Mercury and Dental Amalgam,
FDA
(with
Medical Study References)
I. Introduction
II. Toxicity and Health Effects of Mercury
III. Systemic Mercury Intake Levels from Amalgam Filling Exposure
IV. Immune System Effects and Autoimmune
Disease
V. Medical Studies Finding Health Problems Related to
Amalgam Fillings
VI. Documented Results of Removal of Amalgam Fillings
VII. Health Effects from Dental Staff Exposure to
Mercury
VIII. Scientific Panel and Government Bodies That Have Found Amalgam
Fillings Unsafe
_________________________________________________________________________________
I.
Toxic metals such as mercury, lead, cadmium, etc. have been documented to be
neurotoxic, immunotoxic, reproductive/developmental toxins that according to
U.S. Government agencies cause adverse health effects and learning disabilities
to millions in the U.S. each year, especially children and the
elderly(105,160). Exposure of humans and animals to toxic metals such as
mercury, cadmium, lead, copper, aluminum, arsenic, chromium, manganese, etc. is
widespread and in many areas increasing. . The U.S. Center for Disease
Control(276) ranks toxic metals as the number one environmental health threat
to children. According to an EPA/ATSDR assessment, the toxic metals mercury,
lead, arsenic, and cadmium are all ranked in the top 7 toxics having the most
adverse health effects on the public based on toxicity and current exposure
levels in the U.S., with nickel and chromium also highly listed. While there
are large numbers of neurological and immune conditions among adults, the
incidence of neurotoxic or immune reactive conditions in infants such as
autism, scizophrenia, ADD, dyslexia, learning disabilities, etc. have been
increasing especially rapidly in recent years(2,276,409,441). A recent
report by the National Research Council found that 50% of all pregnancies in
the U.S. are now resulting in prenatal or postnatal mortality, significant
birth defects, or otherwise chronically unhealthy babies(441). Exposure
to toxic chemcials or environmental factors appear to be a factor in as much as
28 percent of the 4 million children born each year(441), with 1 in 6 having
one of the neurological conditions previously listed. EPA estimates that over 3
million of these are related to lead or mercury toxicity(2,276,409).
While there is considerable commonality to the health effects commonly caused
by these toxic metals, and effects are cumulative and synergistic in many
cases, this paper will concentrate on the health effects of elemental mercury
from amalgam fillings. Studies have found considerable genetic variability in
susceptibility to toxic metals as well. The public appears to be
generally unaware that considerable scientific evidence supports that mercury
is the metal causing the most widespread adverse health effects to the public,
and amalgam fillings have been well documented to be the number one source of
exposure of mercury to most people, with exposure levels often exceeding
Government health guidelines and levels documented to cause adverse health
effects.
II. Toxicity
and Health Effects of Mercury
1. Dental
amalgam contains about 50 % mercury. The average filling has 1 gram of
mercury and leaks mercury vapor continuously due to mercury’s low vapor
pressure along with loss due to galvanic action of mercury with dissimilar
metals in the mouth(182,192,292,348,349), resulting in significant exposure for
most with amalgam fillings(see Section III). Mercury vapor is transmitted
rapidly throughout the body, easily crosses cell membranes, and like
organic methyl mercury has significant toxic effects at much lower levels of
exposure than other inorganic mercury forms(38,281,287,304,329). According to
the U.S. EPA & ATSDR, mercury is among the top 3 toxic substances
adversely affecting large numbers of people(217), and amalgam is the
number one source of exposure for most people(see III).
2. Mercury
is the most toxic of the toxic metals. Mercury (vapor) is carried by the blood
to cells in all organs of the body where it:
(a) is cytotoxic(kills cells)
(2,21,27,36,56,147,148,150,160,210,259,295,333/333)
(b) penetrates and damages the blood brain barrier(311), resulting in
accumulation of mercury and other toxic substances in the brain(14,20,25,85,
99,175,273,301/262,274); also accumulates in the motor function
areas of the brain and CNS(48,291,327,329).
© is neurotoxic(kills brain and nerve cells): damages
brain cells and nerve cells (19,27,34,36,43,69,70,147,148,175,207, 211,273,
291,295,327,329,301,303,395/39,262,274,303); generates high levels of reactive
oxygen species(ROS) and oxidative stress, depletes glutathione and thiols
causing increased neurotoxicity from interactions of ROS, glutamate, and
dopamine(13,56,98,102,126,145,169,170,184,213,219, 250, 257,259,286,290,291,302,324,326,329,424);
kills or inhibits production of brain tubulin cells (66,67,161,166,
207,300); inhibits production of neurotransmitters by inhibiting:
calcium-dependent neurotransmitter release(372,432), dihydroteridine reductase(27,122,257,333),
nitric oxide synthase(259), blocking neurotransmitter amino acids(438), and
effecting phenylalanine, seratonin, tyrosine and tryptophan transport to
neurons (34,122,126,257,285, 288,333,372,374,438/255,333)
(d) is immunotoxic(damages and inhibits immune T-cells, B-cells, neutrophil
function, etc.)
(17,27,31,38,44,45,46,60,127,128,129,130,152,155,165,181,226,252,270,285,316,355/272)
and induces ANA antibodies and autoimmune
disease(38,43,45,59,60,118,131,181,234,269,270,313,314,334,342,343)
(e) is
nephrotoxic(toxic to kidneys) (14,20,203,223,260,268,334)
(f) is
endocrine system-disrupting chemical(accumulates in pituitary gland and damages
or inhibits pituitary glands hormonal functions at very low
levels(9,19,20,25,85,99,105,273,312,327,348,369/274), adrenal gland
function(84,369,381), thyroid gland function(50,212,369), and disrupts
enzyme production processes at very low levels of exposure
(9,13,33,56,111,194,348,355,410-412)
(g) exposure to mercury vapor (or methyl mercury)
causes rapid transmittal through the placenta to the fetus
(20,22-24,27,38,39,61,112,186,281,287,304,311,338,339,348,361,366,20/4,22,37,39,41,42)
and significant developmental effects-much more damage to the fetus than for
maternal exposure to inorganic mercury and at lower exposure levels than for
for organic mercury(287,304,etc.).
(h) reproductive and developmental toxin
(2,4,9,10,22,23,24,37,38,41,61,105,149,160,275,276,281,305,338,
361,367,381,20/4,39,55,149,162,255,308,339,357); damages DNA(296,327,272,392,142,38,41,42)
and inhibits DNA & RNA synthesis(114/149); damages sperm,
lowers sperm counts and reduces motility. (4,37,104.105,159,160/4, 55,162);
causes menstrual disturbances (9,27,146); reduces bloods ability to transport
oxygen to fetus and transport of essential nutrients including amino acids,
glucose, magnesium, zinc and Vit B12(43,96,198,263,264,338,339,347,427);
depresses enzyme isocitric dehydrogenase (ICD) in fetus, causes reduced iodine
uptake & hypothyroidism(50,91,212,222,369) & learning deficits; causes
learning disabilities and impairment, and reduction in
IQ(1,3,38,110,160,285c,263,264/39), causes infertility
(4,9,10,24,38,121,146,357,365,367/4,10,55,162), causes birth defects
(23,35,37,38,110,142,241/241).
(i) prenatal/early postnatal exposure
affects level of nerve growth factor in the brain,impairs astrocyte
function, and causes imbalances in development of
brain(38,119,161,175,194,305/175,255,39)
(j) causes cardiovascular damage and
disease: including damage to vascular endothelial cells, damage to sarcoplasmic
reticula, sarcolemma, and contractile proteins, increased white cell count,
decreased oxyhemoglobin level, high blood pressure, tachycardia, inhibits
cytochrome P450/heme synthesis(84), and increased risk of acute myocardial
infarction (35,59,202,205,212,232,306,310,351/201,308).
(k) causes immune system damage resulting
in allergies, asthma, lupus,chronic fatigue syndrome(CFS),and multiple
sensitivities(MCS)
(8,17,45,46,52,60,75,86,87,90,97,101,128,129,131,154,168,181,212, 226,
228,230,234,265, 267,296,313,342, 388/272) and neutrophil functional
impairment(285/59,etc.).
(l) causes interruption of the cytochrome
oxidase system/ATP energy function(84) and progressive
coproporphyrinuria, resulting in low energy, digestive problems, and
porphyrins in urine (34,69,70,73,210,212,226,232,260)
(m)
inhibition of immune system facilitates increased damage by bacterial, viral,
and fungal infections (17,45,59,129,131,251,296,350,40), and
increased antibiotic resistance(116,117,161,258,389,53).
(n) mercury causes significant destruction of
stomach and intestine epithelial cells, resulting in damage to stomach
lining(leaky gut)(222,Shelton,228) and accumulation of heliobacter pylori, a
suspected major factor in stomach ulcers and stomach cancer(256).
(o) causes mitochondrial release of
calcium induced by modification of the--SH groups of proteins
(1,21,35,38,43,329,333,432),as well as damaging enzymatic
process(33,96,111,194,252,338,410-412) resulting in improper cysteine
regulation(194), inhibited glucose transfer(338,254), damaged sulfur oxidation
processes(33,338), and reduced glutathione availability (necessary for
detoxification)(13,126,54).
3.
Mercury has been well documented to be an endocrine system disrupting chemical
in animals and people, disrupting function of the pituitary gland, thyroid
gland, enzyme production processes, and many hormonal functions at very low
levels of exposure . Mercury (especially mercury vapor) rapidly crosses the
blood brain barrier and is stored preferentially in the pituitary gland,
hypothalamus, and occipital cortex in direct proportion to the number and
extent of dental amalgam surfaces (1,14,16,19,20,25,34,38,61,85,99,162,211,
273,274,287,327,348,360,366,369) Thus mercury has a greater effect on the
functions of these areas. The pituitary gland controls many of the
body’s endocrine system functions and secretes hormones that control most
bodily processes, including the immune system and reproductive systems
. One study found mercury levels in the pituitary gland ranged from 6.3
to 77 ppb(85), while another(348) found the mean level to be 30ppb- levels
found to be neurotoxic and cytotoxic in animal studies. The hypothalamus
regulates body temperature and many metabolic processes. Mercury damage thus
commonly results in poor bodily temperature control, in addition to many
problems caused by hormonal imbalances. Such hormonal secretions are
affected at levels of mercury exposure much lower than the acute toxicity
effects normally tested, as previously confirmed by hormonal/reproductive
problems in animal populations(104,381). Mercury also damages the blood
brain barrier and facilitates penetration of the brain by other toxic metals
and substances(311).
4.
Mercury’s biochemical damage at the cellular level include DNA damage,
inhibition of DNA and RNA
synthesis(4,38,41,42,114,142,197,272,296,392/149); alteration of protein
structure(33,111,114,194,252/114); alteration of the transport of
calcium(333,43,96,254,329,432); inhibitation of glucose transport(338,254), and
of enzyme function and other essential
nutrients(96,198,254,263,264,338,339,347,410-412); induction of free
radical formation(13,54), depletion of cellular gluthathione(necessary for detoxification
processes) (111,126), inhibition of glutathione peroxidase enzyme(13),
endothelial cell damage(202), abnormal migration of neurons in the cerebral
cortex(149), and immune system damage (34,38,111,194, 226,252,272,316,325,355).
Oxidative stress and reactive oxygen species(ROS) have been implicated as major
factors in neurological disorders including stroke, PD, Alzheimer’s, ALS,
etc.(13,56,84,98,145,169,207b,424). Mercury induced lipid peroxidation has been
found to be a major factor in mercury’s neurotoxicity, along with leading to
decreased levels of glutathione peroxidation and superoxide
dismustase(SOD)(13). Only a few micrograms of mercury severely disturb
cellular function and inhibit nerve
growth(175,147,175,226,255,305). Exposure to mercury results in
metalloprotein compounds that have genetic effects, having both structural and
catalytic effects on gene expression(114,241,296). Some of the processes
affected by such metalloprotein control of genes include cellular respiration,
metabolism, enzymatic processes, metal-specific homeostasis, and adrenal stress
response systems. Significant psysiological changes occur when metal ion
concentrations exceed threshold levels. Such metalloprotein formation
also appears to have a relation to autoimmune reactions in significant numbers
of people(114,60,313,342,368,369). Of a population of
over 3000 tested by the immune lymphocyte reactivity test(MELISA,60,275), 22%
tested positive for inorganic mercury and 8% for methyl mercury .
