist in California. His clients include Tom
Cruise. His less glamorous work recently took him to the county morgue
to investigate the relationship between dental mercury and the brains
of the dead. Eggleston spent months studying the records, and
discovered that mercury from amalgams not only accumulates in the
brain, but some of this poison stays in the skull for as long as 40
years.
(Vision cuts to new interview extract)
DR DAVID EGGLESTON (University of Southern California): I think there
is
legitimate concern regarding the mercury issue in dentistry. Mercury
does release from the silver fillings; it does accumulate in the body.
BBC REPORTER: Do you insert mercury amalgam in this practice?
DR EGGLESTON: No, I do not.
BBC REPORTER: For the reasons you've just given?
DR EGGLESTON: For the mercury issue, yes.
BBC REPORTER: And have you had your amalgam fillings removed?
DR EGGLESTON: Yes I have.
BBC REPORTER: Again, for the same reason?
DR EGGLESTON: For concern with mercury, yes.
(Vision cuts away from interview)
VOICE OVER: So if dental mercury enters and stays in the brain for
most of our lives, then what evidence is there that it produces
long-term damage? Testing humans for mercury damage over a lifetime
would be a notoriously difficult and expensive study. No one has ever
tried.
But suddenly researchers are on the verge of a breakthrough. The
dental records of scores of elderly nuns in a convent in Wisconsin may
hide pan of the answer to one of amalgam's greatest riddles: is there
a link between the mercury in fillings and the deadly disease of
Alzheimer's? A unique study, starting witts these files, may provide
the clues. These sprightly ladies have made it into a fulfilling old
age. They've agreed to take pan in a scientific gamble, by donating
their brains to medical researchers, who will look for a positive
relationship between dental amalgams and Alzheimer's disease.
Already some scientists are reaching provisional conclusions about the
dangers of dental amalgams.
(Vision cuts to new interview extract)
BBC REPORTER: Is there any doubt in your mind about the association
between mercury and Alzheimer's?
DR BOYD HALEY (University of Kentucky): I would not want to make a
statement that mercury causes Alzheimer's disease, but 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.
VOICE OVER: Dr Boyd Haley, Professor of Medicinal Biochemistry, has
just made a dramatic breakthrough while investigating the implication
of dental amalgam in Alzheimer's. He's discovered that even tiny
quantities of the metal can produce chaages in the brain that are
identical to changes caused by the disease. Specifically, the mercury
inhibits the efficiency of tubulin, a protein essential to brain
cells.
DR HALEY: 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. If it's not bothering someone when they're young, especially
when they age it can turn into something quite disastrous.
BBC REPORTER: So, in the worst-case scenario, what happens to the
human
being?
DR HALEY: You would become demented.
BBC REPORTER: Although Dr Haley knows there's still no proof of
damage,
he for one has heard enough.
BBC REPORTER: What did you do about your own fillings?
DR HALEY: I still have one amalgam filling, but when I have them
replaced I have them replaced with non-amalgam material.
BBC REPORTER: Why?
DR HALEY: Because I'm concemed enough that I don't want it in my
mouth. Nor do I want it in the mouths of my children, or my wife.
(Vision cuts to BDA interview extract)
BBC REPORTER: Are you aware of the association between dental mercury
and Alzheimer's?
PETER GORDON: As far I know there is no association with mercury and
Alzheimer's.
BBC REPORTER: Are you aware of a paper by Dr Boyd Haley, of the
University of Kentucky?
PETER GORDON: No.
BBC REPORTER: Gentlemen, this was published in 1993 - isn't this a
document that should be on your desk?
JOHN HUNT: I come back to the point that we rely on expert advice.
BBC REPORTER: But what kind of advice are you getting if these papers
are not being put on your desk so that you can inform your dentists
and members of the public?
JOHN HUNT: We look to a group of people, including our consultants,
but also we rely upon the Deparanent of Health and other bodies to let
us have their results and their advice about results that they would
have read in papers.
BBC REPORTER: These are key papers, Mr Hunt, these are very important
papers, aren't they? A relationship between dental amalgam and
Alzheimer's is not an unserious matter.