A direct mechinism involving mercury’s
inhibition of cellular enzymatic processes by binding with the hydroxyl
radical(SH) in amino acids appears to be a major part of the connection
to allergic/immune reactive conditions such as autism, schizophrenia, eczema,
psoriasis(375,385,408,413,419,438,439,33), and allergies(410-412,etc.). For
example mercury has been found to strongly inhibit the activity of dipeptyl
peptidase (DPP IV) which is required in the digestion of the milk protein
cassein(411,412) as well as of xanthine oxidase(439). Studies involving a large
sample of autistic and schizophrenic patients found that over 90 % of those
tested had high levels of the milk protein beta-casomorphin-7 in their blood
and urine and defective enzymatic processes for digesting milk
protein(410). Elimination of milk products from the diet has been found
to improve the condition. Such populations have also been found to have
high levels of mercury and to recover after mercury detox(413,60,313). As
mercury levels are reduced the protein binding is reduced and improvement in
the enzymatic process occurs. Additional cellular level enzymatic effects of
mercury’s binding with proteins include blockage of sulfur oxidation
processes(33,114,438), enzymatic processes involving vitimins B6 and B12(418),
effects on the cytochrome-C energy processes(232,35), along with mercury’s
adverse effects on cellular mineral levels of calcium, magnesium, zinc, and
lithium(43,96,198,333,386,427,432,38). And along with these blockages of
cellular enzymatic processes, mercury has been found to cause additional
neurological and immune system effects in many through immune/autoimmune
reactions (60,313,314).
But the effect on the immune system of exposure to various toxic substances
such as toxic metals and environmental pollutants has also been found to have
additive or synergistic effects and to be a factor in increasing eczema,
allergies, asthma, and sensitivity to other lesser allergens. Most
of the children tested for toxic exposures have found high or reactive levels
of other toxic metals, and organochlorine
compounds(413,313,414). Much mercury in
saliva and the brain is also organic (220,272), since mouth bacteria and other
organisms in the body methylate inorganic mercury to organic mercury(51,
81,225). Bacteria also oxidize mercury vapor to the water soluble,
ionic form Hg(II) (431).
5.
Because of the extreme toxicity of mercury, only ½ gram is required to
contaminate a 10 acre lake to the extent that a health warning would be issued
by the government to not eat the fish(151,160). Over half the rivers and
lakes in Florida have such health warnings(160). Some Florida
panthers that eat birds and animals that eat fish containing very low levels of
mercury(about 1 part per million) have died from chronic mercury
poisoning(104,160). Since mercury is an estrogenic chemical and
reproductive toxin, the majority of the rest cannot reproduce. The
average male Florida panther has higher estrogen levels than females, due
to the estrogenic properties of mercury(105,160). Similar is true of some
other animals at the top of the food chain like alligators, which are affected
by mercury and other hormone disrupting chemicals..
6.
In addition to having estrogenic effects, mercury has other documented hormonal
effects including effects on the reproductive system resulting in lowered sperm
counts, defective sperm cells, and lowered testosterone levels in males;
menstrual disturbances and infertility in women; and increased neurological problems
related to lowered levels of neurotransmitters dopamine, serotonin, and
noreprenephrine (4,9,38,104,105,107,140,141,275,276,
288,290,365,367,372,381,432,438).
7. An
average amalgam filling contains over ½ gram of mercury, and the average adult
had at least 5 grams of mercury in fillings(unless most has vaporized).
Mercury in solid form is not stable, having low vapor pressure and being
subject to galvanic action with other metals in an oral
environment(182,192,292,348,349),so that within 10 years up to half has been
found to have been transferred to the and body of the host(34,35,182, &
section III).
8.
Elemental mercury vapor is more rapidly transmitted throughout the body than
most other forms of mercury and has more much toxic effects on the CNS and
other parts of the body than inorganic mercury due to its much greater capacity
to cross cell membranes, according to the World Health Organization and
other studies (38,183, 282,287,360,section III). Mercury vapor rapidly crosses
the blood-brain barrier(14,85,311) and placenta of pregnant women
(20,22-24,27,38,105,162,186,231,281,287,304,308, 311,361) Developmental,
learning, and behavioral effects have been found from mercury vapor at much
lower levels than for exposure to methyl mercury(287,304). Similarly for
inhibition of some essential cellular processes(333,338,329).
9.
Running shoes with ½ gram of mercury in the heels were banned by several
states, because the amount of mercury was considered dangerous to public health
and created a serious disposal problem. Mercury from dental
10.
Studies have found that levels of exposure to the toxic metals mercury,
cadmium, and lead have major effects on classroom behavior, learning ability,
and also in mental patients and criminals behavior(3,160).
Studies
have found that both genetic susceptability and environmental exposures are a
factor in xenobiotic related effects and disease propagation. Large
numbers of animal studies have documented tha
11. Long
term occupational exposure to low levels of mercury can induce slight cognitive
deficits, lability, fatigue, decreased stress tolerance, etc. Higher levels
have been found to cause more serious neurological problems
(119,128,285,etc.). Occupational exposure studies have found mercury
impairs the body’s ability to kill Candida albicans by impairment of the lytic
activity of neutrophils and myeloperoxidase in workers whose mercury excretion
levels are withing current safety limits(285,404). Such levels of mercury
exposure were also found to inhibit cellular respiratory burst. A
population of plant workers with average mercury excretion of 20 ug/ g creatinine
was found to have long lasting impairment of neutrophil function. Another
study(59) found such impairment of neutraphils decreases the body’s ability to
combat viruses such as those that cause heart damage, resulting in more
inflamatory damage. Another group of workers with average excretion rates
of 24.7 ug/ g creatinine had long lasting increases in humoral immunological
stimulation of IgG, IgA, and IgM levels. Other studies(285b,g) found that
workers exposed at high levels at least 20 years previous(urine peak levels
above 600 ug/L demonstrated significantly decreased strength, decreased
coordination, increased tremor, decreased sensation, polyneuropathy,
etc. Significant correlations between increasing urine mercury
concentrations and prolonged motor and sensory distal latencies were
established(285g). Elemental mercury can affect both motor and sensory
peripheral nerve conduction and the degree of involvement is related to
time-integrated urine mercury concentrations.
Another study found that many of the symptoms and signs of chronic candidiasis,
multiple chemical sensitivity and chronic fatigue syndromes are identical to
those of chronic mercurialism and remit after removal of amalgam combined with
appropriate supplementation and gave evidence to
implicate
amalgam as the only underlying etiologic factor that is common to
all(404).
Other
studies(285c) found that mercury at levels below the current occupational
safety limit causes adverse effects on mood, personality, and memory- with
effects on memory at very low exposure levels.
More
studies found that long term exposure causes increased micronuclei in
lymphocytes and significantly increased IgE levels at exposures below current
safety levels(128), as well as maternal exposure being linked to mental
retardation(110) and birth defects(23,35,37,38,142,241,361/241).
III.
Systemic Mercury Intake Level from Amalgam Fillings
1.
The tolerable daily exposure level for mercury developed in a
report for Health Canada is .014 micrograms/kilogram body
weight(ug/kg) or approximately 1 ug/day for average adult(217). The U.S.
EPA Health Standard for elemental mercury exposure(vapor) is 0.3 micrograms
per cubic meter of air(2). The U.S. ATSDR health standard(MRL) for
mercury vapor is 0.2 ug/ M3 of air, and the MRL for methyl mercury is 0.3 ug/kg
body weight/day(217). For the average
adult breathing 20 M3 of air per day, this amounts to an exposure of 4 or 6
ug/day for the 2 elemental mercury standards. The EPA health
guideline for methyl mercury is 0.1 ug/kg body weight per day or 7 ug for the
average adult(2), or approx. 14 ug for the ATSDR acute oral toxicicity
standard. Since mercury is methylized in the body, some of both types are
present in the body. The older World Health Organization(183)
mercury health guideline(PTWI) is 300 ug per week total exposure or approx. 42
ug/day.
2.
Mercury in the presence of other metals in the oral environment undergoes
galvanic action, causing movement out of amalgam and into the oral mucosa and
saliva(174,192,436). Mercury in solid form is not stable due to low vapor
pressure and evaporates continuously from amalgam fillings in the mouth,
being transferred over a period of time to the
host(15-19,26,31,36,79,83,211,182,183,199,298,299,303,332,335,371).
The daily total exposure of mercury from fillings is from 3 to 1000 micrograms
per day, with the average exposure being above 10 micrograms per day and the
average uptake over 5 ug/day (183,199,209,18,19,77,83,
85,100,335,352,371,etc.). (see further details continued)
A large study was carried out at the Univ. Of Tubingen Health Clinic in
which the level of mercury in saliva of 20,000 persons with amalgam fillings
was measured(199). The level of mercury in unstimulated saliva was
found to average 11.6 ug Hg/L, with the average after chewing being 3 times
this level. Several were found to have mercury levels over 1100
ug/L, 1 % had unstimulated levels over 200 ug/L, and 10 % had
unstimulated mercury saliva levels of over 100 ug/L.. The level of
mercury in saliva has been found to be proportional to the number of amalgam
fillings, and generally was higher for those with more fillings. The
following table gives the average daily mercury exposure from saliva alone for
those tested, based on the average levels found per number of fillings and
using daily saliva volumes of 890 ml for unstimulated saliva flow and 80 ml for
stimulated flow (estimated from measurements made in the study and comparisons
to other studies). It also gives the 84th percentile mercury exposure
from saliva for the 20,000 tested by number of fillings. Note that 16% of
all of those tested with 4 amalgam fillings had daily exposure from their
amalgam fillings of over 17 ug per day, and even more so for those with more
than 4 fillings.
Table: Average daily mercury exposure in saliva by number of
amalgam fillings(199)
Number of fillings: 4
5
6
7 8
9
10
11 12
13 14
15 16
Av. Daily Hg(ug) 6.5
8 9.5
11 12.4
14 15.4
16.9 18.3 19.8 21.3
22.8 24.3
84th percentile(ug) 17 23.5
26 30.5 35
41.5 43.8
48.6 50.3 46.7 56.6
61.4 64.5
Saliva tests for mercury are commonly performed in Europe, and many other
studies have been carried out with generally comparable
results(292,315,79,9b,335,179,317,352). Another large German study(352) found
significantly higher levels than the study summarized here, with some with
exposure levels over 1000 ug/day.
Three
studies that looked at a population with more than 12 fillings found generally
higher levels than this study, with average mercury level in unstimulated
saliva of 29 ug/L(18), 32.7 ug/L (292c), and 175 ug/day(352). The average
for those with 4 or less fillings was 8 ug/L(18). While it will be seen
that there is a significant correlation between exposure levels and number of
amalgam surfaces and exposure generally increases as number of fillings
increases, there is considerable variability for a given number of
fillings. Some of the factors that will be seen to influence this
variability include composition of the amalgam, whether person chews gum or
drinks hot liquids, bruxism, oral environmental factors, type of tooth patse
used, etc.
The Tubingen study did not assess the significant exposure route of intraoral
air and lungs. One study that looked at this estimated a daily
average burden of 20 ug from ionized mercury from amalgam fillings absorbed
through the lungs(191), while a Norwegian study found the average level in oral
air to be 0.8 ug/M3(176). Another study at a Swedish
University(335) measured intraoral air mercury levels from fillings of
from 20 to 125 ug per day, for persons with from 18 to 82 filling
surfaces. Another study found similar results(83), and some individuals
have been found to have intraoral air mercury levels above 400 ug/ M3
(319). Most of those whose intraoral air mercury levels were measured
exceeded Gov’t health guidelines for workplace exposure(2).
The studies also determined that the number of fillings is the most important
factor related to mercury level, with age of filling being much less
significant(319b). Different filling composition/manufacturer can also
make a difference in exposure levels( as will be further
discussed). The authors of the Tubingen study calculated that based
on the test results with estimates of mercury from food and oral air included,
over 40 % of those tested in the study received daily mercury exposure higher
than the WHO standard(PTWI). As can be seen most people with several
fillings have daily exposure exceeding the Health Canada TDE and the U.S. EPA
and ATSDR health guideline for mercury(2,209,199,etc.), and many tested in past
studies have exceeded the older and higher WHO guideline for mercury(183),
without consideration of exposure from food, etc..
3.
The main exposure paths for mercury from amalgam fillings are absorption by the
lungs from intraoral air; vapor absorbed by saliva or swallowed; amalgam
particles swallowed; and membrane, olfactory, venous, and neural path transfer
of mercury absorbed by oral mucosa, gums, etc.
(6,17,18,31,34,77,79,83,94,133,174,182,209,211,216,222,319,335,348,364,436)
A study at Stockholm Univ.(335) made an effort to determine the respective
parts in exposure made by these paths. It found that the majority of
excretion is through feces, and that the majority of mercury exposure was from
elemental vapor. Daily exposure from intraoral air ranged from 20 to 125 ug of
mercury vapor, for subjects with number of filling surfaces ranging from 18 to
82. Daily excretion through feces amounted to from 30 to 190
ug of mercury, being more variable than other paths. Other studies
had similar findings(6,15,16,18,19,25,31,36,79,80,83,115,196,386.)
The feces mercury was essentially all inorganic with particles making up at
most 25%, and the majority being mercury sulfuhydryl compounds- likely
originating as vapor. Their study and others reviewed found that at
least 80% of mercury vapor reaching the lungs is absorbed and enters the blood
from which it is taken to all other parts of the body(335,348,349,363).
Elemental mercury swallowed in saliva can be absorbed in the digestive tract by
the blood or bound in sulfhydryl compounds and excreted through the
feces. A review determined that approx.20 % of swallowed mercury sulfhydryl
compounds are absorbed in the digestive tract, but approx 60% of
swallowed mercury vapor is absorbed(292,335,348). At least 80% of particle
mercury is excreted. Approx. 80% of swallowed methyl mercury is
absorbed(335,199,etc.)e, with most of the rest being converted to inorganic
forms apparently. The primary detoxification/excretion pathway for mercury absorbed
by the body is as mercury-glutathione compounds through the liver/bile loop to
feces(111,252), but some mercury is also excreted though the kidneys in urine
and in sweat. The range of mercury excreted in urine per day by those with
amalgams is usually less than 15 ug(6,49,83,138,174,335,etc.), but some
patients are much higher(93). A large NIDH study of the U.S. military
population(49) with an average of 19.9 amalgam surfaces and range of 0 to 60
surfaces found the average urine level was 3.1 ug/L, with 93% being inorganic
mercury. The average in those with amalgam was 4.5 times that of controls and
more than the U.S. EPA maximum limit for mercury in drinking water(218).
The avergage level of those with over 49 surfaces was over 8 times that of
controls. The same study found that the average blood level was 2.55 ug/L, with
79 % being organic mercuy. The total mercury level had a significant
correlation to the number of amalgam fillings, with fillings appearing to be
reponsible for over 75% of total mercury. From the study results it was found
that each 10 amalgam surfaces increased urine mercury by approx. 1 ug/L.
A study of mercury species found blood mercury was 89% organic and urine
mercury was 87% inorganic(349b), whicle another study(363) found on average 77%
of the mercury in the occipital cortex was inorganic. In a population of
women tested In the Middle East(254), the number of fillings was highly
correlated with the mercury level in urine, mean= 7 ug/L. Nutrient transport
and renal function were also found to be adversely affected by higher levels of
mercury in the urine.
As is known from autopsy studies for those with chronic exposure such as
amalgam fillings (1,14,17,20,31,34,85,94), mercury also bioaccumulates in
the brain/CNS(301,274,327,329,348,18,19,85),liver, kidneys,
(14,85)heart(59,205,348)), and oral mucosa(174,192,436) with the half life in
the brain being over 20 years. Elemental mercury
vapor is transmitted throughout the body via the blood and readily enters cells
and crosses the blood-brain barrier, and the placenta of pregnant
women(38,61,287,311,361), at much higher levels than inorganic mercury and also
higher levels than organic mercury. Significant levels are able to cross the
blood brain barrier, placenta, and also cellular membranes into major organs
such as the heart since the oxidation rate of Hg0 though relatively fast is
slower than the time required by pumped blood to reach these organs(290,370).
Thus the level in the brain and heart is higher after exposure to Hg vapor than
for other forms(360,370). While mercury vapor and methyl
Hg readily cross cell membranes and the blood-brain barrier, once
in cells they form inorganic mercury that does not readily cross cell membranes
or the blood brain barrier readily and is responsible for the majority of
toxicity effects. Thus inorganic mercury in the brain has a very long
half life(274,etc.).
4.
The average amalgam filling has approximately 0.5 grams(500,000 ug) of
mercury. As much as 50% of mercury in fillings has been found to have
vaporized after 5 years and 80% by 20 years(182,204). Mercury vapor
from amalgam is the single largest source of systemic mercury intake
for persons with amalgam fillings, ranging from 50 to 90 % of total exposure.
(14,16,17,19,36,57,61,78-83,94,129,130,138,161,167,183, 191,
196,211,216,273,292,303,332,),
averaging about 80% of total systemic intake. After filling replacement
levels of mercury in the blood, urine, and feces typically temporarily are
increased for a few days, but levels usually decline in blood and urine within
6 months to from 60 to 85% of the original levels(57,79,82,89,196,303). Mercury
levels in saliva and feces usually decline between 80 to 95%
(79,196,335,386)
5. Having
dissimilar metals in the teeth(e.g.-gold and mercury) causes galvanic action,
electrical currents, and much higher mercury vapor levels and levels in
tissues. (182,192,292,348,349,390,19,25,27,29,30,47,48,100) Average
mercury levels in gum tissue near amalgam fillings are about 200 ppm, and are
the result of flow of mercury into the mucous membrane because of galvanic
currents with the mucous membrane serving as cathode and amalgam as
cathode(192). Average mercury levels are often 1000 ppm near a gold cap
on an amalgam filling due to higher currents when gold is in
contact with amalgam (30,25,35,48). These levels are among the highest levels
ever measured in tissues of living organisms, exceeding the highest levels
found in chronically exposed chloralkali workers, those who died in Minamata,
or animals that died from mercury poisoning. Concentrations of mercury in
oral mucosa for a population of patients with 6 or more amalgam fillings taken
during oral surgery were 20 times the level of controls(174). German oral
surgeons have found levels in the jaw bone under large amalgam fillings or gold
crowns over amalgam as high as 5760 ppm with an average of 800 ppm(436).
These levels are much higher than the FDA/EPA action level for prohibiting use
of food with over 1 ppm mercury. Likewise the level is tremendously over
the U.S. Dept. Of Health/EPA drinking water limit for mercury which is 2 parts
per billion(218). Studies have shown that mercury in the gums such as from root
caps for root canaled teeth result in chronic inflammation, in addtion to
migration to other parts of the body(200,47). Mercury and silver from
fillings can be seen in the tissues as amalgam “tatoos”, which have been found
to accumulate in the oral mucosa as granules along collagen bundles, blood
vessels, nerve sheaths, elastic fibers, membranes, striated muscle fibers, and
acini of minor salivary glands. Dark granules are also present
intracellularly within macrophasges, multinucleated giant cells, endothelial
cells, and fibroblasts. There is in most cases chronic inflammatory response or
macrophagic reaction the the metals(47), usually in the form of a foreingn body
granuloma with multinucleated giant cells of the foreign body and Langhans
types(192).
The component mix in amalgams has also been found to be an important factor in
mercury vapor emissions. The level of mercury and copper released from
high copper amalgam is as much as 50 times that of low copper
amalgams(191). Studies have consistently found
modern high copper non gamma-two amalgams have greater release of mercury vapor
than conventional silver amalgams (298,299). While the non
gamma-two amalgams were developed to be less corrosive and less prone to
marginal fractures than conventional silver amalgams, they have been found to
be instable in a different mechanism when subjected to wear/polishing/ chewing/
brushing: they form droplets of mercury on the surface of the
amalgams(182,297). This has been found to be a factor in the much higher
release of mercury vapor by the modern non gamma-two amalgams.
Recent studies have concluded that because the high mercury release levels of
modern amalgams, mercury poisoning from amalgam fillings is widespread
throughout the population”(95,199,238). Numerous other studies also
support this finding(Section IV).
Amalgam also releases significant amounts of silver, tin, and copper which also
have toxic effects, with organic tin compounds formed in the body being
even more neurotoxic than mercury(51,222,262)
7.
Feces is the major path of excretion of mercury from the body, having a higher
correlation to systemic body burden than urine or blood, which tend to
correlate with recent exposure level (35,36,79,80,183, 278). For this reason
many researchers consider feces to be the most reliable indicator of daily
exposure level to mercury or other toxics. The average level of mercury in
feces of those with fillings is over 1 ppm and approx. 10 times that of a
similar group without fillings (79,80,83,335,386,25,), with significant numbers
of those with several filings having over 10 ppm and 170 times those without
fillings(80). The saliva test is another good test for daily
mercury exposure, done commonly in Europe and representing one of the largest
sources of mercury exposure.
There is only a weak correlation between blood or urine mercury levels and body
burden or level in a target organ(36,157,183,278,11,etc.). Mercury vapor passes
through the blood rapidly(half-life in blood is 3 seconds,370) and
accumulates in other parts of the body such as the brain, kidneys, liver,
thyroid gland, pituitary gland, etc. Thus blood test measures mostly recent
exposure. As damage occurs to kidneys over time, mercury is less
efficiently eliminated (11,36,57,183, 216,260), so urine tests are not
reliable for body burden after long term exposure. Some researchers suggest
hair offers a better indicator of mercury body burden than blood or urine(279),
though still not totally reliable and may be a better indicator for organic
mercury than inorganic.
Hair was
found to be significantly correlated with fish consumption, as well as with
occupational dental exposure and to be a good medium for monitoring internal
mercury exposure, except that external occupational exposure can also affect
hair levels. Mercury hair level in a population sampled in
Madrid Spain ranged from 1.3 to 92.5 ppm. This study found a significant
positive correlation between maternal hair mercury and mercury level in nursing
infants. Hair mercury levels did not have a significant correlation with urine
mercury in one study(340) and did not have a significant correlation to number
of fillings(350). One researcher suggests that mercury levels in hair of
greater than 5 ppm are indicative of mercury intoxication.
A new test approved by the FDA for diagnosing damage that has been caused by
toxic metals like mercury is the fractionated porphyrin test(260), that
measures amount of damage as well as likely
source. Provocation challenge
tests after use of chemical chelators such as DMPS or DMSA also are effective
at measuring body burden(57,58), but DMPS can be dangerous to some people-
especially those still having amalgam fillings or those allergic to sulfur
drugs or sulfites. Many studies using chemical chelators such as DMPS or DMSA
have found post chelation levels to be poorly correlated with prechelation
blood or urine levels(57,115,303), but one study (340) found a significant
correlation between pre and post chelation values when using DMPS.
Challange tests using DMPS or DMSA appear to have a better correlation with
body burden and toxicity symptoms such as concentration , memory, and motor
deficits(290)- with many studies finding a significant correration between post
chelation mercury level and the number of amalgam surfaces(57,172,173,222,290,292,273,303).
Several doctors use 16 ug/L as the upper bound for mercury after DMPS
challange, and consider anyone with higher levels to have excess body
burdern(222,352). However one study(290) found significant effects at lower
levels. Some researchers believe DMSA has less adverse side effects than
DMPS and prefer to use DMSA for chelation for this reason. Some studies have
also found DMSA as more effective at removing mercury from the
brain(58). Another chelator used for clogged arteries, EDTA, forms
toxic compounds with mercury and can damage brain function(307). Use of
EDTA may need to be restricted in those with high Hg levels.