JOHN HUNT: No - we should look at that paper.
(Vision cuts away from interview)
VOICE OVER: A few dentists who have read the new data now refuse to
handle amaLgam at all. The majority who do are warned by their dental
associations to deal with it with considerable caution and respect.
(Vision shows dentists wearing protective clothing)
Some even treat it like a journey to a hostile planet. Given
their occupational exposure to dental amalgam, they are taking
sensible precautions. But are all these precautions enough to
protect the dentists and their assistants from the mercury
vapour that they'll encounter in the workplace?
One long-established and apparent fact has always consoled dentists
who work with amalgam - if it doesn't hurt us, they argue, how can it
harm you, the patient? But in a dramatic new study to be published
shonly, even that comforting truth is now revealed as yet another
illusion.
A dentist is being tested for his speed of action and reaction as part
of a complex assessment of his central nervous system. Dr Diana
Echeverria, a neuro-toxicologist, has just completed a remarkable
study: she tested American dentists to see whether they have the
subtle but dangerous symptoms of mercury poisoning.
DR DIANA ECHEVERRIA (University of Washington): The kinds of things
that we have found are: losses in function associated with the ability
to move very small things with your hands - a manual dexterity
problem; other kinds of really distinct functionsconcentration, the
inability to concentrate. Actually those are skills that anybody
needs.
(Vision cuts to interview)
PROFESSOR APOSHIAN: If I were to time how fast you could put this pen
into these holes, or similar tasks - normal people might take, let's
say, one second to find the right hole and very quickly make the
connections. A person with a deficit would take more time, maybe two
or maybe even five seconds. In the studies that Diana did, she was
measuring things in milliseconds, which is an even more careful
approximation of the times.
BBC REPORTER: What are the implications?
PROFESSOR APOSHIAN: The implications are that in the dental
technicians the mercury has caused very definite central nervous
system disorders.
(Vision cuts away from interview)
VOICE OVER: No one has ever tested human beings who have such a low
level of mercury before. Dentists will be alarmed to leam that some of
their physical functions and emotions are already being injured by
exposure to such small levels of mercury vapour. It's only a question
of time and research funds before similar tests are conducted on
patients. And to add to the discomforting news, the difference in body
mercury levels between dentists and patients is already too close for
comfort.
(Vision cuts to interview)
BBC REPORTER: Doctor, is there an overlap between the lowest figure
of exposure for dentists and the highest figure for ordinary patients
with quite a lot of amalgam fillings?
DR ECHEVERRIA: Probably, yes.
BBC REPORTER: And does that mean then that a lot of patients are
probably suffering the same symptoms that the dentists are suffering?
DR ECHEVERRIA: That's the next research question that we need to ask
ourselves, because we don't know for sure. We have indications that
comparable effects are appearing just above that range, but the
leading question now is whether or nor we have a problem at that
lower overlap level.
BBC REPORTER: But that means that at that level, the safety margin is
extremely small.
DR ECHEVERRIA: Very narrow, extremely narrow. That's a major concern,
that's right.
(Vision cuts to other interview)
BBC REPORTER: Just tell me this - because people will say "OK, that's
bad, it takes a microsecond longer to put a pen into a hole." Does it
matter?
PROFESSOR APOSHIAN: My greatest worry would be among children.
Children are going to school, they are being taught things, they are
being taught how to handle living situations, everyday situations,
they're being given information that we hope they'll keep in their
minds for a better way of life. It is conceivable that, as they're
being educated and as they're being trained to do something, their
training will not stay with them as long, they may not be able to do
things as quickly, and therefore they will not be able to be judged
proficient in cenain tasks.
(Vision cuts away from interview)
VOICE OVER: If you write to the British Dental Association here in
Wimpole Street, asking about the safety of amaigam fillings, they'll
send you a so-called fact sheet. It covers the subject of children by
stating categorically that the evidence available to the BDA doesn't
justify banning the use of amalgam in young children. Yet it's
precisely the young who are most vulnerable to mercury poisoning.