N-acetylcystein(NAC) has been found to be effective at increasing cellular
glutathione levels and chelating mercury(54). Experienced doctors have
also found additional zinc to be useful when chelating mercury(222) as well as
counteracting mercury’s oxidative damage(43). Zinc induces metallothionein
which protects against oxidative damage and increases protective enzyme activities
and glutathione which tend to inhibit lipid peroxidation and suppress mercury
toxicity(430). Also lipoic acid has been found to dramatically
increase excretion of inorganic mercury(over 12 fold), but to cause decreased
excretion of organic mercury(54) and copper. Lipoic acid has a protective
effect regarding lead or inorganic toxicity through its
antioxidant
proprties, but should not be used with high copper. Zinc is a mercury and
copper antgonist and can be used to lower copper levels aand protect against
mercury damage.
8. The
number of amalgam surfaces has a statistically significant correlation to :
(a) blood plasma mercury level
(17,49,79,89,133,211)(usually not as strong as other measures)
(b) urine mercury level
(38,49,57,76,77,79,82,83,134,138,167,176,254,303,332,335)
© oral air(16,18,100,176,335)
(d) saliva and oral
mucosa(18,30,77,79,117,179,174,199,211,222,292,315,317)
(e) feces mercury
(25,79,80,83,115,117,182,335,386)
(f) pituitary gland
(19,20,25,85,99,273/274)
(g) brain occipital cortex
(14,16,19,25,34,85,211,273,348,366/274)
(h) renal(kidney)
cortex(14,16,19,20,85,273,348,366)
(I) liver(14,19,85,366)
(j) motor function areas of the brain & CNS:
brain stem, cerebellum, rhombencephalon, dorsal roo
(k) fetal and infant liver/brain
levels(61,112,186,231) related to maternal fillings.
9. A
person with amalgam fillings has daily systemic intake from mercury vapor of between
3 and 70 micrograms of mercury, with the average being at least 7
micrograms(ug) per day
(18,77,83,85,93,138,183,199,211,292,315,335). In a large German
study, the median daily exposure for those with fillings through saliva was
approx. 10 ug/day, 4% of those with fillings had daily exposure through saliva
of over 80 ug/day, and 1% had over 160 ug/day(199). The methods and results of
the Tubingen study(199) were similar to those of other German
studies(292,315,9, 138, 317,335). Total intake is proportional to the number
and extent of amalgam surfaces, but other factors such as chewing gum, drinking
hot liquids, brushing or polishing, and using fluoride toothpaste
significantly increase the intake(15,18,28,31,100,134-137,182, 183,199,209,211,292,317,319,348,349,350).
Vapor emissions range up to 200 ug/M3 (35) and are much higher after
chewing(137,319). After chewing, those with amalgams had levels over 50 times
higher than those without, and the average level of exposure was 29 ug/day for
those with at least 12 occlusal surfaces(18). At least 30% of those
having amalgam fillings tested in a large German study had ingested mercury
levels exceeding the WHO PTWI mercury standard of 43 ug/day (199,183), and over
50% of those with 6 or more fillings had daily exposures more than the U.S. EPA
health guideline level(199) of 0.1 ug/kg body weight/day(199). The median daily
exposure through saliva for those with 10 or more fillings was over 10 times
that of those with no fillings(199,292,315,318). Mercury level in saliva
has been found to give much better indication of body levels than blood or
urine levels(36). Most people with fillings have daily exposure levels
exceeding the U.S. ATSDR and EPA health guideline levels
(2,36,83,89,183,199,209,217,261,292,335,93)
10.
The blood and urine mercury load of a person with amalgam fillings is often 5
times that of a similar person without.(14,16,17,79,80,82,93,136,138,
303,315,317,318) The average blood level for one large population was 5
ug/l(176). Normal blood levels are less than 20 ppb, but health effects have
been observed in patients in the upper part of this range. A Swedish
study estimated the total amount mercury swallowed per day from intra-oral
vapor was 10 micrograms per day(177),and a large German study(199) found median
exposure through saliva alone for those with fillings to be about 10 ug/day,
with many having several fillings with over 10 times that level. Other
studies have found similar amounts(18,83,211,183,209).
11. Teeth
are living tissue and have massive communication with the rest of the body via
blood, lymph, and nerves. Mercury vapor (and bacteria in teeth ) have paths to
the rest of the body. (34,etc.) German studies of mercury loss from vapor
in unstimulated saliva found the saliva of those with amalgams had at least 5
times as much mercury as for controls(138,199,292,315).
12.
Mercury (especially mercury vapor) rapidly crosses the blood brain
barrier and is stored preferentially in the pituitary gland,
hypothalamus, and occipital cortex in direct proportion to the number and
extent of amalgam surfaces.(14,19,20,25,34,38,85,99,273,274,287,348,366)
Thus mercury has a greater effect on the functions of these areas. The
range in one study was 2.4 to 28.7 ppb(85), and one study found on average that
77% of the mercury in the occipital cortex was inorganic(363).
13. Some
mercury entering nasal passages is absorbed directly into the olfactory lobe
and brain without coming from blood(34,35,182,222,348,364). Mercury
also is transported along the axons of nerve fibres (5,25,34,35,327,329).
14.
Mercury has a long half life in the body and over 20 years in the brain, and
chronic low level intake results in a slow accumulation in body tissues.
(20,34,35,38,85,etc.)
15.
Methyl mercury is more toxic to some body processes than inorganic
mercury. Mercury from amalgam is methylated by bacteria and candida
albicans in the mouth and intestines(51,81,98,182,225). Oral bacteria
streptococommus mitior,S.mutans, and S.sanguis were all found to methylate
mercury(81). High levels of Vit B12 in the system also have been found to
result in increased methyl mercury concentrations in the liver and brain(51).
Methyl mercury is 10 times more potent in causing genetic damage than any other
known chemical (Ramel, in(35)), and also crosses the blood-brain barrier
readily. Once mercury vapor or methyl mercury are converted to inorganic
mercury in cells or the brain, the mercury does not readily cross cell
membranes or the blood-brain barrier. Thus mercury has a very long half
life in the brain. N-acetylcysteine(NAC) has been found to be effective
at increasing glutathione levels and chelating methyl mercury(54,126).
16. The
level of mercury in the tissue of the fetus, new born, and young children
is directly proportional to the number of amalgam surfaces in the mother’s
mouth. (20,23,61,112,210,361) The level of mercury in umbilical cord blood and
placenta was higher than that in mother’s blood(22,186). The saliva and
feces of children with amalgams have approximately 10 times the level of
mercury as children without(25,315,386), and much higher levels in saliva after
chewing. A group of German children with amalgam fillings had urine mercury
level 4 times that of a control group without amalgams(76), and in a Norwegian
group with average age 12 there was a significant correlation between
urine mercury level and number of amalgam fillings(167). The level of
mercury in maternal hair was significantly correlated to level of mercury in
nursing infants(279). One study found a 60% increase in average cord blood
mercury level between 1980 and 1990 in Japan(186).
17. The
fetal mercury content after maternal inhalation of mercury vapor was found to
be higher than in the mother( 4,etc.) Mercury from amalgam in the blood
of pregnant women crosses the placenta and appears in amniotic fluid and fetal
blood, liver, and pituitary gland soon after placement
(20,22,23,31,36,61,162,186,281,348,366). Dental amalgams are the main source of
mercury in breast milk(112,186,304,339,20). Milk increases the bioavailability
of mercury(112,304,391) and mercury is often stored in breast milk and the
fetus at much higher levels than that in the mother's tissues
(19,20,22,23,61,112,186,210, 287,304). The level of mercury in breast milk was
found to be significantly correlated with the number of amalgam fillings(61),
with milk from mothers with 7 or more fillings having levels in milk approx. 10
times that of amalgam free mothers. The milk sampled ranged from 0.2 to 6.9
ug/L. Several authors suggest use of early mother’s milk as a screen for
potenital problems since it is correlated both to maternal and infant mercury
levels. The highest level is in the pituitary gland of the fetus which
affects development of the endocrine to be approx 0 times that for maternal
exposure to an equivalent dose of inorganic mercury(281,287), and developmental
behavioral effects from vapor have been found at levels considerably below that
required for similar effects by methyl mercury(20,49,119c,264,287,304,338).
The level of total mercury in nursing infants was significantly correlated to
total mercury level in maternal hair(22,279).
18. There
is a significant correlation between number of amalgam fillings of the mother
and the level of the fetus and older infants(20,23,61,304), and also with the
level in mother’s milk (19,20,38,112, 304). Fertile women should not be
exposed to vapor levels above government health guidelines(38,61,182,282) ;the
U.S. ATSDR mercury health MRL of 0.2 mcg/M3 (2,217); or have amalgams placed or
removed during pregnancy(20,182,231,304,etc.).
IV.
Immune System Effects and Autoimmune Disease
1. Many
thousands of people with symptoms of mercury toxicity have been found in tests
to have high levels of mercury, and many thousands who have had amalgam
fillings removed(most) have had health problems and symptoms alleviated or
greatly improved(see Section VI). From clinical experience some of the
symptoms of mercury sensitivity/mercury poisoning include chronic fatigue,
dizziness, frequent urination, insomnia, headaches, chronic skin problems,
metallic taste, gastrointestinal problems, asthma(8,97), stuffy nose, drycrusts
in nose, rhinitis, plugged ears, ringing ears, chest pain, hyperventilation,
diabetes, spacy feeling, chilly, chronic skin problems, immune and autoimmune
diseases, cardiovascular problems and many types of neurological problems
(26,34,35,36,38,45,59,60,69,70,71,75,91,109,148,165,204,212,199,246,255,268-270,290,291,294,
313,343). Amalgam results is chronic exposure rather than acute
exposure and accumulation in body organs over time, so most health effects are
of the chronic rather than acute in nature, but serious health problems have
been documented to be related to amalgam and researchers have attributed some
deaths as due to amalgam (356,32,245).
2.
Mercury vapor exposure at very low levels adversely affects the immune
system(17,27,31,38,45,60,84,118,129,
131,165,226,270,285,296,313,314,355368,369). From animal
studies it has been determined that mercury damages T-cells by generating
reactive oxygen species(ROS), depleting the thiol reserves of cells, damaging
and decreasing the dimension of mitochondria, causing destruction of
cytoplasmic organelles with loss of cell membrane integrity, inhibiting ability
to secrete interleukin IL-1 and IL-2R, causing activation of glial cells to
produce superoxide and nitric oxide, and inactivating or inhibiting enzyme
systems involving the sulphydrol protein groups(226,424). Mercury caused
adverse effects on both neutrophil and macrophage function and after depletion
of thiol reserves, T-cells were susceptible to Hg induced cellular death
(apoptosis).(226,272,355) Interferon syntheses was reduced in a
concentration dependent manner with either mercury or methyl mercury as well as
other immune functions(131), and low doses also induce aggregation of cell
surface proteins and dramatic tyrosine phosporlation of cellular proteins
related to asthma, allergic diseases such as eczema and lupus(234), and
autoimmunity(181,314). One study found that insertion of amalgam fillings
or nickel dental materials causes a supression of the number of
T-lympocytes(270), and impairs the T-4/T-8 ratio. Low T4/T8 ratio has
been found to be a factor in lupus, anemia, MS, eczema, inflamatory bowel disease,
and glomerulonephritis. Mercury induced autoimmunity in animals and
humans has been found to be associated with mercury’s expression of major
histocompatibility complex(MHC) class II genes(314,181,226,425c). Both mercuric
and methyl mercury chlorides caused dose dependent reduction in immune B-cell
production. (316) B-cell expression of IgE receptors were significantly
reduced(316,165), with a rapid and sustained elevation in intracellular levels
of calcium induced(316,333). Both forms are immontoxic and cytotoxic ant
very low levels seen in individuals. Mercury also inhibited B-cell and T-cell
RNA and DNA synthesis. The inhibition of these functins by 50 % occurred
rapidly at very low levels, in the range of 10 to 25 ug/L. All types of
cells exhibited a dose dependent reduct in cellular glutathione when exposed to
mercury, inhibiting generation of GSH by lumpocutes and moncytes(252).
Workers occupationally exposed to mercury at levels within guidelines have been
found to have impairment of lytic activity of neutrophils and reduced abiltiy
of neutraphils to kill invaders such as candida(285,404). Immune
Th1 cells inhibit candida by cytokine related activation of macrophages and
neutraphils. Development of Th2 type immune responses deactivate such
defenses(404b). Mercury inhibits macrophage and neutraphil defense against
candida by its affects on Th1 and Th2 cytokine effects(181,285).
Low doses also induced autoimmuntiy in some species(181,314,404,131,129,43).
Another effect found is increase in the average blood white cell count
significantly (35). The increased white count usually normalizes after
amalgam removal. Mercury also blocks the immune function of
magnesium and zinc (198,427,43,38). Several studies found adverse health
effects at mercury vapor levels of 1 to 5 mcg/M3 (35). Large numbers of people
undergoing amalgam removal have clinically demonstrated significant
improvements in the immune system parameters discussed here and recovery and
significant improvement in immune system problems in most cases
surveryed(Section VI).
3.
Mercury from amalgam interferes with production of cytokines that activate
macrophage and neutraphils, disabling early control of viruses and leading to
enhanced infection(131,251). Animal studies have confirmed that
mercury
increases effects of the herpes simplex veris type 2 for
example(131). Both mercuric and methyl mercury were equally highly
toxic at the cellular level and in causing cell volume redcuctions(131).
However methyl mercury inhibits macrophage functions such as migration and
phagocytosis at lower levels.
4. Body
mercury burden was found to play a role in resistant infections such as
Chlamydia trachomatis and herpes family viral infections; it was found many
cases can only be effectively treated by antibiotics after removal of body
mercury burden(cilantro tablets were used with followup
antibiotics)(251,131). Similar results have been found for treatment of
cancer.
5.
Mercury by its effect of weakening the immune system contributes to increased
chronic diseases and cancer(91,180,237,239,222,234,355,38,40,etc,).
Exposure to mercury vapor causes decreased zinc and methionine availability,
depresses rates of methylation, and increased free radicals-all factors in
increased suscepability to cancer(14,34,38,43,143,144,180,237,239,251,256,283).
Amalgam fillings have also been found to be positively associated with mouth
cancer(206,251,403).
6. Among
a group of patients testing positive as allergic to mercury, low level mercury
exposure was found to cause adverse immune system response, including reduction
of in vitro production of tumor necrosis factor TNF alfa and interleukin-1.
(131,152) Mercury also interrupts the cytochrome oxidase system, blocking
the ATP energy function (35,232) and impairing astrocyte
function(119).. These effects often result in fatigue and reduced
energy levels (35,60,119,140,141,182,202,212,232,235,313).
7.
Toxic/allergic reactions to metals such as mercury often result in lichen
planus lesions in oral mucosa or gums and play a roll in pathogenesis of
periodontal disease. A high percentage of patients with oral mucosal problems
along with other autoimmune problems such as CFS have significant immune
reactions to mercury, palladium, gold, and nickel(60,118,313,81,90,212,313,342,368,369,375),
including to mercury preservatives such as thimersol. 94% of such
patients had significant immune reactions to inorganic mercury(MELISA test) and
72% had immune reactions to low concentrations of HgCl2(<0.5 ug/ml). 61% also
had immune reaction to phenylHg, which has been commonly used in root canals
and cosmetics(313). 10% of controls had significant immune
reactions to HgCl and 8.3% to palladium. Removal of amalgam
fillings usually results in cure of such lesions. (46,60,75,78,82, 86,
87,90,94,101,118,133,168,313). Other studies of patients suffering
from chronic fatigue found similar results(369,375). Of 50 patients
suffering from serious fatigue refered for MELISA test(369), over 70% had
significant immune reaction to inorganic mercury and 50% to nickel, with most
patients also reactive to one or more other metals such as palladium, cadmium,
lead, and methyl mercury.
Mercury
has been found to impair conversion of thyroid T4 hormone to the active T3 form
as well
as
causing autoimmune thyroiditis common to such patients(369,382). In
general immune activation from toxics such as heavy metals resulting in
cytokine release and abnormalities of the hypothalamus-pituitary-adrenal axis
can cause changes in the brain, fatigue, and severe psycholgical
symtoms(379-382,385,369,375,381,118,60) such as profound fatigue, muscosketal
pain, sleep disturbances, gastrointestinal and neurological problems as are
seen in CFS, fibromyalgia, and autoimmune thyroidititis. Such symptoms usually
improve significantly after amalgam removal. Such hypersensitivity
has been found most common in those with genetic predisposition to heavy
metal sensitivity(369,60), such as found more frequently in patients with
HLA-DRA antigens(383). A significant portions of the population appear to fall
in this category.
8.
Patients with other systemic neurological or immune symptoms such as arthritis,
myalgia, eczema, CFS, MS, diabetes, etc. also often recover after amalgam
replacement (60,212,313,342,368,369,section VI). Of a group of 86
patients with CFS symptoms, 78% reported significant health improvements after
replacement of amalgam fillings within a relatively short period, and MELISA
test found significant reduction in lymphocyte reactivity compared to pre removal
tests(342,368). The improvement in symptoms and lymphocute reactivity imply
that most of the Hg-induced lymphocyte reactivity is allergenic in
nature. Although patch tests for mercury allergy are often given for
unresolved oral symptoms, this is no
Of the over 3,000 patients tested for lymphocyte reactivity to
metals(342,368,375), the following were the percentages testing positive:
nickel- 34%, inorganic mercury- 23%, phenol mercury- 13%, gold-
12%, cadmium- 11%, palladium- 11%, silver- 1%. Other
studies have also found relatively high rates of allergic reactions to inorganic
mercury and nickel(81,etc.). For groups with suspected autoimmune
diseases such as neurological problems, CFS, and oral lichen planus; most of
the patients tested positive to inorganic mercury and most of such patients
health improved significantly and immune reactivity declined after amalgam
removal. In a group of patients tested by MELISA before and
after amalgam removal at a clinic in Uppsula Sweden, the patients reactivity to
inorganic mercury, palladium, gold and phenyl mercury all had highly significant
differences from the control group, with over 20 % being hihgly reactive to
each of these metals(375). A high percentage were also reactive to nickel
in both groups. After amalgam revoval the immune reactivity to all of
these metals other than nickel declined significantly, and 76% reported
significant long term health improvements after 2 years. Only 2% were
worse. The study concluded that immune reactivity to mercury and
palladium is common and appears to be allegenic/immune related in nature since immune
reactivity declines when exposure levels are reduced. Such studies have
also found that deficiencies in detoxification enzymes such as glutathione
transfereases cause increased susceptibility to metals and other
chemicals(384). Such deficiencies can be due to genetic predisposition,
but are also known to be caused by acute or chronic toxic exposures.
For MS
and lupus patients, a high percentage tested positive to nickel and/or
inorganic mercury.
A patch
test was given to a large group of medical students to assess factors that lead
to sensitization to mercury(132). 13% tested positive for allergy to
mercury. Eating fish was not a significant factor between sensitive and
non- sensitized students, but the sensitized group had a significantly higher
average number of amalgam fillings and higher hair mercury levels. In a
population of dental students tested, 44% were positive for allergy to
mercury(156).
9. A high
correlation has been found between patients subjectively diagnosed with CNS
& systemic symptoms suggestive of mercury intoxication and immune
reactivity to inorganic mercury(MELISA test,118) as well as with MRI positive
patients for brain damage. 81% of the group with health complaints
had pathological MRI results including signs of degeneration of the basal
ganglia of the brain, but none in the controls.
60% of the symptom group tested positive for immune system reaction to mercury.
Controls without CNS problems did not have such positive correlations.
The authors concluded that immune reactions have an important role in
development of brain lesions ,and amalgam fillings induce immune reactions in
many patients (91,118)(270,286). Mercury,nickel,palladium, and gold induce
autoimmunity in genetically predisposed or highly exposed individuals(314,234,130,342,).
Tests have found a significant portion of people to be in this category and
thus more affected by exposure to amalgam than others.
10.
Low level mercury exposure(as well as other toxic metals) including exposure to
amalgam fillings has been found to be associated with increased autoimmune
diseases (19, 27,34,35,44,45,60,215,234,268,269,270, 313,314), including
lupus(12,60,113,234),Chrons Disease,lichen planus(86,87,90,168), endometriosis
(1,9,38,229). Silver also is released from amalgam fillings and stored in
the body and has been shown to cause immune complex deposits, immune reactions
and autoimmunity in animal studies (77,78,129,314).
11.
Mercury exposure through fillings appears to be a major factor in chronic fatigue
syndrome(CFS) through its effects on ATP and immune system(lymphocute
reactivity, neutraphil activity, effects on T-cells and B-cells) and its
promotion of growth of candida albicans in the body and the methylation of
inorganic mercury by candida to the extremely toxic methyl mercury form which
like mercury vapor crosses the blood-brain barrier and also damages and weakens
the immune system(222,225,226,234,235,265,293,60,313,314,342,368,369, 404), and
both inorganic and methyl mercury have been shown in animal studies to
induce autoimmune reactions and disease in susceptible types through effects on
immune system T cells (226,234,268,269,270,314,425,426/272.)
Spatial
and temporal changes in intracellular calcium concentrations are critical for
controlling gene expression and neurotransmitter release in
neurons(432,438). Mercury alters calcium homeostasis and calcium levles
in the brain and affects gene expression and neurotransmitter release through
its effects on calcium, etc.
Mercury
inhibits sodium and potassium (N,K)ATPase in dose dependent manner and inhibits
dopamine and noreprenephrine uptake by synaptosomes(288,50,270).
Mercury lymphocyte reactivity and effects on glutamate in the CNS induce
CFS type symptoms including profound tiredness, musculoskeletal pain, sleep
distubances, gastrointestinal and neurological problems along with other CFS
symptoms and fibromyalgia(342,346,368,369). Mercury has been found to be a
common cause of fibromyalgia(293,346,369). Glutamate is the
most abundant amino acid in the body and in the CNS acts as excitory
neurotransmitter(346,386,438), which also causes inflow of calcium.
Astrocytes, a type of cell in the brain and CNS with the task of keeping clean
the area around nerve cells, have a function of neutralizing excess glutamate
by transforming it to glutamic acid. If astrocytes are not able to
rapidly neutralize excess glutamate, then a buildup of glutamate and calcium
occurs, causing swelling and neurotoxic effects(119,333). Mercury
and other toxic metals inhibit astrocyte function in the brain and CNS(119),
causing increased glutamate and calcium related neurotoxicity(119,333,226a)
which are responsible for much of the fibromylgia symptoms. This is also
a factor in conditions such as CFS, Parkinson’s, and ALS(346,416).
Animal studies have confirmed that increased levels of glutamate(or aspartate,
another amino acid excitory neurotransmitter) cause increased sensitivity to
pain , as well as higher body temperature- both found in CFS/fibromyalgia.
Mercury and increased glutamate activate free radical forming processes like
xanthine oxidase which produce oxygen radicals and oxidative neurological
damage(346,142,13). Medical studies and doctors
treating fibromylagia have found that supplements which cause a decrease in
glutamate or protect against its effects have a positive effect on
fibromyalgia. Some that have been found to be effective include Vit B6,
methyl cobalamine(B12), L-carnitine, choline, ginseng, Ginkgo biloba,vitamins C
and E, nicotine, and omega 3 fatty acids(fish and flaxseed oil)(417).
V.
Medical Studies Finding Health Problems Related to Amalgam Fillings (other than
immune)
1.
Neurological problems are among the most common and serious and include memory
loss, moodiness, depression, anger and sudden bursts of anger/rage(434),
self-effacement, suicidal thoughts, lack of strength/force to resolve doubts or
resist obsessions or compulsions, etc. Many studies of patients with major
neurological diseases have found evidence amalgam fillings may play a major
role in development of conditions such as
depression(107,109,212,222,271,294,212,229,233,285e,317,320,322,372,374),
schizophrenia(34,35,295), memory problems(212,222), and other more serious
neurological diseases such as MS, ALS, Parkinson’s, and Alzheimer’s(see #
25.).