These children at a Liverpool comprehensive have on average a couple
of fillings each. It's easy to demonstrate how the mercury vapour
escapes from these small fillings. We invited an expen to bring a
mercury vapour tester to check. The air around the fillings is
measured. Even without stimulation, some mercury vapour is escaping
from the filling. Then the filling is rubbed to simulate chewing,
brushing or grinding. This time there's no doubt the mercury vapour
has begun to leak copiously, and this is the actual reading the needle
goes off the scale.
(Vision cuts to schoolroom)
BBC REPORTER: She's only got one filling, hasn't she?
TESTER: Right.
BBC REPORTER: And if she had eight fillings?
TESTER: There'd be eight times as much.
VOICE OVER: The United States authorities recommend a maximum safe
mercury exposure limit of ten micrograms a day. But scientists have
discovered that dental amalgams alone can produce between 1 and 29
micrograms of mercury vapour a day. So some people exceed the safety
limits for mercury just with their fillings.
(Vision cuts to BDA interview)
BBC REPORTER: Do you believe it is safe to use amalgam in children?
JOHN HUNT (BDA Chief executive): Yes, certainly. I've treated my
children with amalgam, and I have no doubt that when they have their
own children, they will also require amalgam.
(Vision cuts away from interview)
VOICE OVER: In Sweden, Dr Lars Friberg, the world authority on metals
poisoning, remains baffled at the various attempts by dental lobbies
to maintain a rearguard defence for a material whose time, he feels,
has come.
(Vision cuts to Friberg interview)
BBC REPORTER: British dentists say that there is no evidence that
it shouldn't be continued for use in children.
DR LARS FRIBERG (Consultant, World Health Organisation): Yes. I think
there is no basis for such a statement.
BBC REPORTER: Are you saying that children are particulady vulnerable?
DR FRIBERG: 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.
BBC REPORTER: You don't think that putting mercury into the brain of a
child is a good thing at all, do you?
DR FRIBERG: No, I don't think so.
(Vision cuts away from interview)
VOICE OVER: But it's not just young children who are at risk. Even
the unborn have mercury pollution in their brains from their mother's
amalgams. This evidence came to light in a study just completed by
Professor Gustav Drasch, a forensic toxicologist. He examined the
brains of dead babies and foetuses and found mercury deposits across
the placenta into their tiny skulls.
(Vision cuts to quote)
PROFESSOR GUSTAV DRASCH (University of Munich): I think the
implications are serious. It is a question of whether or not we have
to restrict the application of dental amalgam for women, not only of
childbearing age, but even before - because if, for instance, a girl
of 15 gets an amatgam filling, this fiilling lies in her mouth For ten
years, all the time releasing some mercury. If this girl gets
pregnant, say five years after she has a mercury filling, the mercury
goes to the baby. So really the question now being discussed in
Germany today is, not to forbid it, but to restrict amalgam fillings
for women from, say, 15 to 50 years.
(Vision cuts to BDA interview)
BBC REPORTER: Do you believe it's safe to use amalgam in pregnant
women?
PETER GORDON (BDA Scientific Adviser) There's no evidence to say it is
unsafe.
BBC REPORTER: But are you saying it's safe to use with pregnant women?
JOHN HUNT: Yes, there's no doubt that the available data we have at
present demonstrates that amalgam is just as safe as any other
material that we may use for pregnant women.
BBC REPORTER: This is terribly important, isn't it? Mercury crosses
the
placenta and goes into the unbom child.
JOHN HUNT: Before you say it is dangerous or poses a risk, you have to
say that mercury in those places is dangerous. There's no evidence to
suggest that, merely because it is found in the kidneys and so on of
foetuses and young children, it is a hazard to health.
BBC REPORTER: Do you think that mercury, one of the most toxic metals
known to man, is a good thing in the brain of an unborn child?
JOHN HUNT: As far as I know there's nothing to prove that it is
causing any damage.
BBC REPORTER: Don't you think that this is something that ought to be
put into your fact sheet?
PETER GORDON: I don't see why we should necessarily worry the
population at large if there are no proven arguments one way or the
other - the fact that it is there and detectable doesn't mean to say
that it's potentially doing any damage.
BBC REPORTER: I havc to say, gentlcmen, that I havcn't met anybody who
thinks that mercury in the brain of an unbom child is a good thing.