Calcium plays a major role in the extreme neurotoxicity of mercury and methyl
mercury. Both inhibit cellular calcium ATPase and calcium uptake by brain
microsomes at very low levels of exposure(270,288,329,333,432,56,). Protein
Kinase C (PKC) regulates intracellular and extra cellular singals across
neuronal membranes, and both forms of mercury inhibit PKC at micromolar levels,
as well as inhibiting phorbal ester binding(43,432). They also block or inhibit
calcium L-channel currents in the brain in an irreversable and concecentration
dependent manner. Mecury vapor or inorganic mercury exposure affects the
posterior cingulate cortex and causes sysregulation with sufficient exposure(428).
Some of the resulting conditions include stomatitis, tremor, ADD, erythism,
etc. Metallic mercury is much more potent than methyl mercury in such
actions, with 50 % inhibitation in animal studies at 13 ppb(333,329).
Mercury causes decreased lithium levels, which is a factor in neurological
diseases such as depression and Alzheimer’s. Lithium protects brain cells
against excess glutamate and calcium, and low levels cause abnormal brain cell
balance and neurological disturbances (280,294,333,33,56 ). Medical texts
on neurology (27,295) point out that chronic mercurialism is often not
recognized by diagnosticians and misdiagnosed as dementia or neurosis or
functional psychosis or just “nerves”. “Early manifestations are likely
to be subtle and diagnosis difficult: Insomnia, nervousness, mild tremor,
impaired judgment and coordination, decreased mental efficiency, emotional
lability, headache, fatigue, loss of sexual drive, depression, etc. are often
mistakenly ascribed to psychogenic causes”. Very high levels of mercury
are found in brain memory areas such as the cerebral cortex and hippocampus of
patients with diseases with memory related symptoms
(158,34,207,etc.}
Mercury
interacts with brain tubulin and disassembles microtubiles that maintain
neurite structure(207b). Thus chronic exposure to low level mercury vapor
can inhibit polymerzation of brain tubulin essential to formation of
microtubles. Studies of mercury studies on animals give results similar
to that found the the Alzheimer brain.
Animal studies of developmental effects of mercury on the brain have found
significant effects at extremely low exposure levels, levels commonly seen in
those with amalgam fillings or in dental staff working with amalgam. One
study(175) found mercury vapor decreased NGF concentration in rat’s forebrain
at 4 parts per billion(ppb) tissue concentration. Another study(134)
found general toxicity effects at 1 micromole(uM) levels in immature cell
cultures, increased immunoreactivity for glial fibrillary protein at 1 nanamole
(0.2 ppb) concentration, and microglial response at even lower levels.
Other animal studies on rodents and monkeys have found brain cellular migration
disturbances, behavioral changes, along with reduced learning and adaption capacity
after low levels of mercury vapor exposure (210,264,287,149). The
exposure levels in these studies are seen in the fetus and newborn babies of
mother’s with amalgam fillings or who had work involving amalgam during
pregnancy(61).
Epidemiological studies have found that human embryos are also highly
susceptible to brain damage from prenatal exposure to mercury. Studies have
confirmed that there are vulnerable periods during brain and CNS development
that are expecially sensitive to neurotoxic exposures and affect development
processes and results(429). The fetal period is most sensitive, but neural
developement extends through adolescence. Some conditions found to be
related to such toxic exposures include autism, scizophrenia, ADD, dyslexia,
eczema, etc. Prenatal/early postnatal exposure to mercury
affects level of nerve growth factor(NGF) in the brain and causes brain damage
and imbalances in development of the brain (38,119,181,
305,259,210,149,305,24/39,175,255,149). Exposure of developing neuroblastoma
cells to sub-cytotoxic doses of mercuric oxide resulted in lower levels of
neurofilament proteins than unexposed cells(305). Mercury vapor exposure causes
impaired cell proliferation in the brain and organs, resulting in reduced
volume for cerebellum and organs and subtle deficiencies(38,305).
Exposure to mercury and 4 other heavy metals tested for in a study of school
children accounted for 23% of the variation in test scores for reading,
spelling and visual motor skills(3). A Canadian study found
that blood levels of five metals were able to predict with a 98% accuracy which
children were learning disabled(3). Several studies found that mercury causes
learning disabilities and impairment, and reduction in
IQ(3,21,38,110,264,285c,279). Mercury has an effect on the fetal nervous system
at levels far below that considered toxic in adults, and background levels of
mercury in mothers correlate significantly with incidence of birth defects and
still births (23,38,287,10).
2.
Numerous studies have found long term chronic low doses of mercury cause
neurological, memory, behavior,sleep, and mood
problems(3,34,60,69,70,71,74,107, 108,109,119,140,141,199,212,222,246,255,257,
258,282,290). Neurological effects have been documented at very low levels of exposure(urine
Hg< 4 ug/L), levels commonly received by those with amalgam fillings(290).
One of the studies at a German University(199) assessed 20,000 people.
There is also evidence that fetal or infant exposure causes delayed
neurotoxicity evidenced in serious effect at middle age(255,306). Organic tin
compounds formed from amalgam are even more neurotoxic than
mercury(222,262). Studies of
groups of patients with amalgam fillings found significantly more neurological,
memory, mood, and behavioral problems than the control groups.
(3,34,107,108,109,140,141,199,212,222,290).
A high correlation has been found between patients subjectively diagnosed with
CNS & systemic symptoms suggestive of mercury intoxication and immune
reactivity to inorganic mercury(MELISA test,118) as well as with MRI positive
patients for brain damage. Controls without CNS problems did not have
such positive correlations. Mercury,nickel,palladium, and gold induce
autoimmunity in genetically predisposed or highly exposed individuals(314,234,130,342).
Tests have found a significant portion of people to be in this category and
thus more affected by exposure to amalgam than others(see section
V).
3.
Mercury binds to hemoglobin in the red blood cells thus reducing oxygen carrying
capacity(332,35) and adversely affects the vascular response to
norepinepherin and potassium. Mercury also increases cytosolic fre
calcium levels in lymphocytes in a concentration-dependant manner causing
influx from the extracellular medium(270c), and blocks entry of calcium ions
into the cytoplasm (1,16,17,21,33,35,333), and at 100 ppb can destroy the
membrane of red blood cells(35,22,17,270c) and damage blood vessels- reducing
blood supply to the tissues (34,202,306). Amalgam
fillings have been found to be related to higher blood pressure, hemoglobin
irregularities, tachycardia, chest pains, etc.(201,202,205,212,222,306,310,35).
Mercury also interrupts the cytochrome oxidase system, blocking the ATP energy
function(35,232) and impairing astrocyte function(119).. These
effects often result in fatigue and reduced energy levels (35,60,119,140,141,
182,202,212,232,235,313). Mercury
also accumulates in the heart and damages myocardial and heart valves
(Turpayev,in (35)) & (59,201,205,306,351,370). Both mercury and methyl
mercury have been shown to cause depletion of calcium from the heart muscle and
to inhibit myosin ATPase activity by 50% at 30 ppb(59), as well as reducing
NK-cells in the blood and spleen. The interruption of the ATP
energy chemistry results in high levels of porphyrins in the
urine(260). Mercury,lead, and other toxics have different patterns
of high levels for the 5 types of porphyrins, with pattern indicating likely
source and the level extent of damage. The average for those with
amalgams is over 3 time that of those without, and is over 20 times normal for
some severely poisoned people(232,260). The FDA has approved a test measuring
porphyrins as a test for mercury poisoning. However some
other dental problems such as nickel crowns, cavitations, and root canals also
can cause high porphyrins. Cavitations are diseased areas in bone under
teeth or extracted teeth usually caused by lack of adequate blood supply to the
area. Tests by special equipment(Cavitat) found cavitations in over 90% of
areas under root canals or extracted wisdom teeth that have been tested, and
toxins such as anerobic bacteria and other toxics which significantly inhibit
body enzymatic processes in virtually all cavitations(437). These toxins
have been found to have serious systemic health effects in many cases, and
significant health problems to be related such as arthritis, MCS, and
CFS. These have been found to be factors along with amalgam in serious
chronic conditions such as MS, ALS, Alzheimer’s, MCS, CFS, etc.
(35,204,222,292,437).
The problem occurs in extractions that are not cleaned out properly after
extraction(437).
4. Patch
tests for hypersensitivity to mercury have found from 2% to 44% to test
positive (87,154,156, 178, 267), much higher for groups with more amalgam
fillings and length of exposure than those with less. In studies of
medical and dental students, those testing positive had significantly
higher average number of amalgam fillings than those not testing positive(and
higher levels of mercury in urine(132,156). Of the dental students
with 10 or more fillings at least 5 years old, 44% tested allergic. Based
on these studies and statistics for the number with 10 or more fillings, the
percent of Americans allergic to mercury just from this group would be about 17
million people especially vulnerable to increased immune system reactions to
amalgam fillings. However, the total would
be much larger and patch tests do not measure the total population getting
toxic reactions from mercury. The most sensitive
reactions are immune reactions, DNA mutations, developmental,enzyme inhibition,
and systemic
effects(34,38,61,149,186,226,263,264,270,272,296,305,410-412/357).
5. People
with amalgam fillings have an increased number of intestinal microorganisms
resistant to mercury and many standard antibiotics. (35,116,117,161,389) Recent
studies have found that drug resistant strains of bacteria causing ear
infections, sinuitis, and pneumonia moe than doubled since 1996, and similar
for strains of bacteria in U.S. rivers(53). Studies have found a
significant correlation between mercury resistance and multiple antibiotic
resistance (116,117,161,369), and have found that after reducing mercury burden
antibiotic resistance declines(251,389,40).
6.
Mercury from amalgam binds to the -SH (sulphydryl) groups, resulting in
inactivation of sulfur and blocking of enzyme function, producing sulfur
metobolites with extreme toxicity that the body is unable to properly
detoxify(33,114), along with a defeciency in sulfates required for many body
functions. Sulfur is essential in enzymes, hormones, nerve
tissue, and red blood cells. These exist in almost every enzymatic
process in the body. Blocked or inhibited sulfur oxidation at the cellular
level has been found in most with many of the chronic degenertive diseases,
including Parkinson’s, Alzheimer’s, ALS, lupus, rheumatoid arthritis, MCS,
autism, etc(330,331,33,56), and appears to be a major factor in these
conditions. Mercury also blocks the metabolic action of manganese and the
entry of calcium ions into cytoplasm(333). Mercury from
amalgam thus has the potential to disturb all metabolic processes(25,21,33,
35,56,60,111,180,194,197}. Mercury is transported throughout the body in
blood and can affect cells in the body and organs in different ways.
7. A
large study of 20,000 subjects at a German university found a significant
relation between the number of amalgam fillings with periodontal problems,
neurological problems, and gastrointestinal problems(199).
Allergies and hair-loss were found to be 2-3 times as high in a group with
large number of amalgam fillings compared to controls(199,9).
Levels of mercury in follicular fluid was significantly higher for those with
amalgam fillings (9,146). Based on this finding, a Gynecological Clinic that
sees a large number of women suffering from alopecia/hair loss that was not
responding to treatment had amalgams replaced in 132 women who had not
responded to treatment. 68 % of the women then
responded to treatment and alopecia was alleviated(187). In other studies
involving amalgam removal, the majority had significant improvement
(40,317). Higher levels of hormone disturbances, immune disturbances,
infertility, and recurrent fungal infections were also found in the amalgam
group. The results of hormone tests, cell culture studies, an intervention
studies agree(9,146). Other clinics have also found alleviation of hair
loss/alopechia after amalgam removal and detox(40,317). Another study in Japan
found significantly higher levels of mercury in gray hair than in dark
hair(402).
8.
Mercury accumulates in the kidneys with increasing levels over time. One study
found levels ranging from 21 to 810 ppb. Mercury exposure has been shown to
adversely affect kidney function in occupational and animal studies
(20,203,211,260,etc.), and also in those with more than average number of
amalgam fillings(254).. Inorganic mercury exposure has been found to exert a
dose-dependent cytotoxicity by generating extremely high levels of hydrogen
peroxide, which is normally quenched by pyruvate and catalase(203). HgCl2
also has been found to impair function of other organelles such s lysomomes
that maintain transmembrane proton gradient, and to decrease glutathione
peroxidase activity in the kidneys while upregulating heme oxidase
function. The Government's toxic level for mercury in urine is 30
mcg/L (189), but adverse effects have been seen at lower levels and low levels
in urine often mean high mercury retention and chronic toxicity problems.