PETER GORDON: But you can probably, with the correct analysis, find a
whole lot of other substances in the brain that perhaps shouldn't be
there.
(Vision cuts away from interview)
VOICE OVER: As these are the men who give scientific advice to
British dentists, it's not surprising that pregnant women are still
treated with amalgam fillings despite the possible health hazards to
their unbom babies. In Britain they are encouraged to take free
tteatment on the National Health.
Joe Rich is an ordinary NHS dentist. Like thousands of others, he has
been told little about the latest scientific evidence about mercury.
He doesn't know that much of it points towards the health hazards of
amalgam to vulnerable groups such as the expectant mother in his
chair.
(Vision cuts to new interview)
BBC REPORTER: You are happy to place amalgam fillings in the
mouths of babies, children and pregnant women?
JOE RICH (NHS denaist): Indeed.
BBC REPORTER: No problem in that respect?
JOE RICH: I have no reason to doubt the efficacy of the treatment and
that there are few, if any, dangers to the patient in using it.
(Vision cuts to Friberg interview)
BBC REPORTER: We know that the mercury goes into the brain of the
unborn child. Can this - under any circumstances - be a good thing?
DR FRIBERG: No. I would say no. I think that you should try to
avoid to implant toxic metals in the mouth.
BBC REPORTER: Why then does an organisation like the British Dental
Association say that mescury is safe for everybody unless they are
allergic to it?
DR FRIBERG: Well, I don't know why they say it. That's impossible for
me to answer.
BBC REPORTER: You have written a standard textbook on the toxicology
of
metals, and you don't agree with them, do you?
DR FRIBERG: No I don't.
(Vision cuts away from interview)
VOICE OVER: Sweden is the first country in the world whose parliament
has banned amalgam. They've taken the dangers so seriously that
amalgam's use will end within three years at the latest, and within
six years all mercury will be outlawed. The Swedes have read the
writing on the wall and decided to take action. Faced with opposition
from the dental lobbies and anxious at the potential legal
implications, parliament carefully wrapped the legislation up in a
total environmental package. The members of parliament who had pushed
for the ban knew what the real targets were.
(Vision cuts to new interview)
BBC REPORTER: People say that the only reason the Swedes are
banning dental amalgam is on environmental grounds. Is that true?
SIW PERSSON (Member of Swedish Palliament): No, really not. It's one
reason, but the most important reason is, of course, the health
reason.
BBC REPORTER: Why has Sweden been the first country to ban dental
amalgam - because there's still no evidence, there's no final proof,
that dental amalgam actually hurts human beings?
SIW PERSSON: We said we have seen enough, now we have to stop it
before much more people are more sick than they are today.
(Vision cuts away from interview)
VOICE OVER: The use of amalgam in children under the age of 19 will
be totally banned exactly one year from now. All amalgam fillings for
adults will cease by 1997. The Swedes are fully aware that there is
still no proven evidence that dental amalgam harms humans, but they
have been reading the latest evidence, and their assessment of the
risk/benefit ratio has been changed by it for ever. The health
benefits of amalgam, they judge, are no longer worth the risks.
Now other countries are following Sweden's lead. In Germany, amalgam
is banned for patients with kidney problems and recommended to be used
with great caution in children and pregnant women. Austria plans to
ban their mercuiy amalgams within six years. And in Califomia a new
law now demands that dentists who use amalgam display a health warning
to their patients.
Degussa, whose headquarters are in Germany, is one oE the world's
larger manufacturers of dental amalgam. Even they have now decided to
get out of amalgam, thus abandoning nearly half their dental-products
tumover. They say that there are innocent commercial reasons for this,
but one of their executives suggests there's prudence in the decision
too.
(Vision cuts to new interview)
BBC REPORTER: You are saying that, despite all this new scientific
evidence, it's a commercial coincidence that you are getting
out of amalgam?
DR MATTHIAS KUHNER (Senior manager, Degussar) It was a decision that
was driven by business reasons.
BBC REPORTER: Which would include legal reasons?