9.
Amalgam fillings produce electrical currents which increase mercury vapor
release and may have other harmful
effects(19,27,28,29,30,35,100,192,194). These currents are measured
in micro amps. The central nervous system operates on signals in the range of
nano-amps, which is 1000 times less than a micro amp(28).
Negatively charged fillings or crown appear to cause higher mercury vapor
losses(35). Some studies have also
found
persons with chronic exposure to electromagnetic fields(EMF) to have higher
levels of mercury excretion(28).
10.
Mercury from amalgam fillings is transferred to the fetus of pregnant women and
children who breast feed at levels often higher than those of the
mother(18,19,20,23,31,38,61,112, 186,281). Mercury has an effect on the
fetal nervous system at levels far below that considered toxic in adults, and
background levels of mercury in mothers correlate significantly with incidence
of birth defects and still births(10,23,38,197,210,287,361). Mercury vapor
exposure causes impaired cell proliferation in the brain and organs, resulting
in reduced volume for cerebellum and organs and subtle
deficiencies(38,305).
11.
Since mercury(all forms) is documented from studies of humans and animals
to be a reproductive and developmental
toxin(23,38,61,105,186,224,255,287.305,381,etc.), mercury can reduce
reproductive function and cause birth defects and developmental problems in
children(2,4,9,10,20,23,24,31,37,38,39,41,55,61,104,146,159, 162,224,255).
Clinical evidence indicates that amalgam fillings lead to hormone imbalances
that can reduce fertility(9,38,55,4,105,146,367). Mercury has been found
to cause decreased sperm volume and motility ,increased sperm abnormalities and
spontaneous abortions, increased uterine fibroids/endometritis, and decreased
fertility in animals(4,104,105,162) and in
humans(9,37,105,146,159,395,433,27,35,38). In studies of women having
miscarriages or birth defects, husbands were found to typically have low sperm
counts and significantly more visually abnormal sperm(393). Studies indicate an
increase in the rate of spontaneous abortions with an increasing concentration
of mercury in the fathers' urine before pregnancy(37). Subfertile males in Hong
Kong were found to have 40% more mercury in their hair than fertile
controls(55). Studies in monkeys have found decreased sperm motility,
abnormal sperm, increased infertility and abortions at low levels of
methyl mercury(162,365). Researcher's advise pregnant women should not be
exposed to mercury vapor levels above government health standards (2,19,25,227,
61,100,182,282,366); currently U.S. ATSDR mercury health MRL of 0.2 mcg/M3
which is exceeded by any dental work involving amalgam(Section
III). Many governments have bans or restrictions on use of amalgam
by women of child-bearing age.
12.
Mercury causes breaks in DNA (4,38,41,42,197,272,296). Low
non-cytotoxic levels of mercury induce dose dependent binding of mercury to DNA
and significantly increased cell mutations (142,4) and birth
defects(197,38,105).
13.
Mercury has been well documented to be an endocrine system disrupting chemical
in animals and people, disrupting function of the pituitary gland,
hypothallamus, thyroid gland(50,369), enzyme production processes(111,194,33,56),
and many hormonal functions at very low levels of exposure (9,105,146, 210,
312,369). The pituitary gland controls many of the body’s
endocrine system functions and secretes hormones that control most bodily
processes, including the immune system and reproductive
systems(105,312,381). The hypothallamus regulates body temperature and
many metabolic processes. Mercury damage thus commonly results in
poor bodily temperature control, in addtion to many problems caused by hormonal
imbalances. Such hormonal secretions are affected at levels of
mercury exposure much lower than the acute toxicity effects normally
tested. Mercury also damages the blood brain barrier and facilitates
penetration of the brain by other toxic metals and substances (311). Low
levels of mercuric chloride also inhibit ATPase activity in the thyroid, with
methyl mercury inhibiting ATP function at even lower levels(50). Both
types of mercury were found to cause denaturing of protein, but inorganic mercury
was more potent. These effects result commonly in a reduction in thyroid
production(50) and an accumulation in the thyroid of radiation.
Toxic metal exposure’s adverse influence on thyrocytes can play a major role in
thyroid cancer etiology(144) . Among those with chronic
immune system problems with related immune antibodies, the types showing the
highest level of antibody reductions after amalgam removal include
thyreoglobulin and microsomal thyroid antigens(91)
14. There
has been no evidence found that there is any safe level of mercury in the body
that does not kill cells and harm body processes(WHO,183,189,
etc.). This is especially so for the pituitary gland of
the developing fetus where mercury has been shown to accumulate and which is
the most sensitive to mercury(2-4,19-24,30,31,36-44,61,186).
15. Low
levels of mercury and toxic metals have been found to inhibit dihydroteridine
reductase, which affects the neural system function by inhibiting
transmitters through its effect on phenylalanine, tyrosine and tryptophan
transport into neurons(27,98,122,257,289,372,342,372,438). This was
found to cause severe impaired amine synthesis and hypokinesis.
Tetrahydrobiopterin, which is essential in production of neurotransmitters,
is significantly decreased in patients with alzheimer’s, Parkinson’s, MS,
and autism. Such patients have abnormal inhibition of neurotransmitter
production. Such symptoms improved for most patients after
administration of
R-tetrahydrobiopterin(438),
and some after 5-formyltetrahydrofolate, tyrosine(257), and
5-HTP(438).
16. The
level of mercury released by amalgam fillings is often more than the levels
documented in medical studies to produce adverse effects and above the U.S.
government health guidelines for mercury exposure(see previous text).
17. Many
studies of patients with major neurological or degenerative diseases have found
evidence amalgam fillings may play a major role in development of
conditions such as such as Alzheimers (66,67,158,166,204, 207,221,238,242,244,257,295,300),
ALS(92,97,325,346,416,423), MS(102,163,170,183,184,212,285,291, 302, 324,326),
Parkinson’s(98,169,248,250,258,363,56,84),ADD(285e), etc. Mercury
exposure causes high levels of oxidative stress/reactive oxygen species(ROS)(13),
which has been found to be a major factor in neurological disease(56).
Mercury and quinones form conjugates with thiol compounds such as glutathione
and cysteine and cause depletion of glutathione, which is necessary to mitigate
reactive damage. Such congugates are found to be highest in the brain
substantia nigra with similar congugates formed with L-Dopa and dopamine in
Parkinson’s disease(56). Mercury depletion of GSH and damage to cellular
mitochrondria and the increased lipid perxodation in protein and DNA oxidation
in the brain appear to be a major factor in Parkinson’s disease(33,346).
One study found higher than average levels of mercury in the blood, urine, and
hair of Parkinson’s disease patients(363). Another study(169) found blood
and urine mercury levels to be very strongly related to Parkinson’s with odds
ratios of approx. 20 at high levels of Hg exposure. Increased formation of
reactive oxygen species(ROS) has also been found to increase formation of
advanced glycation end products(AG
considered
part of a vicious cycle, which finally leads to neuronal cell death in the
substantia
nigra in PD(424). Another study (145) that reveiwed occupational exposure data
found that occupational exposure to manganese and copper have high odds rations
for relation to PD, as well as multiple exposures to these and lead, but noted
that this effect was only seen for exposure of over 20 years.
Mercury has been found to accumulate preferentially in the primary motor
function related areas such as the brain stem, cerebellum, rhombencephalon,
dorsal roo
Low levels of toxic metals have been found to inhibit dihydroteridine
reductase, which affects the neural system function by inhibiting brain
transmitters through its effect on phenylalanine, tyrosine and tryptophan
transport into neurons(122,257,289,372). This was found
to cause severe impaired amine synthesis and hypokinesis. Tetrahydro-biopterin,
which is essential in production of nerurotransmitters, is significantly
decreased in patients with Alzheimer’s’s, Parkinson’s, and MS. Such patients
have abnormal inhibition of neurotransmitter production.(supplements which
inhibit breach of the blood brain barrier such as bioflavonoids have been found
to slow such neurological damage).
Clinical tests of patients with MND,ALS, Parkinson’s, Alzheimer’s,
Lupus(SLE), rheumatoid arthritis and autsism have found that the patients
generally have elevated plasma cysteine to sulphate ratios, with the average
being 500%higher than controls(330,331,56,33e), and in general being poor
sulphur oxidizers. This means that these patients have insufficient
sulfates available to carry out necessary bodily processes. Mercury has
been shown to diminish and block sulphur oxidation and thus reducing
glutathione levels which is the part of this process involved in detoxifying
and excretion of toxics like mercury(33). Glutathion is produced through the
sulphur oxidation side of this process. Low levels of available glutathione
have been shown to increase mercury retention and increase toxic effects(111),
while high levels of free cysteine have been demonstrated to make toxicity due
to inorganic mercury more severe(333,194,56,33e). Mercury has also been
found to play a part in inducing intolerance and neuronal problems through
blockage of the P-450 enzymatic process(84,33e).
18.
Mercury at extremely low levels also interferes with formation of tubulin
producing neurofibrillary tangles in the brain similar to those observed in
Alzheimers patients, with high levels of mercury in the brain (207), and
low levels of zinc(363,43). Mercury and the induced neurofibrillary tangles
also appear to produce a functional zinc deficiency in the of AD
sufferers(242),as well as causing reduced lithium levels which is another
factor in such diseases. Lithium protects brain cells against
excess glutamate induced excitability and calcium influx(280,56). Also
mercury binds with cell membranes interfering with sodium and potassium enzyme
functions, causing excess membrane permeability, especially in terms of the
blood-brain barrier (155,207,311). Less than 1ppm mercury in the
blood stream can impair the blood- brain barrier. Mercury was also
found to accumulate in the mitochondria and interfere with their vital
functions, and to inhibit cytochrome C enzymes which affect energy supply to
the brain(43). Persons with the Apo-E4 gene form of
apolipoprotein E which transports cholesterol in the blood, are
especially susceptible to this damage(207,221,346), while those with Apo-E2
which has extra cysteine and is a better mercury scavanger have less
damage. The majority have an intermediate form Apo-E3. This
appears to be a factor in susceptablity to Alzheimer’s disease, Parkinson’s
disease and multiple schlerosis. Ones susceptability can be estimated by
testing for this condition. In
many cases (many thousand documented)removal of amalgam fillings and treatment
for metal toxicity led to “cure’ or significant improvement in health(see
Section V). There is some evidence that some forms of leukemia are
abnormal response to antigenic stimulation by mercury or other such toxics and
removal of amalgam has led to remission in some cases(35,38,180,239).
19.
Mercury and methyl mercury impair or inhibit all cell functions and deplete
calcium stores(96). This can be a major factor in bone loss of
calcium(osteoperosis).
VI.
Results of Removal of Amalgam Fillings
1. For
the week following amalgam removal, body mercury levels increase significantly,
depending on protective measures taken, but within 2 weeks levels fall
significantly.(82,89) Chronic conditions can worsen temporarily, but
usually improve if adequate precautions are taken to reduce exposure during
removal.
2.
Removal of amalgam fillings resulted in a significant reduction in body burden
and body waste product load of mercury(75,82,88,89,93,95,115).
3. Total
reduction in mercury levels in blood and urine is often over 80% within a
few months(79,82,89,93,115,57).
4.