DR KUHNER: Definitely. When you are looking at a business, legal
action can have an intluence on your business. It can greatly increase
the cost of your business if you have to take a lot of legal action or
have to deal with a lot oE legal actions, even if you are sure that in
most cases or in all cases you come out being found not guilty.
BBC REPORTER: In that sense, surely the writing is on the wall for
amalgam?
DR KUHNER Well, as I said before, I feel that the use of amalgam is
going to decline even more in many nations.
(Vision cuts away from interview)
VOICE OVER: Instead, the company is concentrating on making
composites - the plastic altematives aLready used extensively in front
teeth. Currenty they are not as cheap and durable as amalgams, and
Degussa, like many competitors, is hard at work looking for the dream
composite that will rival the cost and strength of amalgam.
So is there an acceptable altemative to mercury amalgam? We've learned
of a scientific breakthrough in the development of a new mercury-free
alloy at this federal research institute near Washington, but they
won't let us film inside.
The question is, how can the demise of mercury amalgam be announced
without acknowledging that mercury shouldn't have been there in the
first place? The new material wrapped in commercial secrecy behind
these walls will be hailed not as a substitute for amalgam, for
reasons of health, but as an improvement on it. This cover story will
please the dentists - and the fillings should be safe for patients,
too.
(Vision cuts to Eggleston interview)
DR DAVID EGGLESTON (University of Southern California): The material
is here and developed. It has to go through trials and research before
it becomes approved, and that will take a few years.
BBC REPORTER: How long?
DR EGGLESTON: I've been told in some quarters to expect two years for
that process to be completed.
BBC REPORTER: Will it be more expensive?
DR EGGLESTON: It will be exactly the same cost - maybe even less
expensive. It uses the same equipment for placement and actually has a
superior strengch once it's in place.
BBC REPORTER: And will it last as long?
DR EGGLESTON: Predictions are that it will last longer, that it has a
supezior strength.
BBC REPORTER: Let's get this absolutely straight: the reason this
new material has been worked on is in order to eliminate mercury
from the entire chemistry?
DR EGGLESTON: There's no question. There's no incentive to develop
this material other than to get rid of mercury.
(Vision cuts away from interview)
BBC REPORTER: So that's the concern with which the whole ama(gam issue
is handled overseas. What's Britain doing? Nothing much, really. We
had hoped to bring you an interview with someone from the Department
of Health, but they refused to talk to us on camera. We would have
asked them what, if anything, has changed since 1986, when they last
looked at the issue and decided that there was no problem with
amalgam. Indeed, they said the controversy didn't even merit research
priority. They've just handed us a four-line statement. I've read it,
but there's nothing new in it.
But while govemment ignores the issue, there is a new awareness in
some quarters that patients need greater protection against the
possible health hazards. Stephen Challacombe is Professor of Medicine
at Guy's Hospital in London and one of Britain's top dentists. He has
bothered to keep up with the new research, and finds much of it
compelling.
(Vision cuts to new interview)
BBC REPORTER: Are you satisfied that amalgam is safe?
PROFESSOR STEPHEN CHALLACOMBE (Guy's Hospital): No, I don't think so.
I think the evidence over the last few years has really suggested that
we should have another look at the ultimate safety of amalgams.
BBC REPORTER: What do you make of the official government view, the
Department of Health view, which is that there is no problem and
therefore it doesn't even merit the priority of further research?
DR CHALLACOMBE: I think things have changed. There are a number of
very good groups in Europe - in Germany, and in Scandinavian countries
of course - who have been very much aware of the environmental effects
of mercury and have looked in some detail at possible biological
effects from mercury from amalgams. I'm a researcher, I'm a clinical
academic, and very keen that we should be absolutely sure of our
facts, and there's no doubt in my mind that we should be supporting
research in this and other countries. We shouldn't be left behind.
BBC REPORTER: And in that sense you wouldn't agree with the govemment
position at all?
DR CHALLACOMBE: If the government position is still that we don't need
sesearch, no, I think that's outdated.
(Vision cuts to BDA interview)
BBC REPORTER: Aren't you in danger of making exactly the same
mistake that was made over lead, asbestos and DDT - that we
had to wait for too long, there were too many tragic side-effects
before the accumulation of scientific evidence showed conclusively
that these were highly dangerous substances?
JOHN HUNT: Well, we can only rely upon the evidence that we have to
date, and I don't think that the amount of mercury that is released -
and we know it's released from amalgam restorations - there's no
evidence to date that it does cause any trouble.
(Vision cuts away from interview)
VOICE OVER: At Murray Vimy's surgery in Calgary, a young woman
anxious to avoid passing mercury to any future child has an amalgam
filling extracted. Paradoxically this process has its health hazards
too, because the drilling out creates a dangerous surge of mercury
vapour - hence all the protective equipment on both sides of the
chair. Extraction of fillings is a serious step unless medically
indicated - patients should consult their doctors or dentists before
making a decision.
(Vision cuts to Challacombe interview)
BBC REPORTER: Professor, can I ask you to in the briefest and
simplest way give advice to people who will have seen this film and
who will wonder if they should take their amalgam fillings out?
What is your considered advice?
DR CHALLACOMBE: I think it would be premature for people to replace
their amalgam fillings. No, the answer is: do not rush to your dentist
to have your amalgam fillings replaced. I think there is dearly a need
for further research, and when all that is through, in the long term
there may be different advice. But there is a danger of doing more
harm than good at this stage, so do not rush out and have your amalgam
fillings replaced.
BBC REPORTER: In the dark places where men work with mercury, turning
old fillings into new, they treat the volatile metal with great
respect. Yet those charged with the responsibility of keeping dentists
and their patients informed deny these realities by insisting there is
still no final proof of amalgam's harm to humans. But in science,
absence of proof is not proof of absence. Ask the men who take the
risks.
------------
BIBLIOGRAPHY
------------
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)
------------------------------------------------------------
ADDENDUM - THE POSITION IN 1996 - SOME ANALYSIS
Despite over 3 years of time, the dental authorities have
largely failed to take further action.
The Swedish government was unable to implement its planned total
Amalgam ban - because of European Union laws on fair trading
access - such a decision needs now to be taken by the EU as
a whole.
The "Californian Nuns" research failed to reveal a direct
Amalgam-Alzheimers link. The ADA have trumpeted this research
as "proof" of the saftey of Amalgam - but it in fact no such thing.
To begin with, the sample was small - around 100 subjects.
Hence a tendancy of around 1% or less would go unnoticed anyway.
Yet 1% would be 2 million people in the USA - so much bigger samples
are needed. The group selected may not be satisfactory - commonsense
tells us that nuns probably do not have the lifestyle that
may provoke Amalgam problems - they do not chew gums, drink
excessive sugary or acid foods/soda drinks spend periods in
front of VDU monitors, (all indicated to increase Hg leakage
from amalgams) and so on. They may be unlikely eat junk-food or
have a poor diet - diet and general health will effect the
bodies natural Hg defence mechanisms such as Glutathione.
Since one of the characteristics of mercury poisoning is
aggression and irritability, a group of nuns may be
"self-censoring" in this respect - ie. Hg victims will drop out.
For this reason, surveys must have large samples, monitoring
a population cross-section in such a manner as not to miss out
potential victims. It may be better to target possible object
groups (ie. Alzheimers, CFS/ME, MS..) directly.
STOP PRESS - NEW NEWS --------------------------------------------
The following quote is from The Valley Advocate, December 5, 1996.
"A team of scientists led by Dr. Boyd Haley recently completed a study
exposing six laboratory rats to a typical intake of amalgam mercury
vapor, diluted to account for the size difference between rats and
humans. To the researchers' astonsihment, every rat developed symptoms
and brain tissue damage indistinguishable from that of Alzheimer's
Disease patients. The reseachers then repeated their experiment only
to find the same results. While the jury is still out for human
patients, the leader of the research team had seen enough. Dr.
Bronte's new book The Mercury in Your Mouth: The Truth About 'Silver'
Dental Fillings quotes Dr. Haley's response to the group's findings.
'The results of this experiment are terrifying,' he said. 'I'm getting
the rest of my fillings taken out right now, and I've asked my wife to
have hers replaced too.'"
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