There are extensive documented cases (many thousands) where removal of amalgam
fillings led to cure or significant improvement of serious health problems such
as periodontal diseases(40,46,57,60,75,78,82,86,87,90,
94,95,100,101,115,133,168,212,222,233,271,313,317,321,322,376), oral
keratosis(pre cancer)(87,251), immune system/autoimmune problems
(8,222,270,271,313,323,368,91,212,229,291,35,etc.), allergies(8,26,40,46,94,
95,97,165,212,222,228,229,233,271,317,322,349,376),
asthma(8,75,97,222,228,271,322), chronic headaches/ migraines(5,34,95,212
222,229,233,271,317,322,349,354,115,376,440), multiple chemical
sensitivities (26,95,222, 229,232,233, 35,115,313,368), epilepsy (5,309,229),
blood conditions( 212,222,232,233,271, 35,95), eczema (60,212,222,
271,313,317,323,94,376,341), chron’s disease(222,229), stomach problems
(95,212,222,228,229, 233,271,317, 322,440,35), lupus(12,113,222, 229,233),
dizzyness/vertigo(40,95,212,222,271,322,376), arthritis(95,103,212,
222,271,313,322,358), MS(94,95,102,170,212,222,271,291,302,34,35,229),
ALS(97,229,423,405,35), Parkinson’s/ muscle
tremor(222,248,229,271,212,94,98,35), Alzheimer’s(204), muscular/joint pain/fibromyalgia
(222,293,317,322,369,440, 94), infertility(9,38,229,367), depression
(94,107,222,271,294,212,229,233,285e,317,322,376,40), schizohprenia
(294,34,35), insomnia(94,212, 222,271, 317,322,376), anger(212,233,102),
anxiety & mental confusion (94,212,222,229,233,271,317,322,440,57),
susceptability to infections (40,222,251,317,349, 350), antibiotic
resistant infection(251), endometriosis(229,38), Chronic Fatigue Syndrome
(8,60,212,293,229,222, 232,233,271,313,317, 368,369,376,440), tachycardia and
heart problems (205,59,94,115,212,222,232,233, 271,306,310,212), memory
disorders(94,222,440),cancer/ leukemia( 35,38,94,180),
neuropathy/paresthesia (94,212,222,322), vision
disturbances(212,271,322), alopecia/hair loss (40,187,271,317,322,349),sinus
problems (40,94,222,271,322), tinnitus(94,222,271,349,376), inflamation of
eye(222,271,322), psoriasis(385,375,408), skin conditions(212,222),
urinary/prostrate problems(212,222), hearing loss(102), candida(26,404),etc.,
or in significant improvement in symptoms (35,38,40,57,78,86-91,93-103,115,148,
165,168,170,180,182,185,199,204, 212,222,229,233, 234, 235,246,
271,282,289,312,317,321,322,323,376). The above over 60,000 cases
of cure or significant improvements were not isolated cases of cures; the clinical
studies indicated a large majority of most such type cases treated showed
significant improvement. Details available and case histories. Some
of the above cases used chemical or natural chelation to reduce accumulated
mercury body burden in addtion to amalgam replacement. Some clinics using
DMPS for chelation reported over 80% with chronic health problems were cured or
significantly improved(222,271, 359). Other clinics reported similar success.
But the recovery rate of those using dentists with special equipment and
training in protecting the patient reported much higher succes rates than those
with standard training and equipment, 97% versis 37 to 88%(435).
Clinical studies have found that patch testing is not a good predictor of
success of amalgam remvoal, as a high percentage of those testing negative also
recovered from chronic conditions after rplacement of fillings(86,87,168,etc.).
In a large German study of MS patients after amalgam revision, extraction
resulted in 85% recovery rate versis only 16% for filling replacement alone
(222,302). Other cases have found that recovery from serious autoimmune
diseases, dementia, or cancer may require more agressive mercury removal
techniques than simple filling replacement due to body burden. This appears to
be due to migration of mercury into roots & gums that is not eliminated by
simple filling replacement. That such mercury(and simiarly bacteria) in
the teeth and gums have direct routes to the brain and CNS has been documented
by several medical studies(34,325,etc.).
Among those with chronic immune system problems with related immune antibodies,
the types showing the highest level of antibody reductions after amalgam
removal include glomerular basal membrane, thyreeoglobulin, and microsomal
thyroid antigens(91)
Swedish researchers have developed a sophisticated test for immune/autoimmune
reactions that has proved sucessful in diagnosing and treating environmetally
caused diseases such as lichen planus, MS, etc. related to mercury and other
immunotoxics(60,313).
Interviews of a large population of Swedish patients that had amalgams removed
due to health problems found that virtually all reported significant health
improvements and that the health improvements were permanent(233). (study
period 17 years) A compilation of an even larger population found similar
results(212,282). For example 89% of those reporting allergies had
significant improvements or total elimination; extrapolated to U.S. population
this would represent over 17 million people who would benefit regarding
allergies alone.
VII.
Health Effects from Dental Personnel Exposure to Mercury Vapor
1. It is
well documented that dentists and dental personnel who work with amalgam are
chronically exposed to mercury vapor, which accumulates in their bodies
to much higher levels than for most non-occupationally exposed. Adverse
health effects of this exposure including subtle neurological effects have also
been well documented that affect most dentists and dental assistants, with
measurable effects among those in the lowest levels of exposure. Mercury
levels of dental personnel average at least 2 times that of controls for
hair(397-401), urine(57,64,69,99,123,124,138,171,173,222,249,290,362,397-399)
and for blood (124,195,253,249,397). Sweden, which has banned use of
mercury in fillings, is the country with the most exposure and health effects
studies regarding amalgam, and urine levels in dental professionals from
Swedish and European studies ranged from 0.8 to 30.1 ug/L with study averages
from 3.7 to 6.2 ug/L (124,172,253,64,68). The Swedish safety guideline
for mercury in urine is 5.6 nmol Hg/mmol(11.6 ug/L). Study
averages for other countries ranged from 3.3 to 36 microgram/liter(ug/L)(69,70,171,290,397).
A large survey of dentists at the Norwegian Dental Assoc. meeting(171) found
that the mean mercury level in 1986 was 7.8 ug/L with approx. 16% above
13.6ug/L, and for 1987 found an average of 8.6 ug/L with approx. 15% above 15.8
ug/L, with women having higher levels than men in general. A U.S. national
sample of dentists provided by the American Dental Association had an average
of 5.2 ug/L (70,290). In that large sample of dentists, 10% of dentists
had urine mercury levels over 10.4 ug/L and 1% had levels over 33.4ug/L(290),
indicating daily exposure levels of over 100
ug/day. Mercury excretion
levels were found to have a positive correlation with the number of amalgams
placed or replaced per week, the number of amalgams polished each week, and
with the number of fillings in the dentist(171,172,173). In one study,
each filling was found to increase mercury in the urine approx. 3%, though the
relationship was nonlinear and increased more with larger number of
fillings(124). Much higher accumulated body burden levels in dental
personnel were found based on challenge tests than for controls(303), with
excretion levels after a dose of a chelator as high as 10 times the
corresponding levels for controls(57,69,290,303). Autopsy studies have
found similar high body accumulation in dental workers, with levels in
pituitary gland and thyroid over 10 times controls and levels in renal cortex 7
times controls(99,363,38). Autopsies of former dental staff found
levels of mercury in the pituitary gland averaged as high as 4,040 ppb.
They also found much higher levels in the brain occipital cortex(as high as 300
ppb), renal cortex(as high as 2110 ppb) and thyroid(as high as 28,000
ppb. In general dental assistants and women dental
workers showed higher levels of mercury than male dentists
(171,172,173,253,303,362).
Mercury levels in blood of dental professionals ranged from 0.6 to 57 ug/L,
with study averages ranging from 1.34 to 9.8 ug/L (124,195,253,249). A
review of several studies of mercury level in hair or nails of dentists and
dental workers found median levels were 50 to 300% more than those of
controls(38, p287-288,& 10,16,178). A group of dental students taking
a course involving work with amalgam had their urine tested before and after the
course was over. The average urine level increased by 500% during the
course(63). Allergy tests given to another group of dental students found 44%
of them were allergic to mercury(156). Studies have found that the
longer time exposed, the more likely to be allergic. Another group of
dental students had similar results(362), while another group of dental student
showed comprimized immune systems compared to medical students. The total
lympocyte count, total T cell numbers(CD3), T helper/ inducer(CD4+CD8-),
and T suppressor/cytotoxic(CD4-CD8+) numbers were singinficantly elevated in
the dental students compared to the matched control group(407). Similar results
have been seen in other studies as well(407).
Urinary porphyrin profiles were found to be an excellent biomarker of level of
body mercury level and mercury damage neurological effects, with coprorphyrin
significantly higher in those with higher mercury exposure and urine
levels(70,260). Coproporphyrin levels have a higher correlation with symptoms
and body mercury levels as tested by challenge test(69,303), but care should be
taken regarding challenge tests as the high levels of mercury released can
cause serious health effects in some, especially those who still have amalgam
fillings or high accumulations of mercury. Screening test that are less
burdensome and less expensive are now available as first morning void urine
samples have been found to be highly correlations to 24 hour urine test for
mercury level or porphyrins(73).
2. The
average dental
Use of high speed drill in removal or replacement has been found to create high
volume of mercury vapor and respirable particles, and dental masks to only
filter out about 40 % of such particles(219,247). This produces high levels of
exposure to patient and dental staff. Use of water spray, high velocity
evacuation and rubber dam reduce exposure to patient and dental staff
significantly, as seen in previous discussion. In addition to these
measures researchers also advise all dental staff should wear face masks and
patients be supplied with outside air(120,153). Some studies note
that carpeting in dental
Use of
such measures along with a Clean-UpTM aspirator tip was found to
reduce exposure to patient and staff approximately 90%(397).
3. Dentists
were found to score significantly worse than a comparable control group on
neurobehavioral tests of motor speed, visual scanning,and visuomotor
coordination(69,70,123,249,290,395), concentration , verbal memory, visual
memory(68,69,70,249,290,395), and emotional/mood tests(70,249,290,395).
Test performance was found to be proportional to exposure/body levels of
mercury(68,70,249,290,395). Significant adverse
neurobehavioral effects were found even for dental personnel receiving low exposure
levels(less than 4 ug/l Hg in urine)(290). This study was for dental personnel
having mercury excretion levels below the 10th percentile of the overall dental
population. Such levels are also common among the general population of non-
dental personnel with several fillings. This study used a new methodology which
used standard urine mercury levels as a measure of recent exposure, and urine
levels after chelation with a chemical, DMPS, to measure body burden mercury
levels. Chelators like DMPS have been found after a fast to release
mercury from cells in tissue to be available for excretion. This method
was found to give enhanced precision and power to the results of the tests and
correlations. Even at the low levels of exposure of the subjects of this
study, there were clear demonstrated differences in test scores involving
memory, mood, and motor skills related to the level of exposure pre and post
chelation(290). Those with higher levels of mercury had deficits in both
memory, mood, and motor function compared to those with lower exposure
levels. And the plotted test results gave no indication of there existing
a theshhold below effects were not measurable. Mood scores including
anger were found to correlate more strongly with pre chelation urine mercury
levels; while toxicity symptoms, concentration, memory(vocabulary,word), and
motor function correlated more strongly with post-chelation mercury
levels.
Several dentists have been documented to suffer from mercury
poisoning(72,74,193,246,247,248,369), other than the documented neurological
effects. One of the common effects of chronic mercury exposure is chronic
fatigue due to immune system overload and activation. Many studies have
found this occurs frequently in dentists and dental staff along with other related
symtoms- lack of ability to concentrate, chronic muscular pain, burnout,
etc.(249,369.377.378). In a group of dentists and dental workers suffering from
extreme fatigue and tested by the immune test MELISA, 50% had autoimmune
reaction to inorganic mercury and immune reactions to other metals used in
dentistry were also common(369). Tests of controls did not find such
immune reactions common.
One dentist with severe symptoms similar to ALS improved after treatment for mercury
poisoning(246), and another with Parkinson’s disease recovered after reduction
of exposure and chelation(248). Similar cases among those with other
occupational exposure have been seen. A survey of over 60,000 U.S.
dentists and dental assistants with chronic exposure to mercury vapor and
anesthetics found increased health problems compared to controls, including
significantly higher liver, kidney, and neurological diseases(99,193).
Other studies reviewed found increased rates of brain cancer and allergies(99,193).
Swedish male dentists were found to have an elevated standardized mortality
ratio compared to other male academic groups(284). Dental workers and other
workers exposed to mercury vapor were found to have a shortening of visual evoked
potential latency and a decrease in amplitude, with magnitudes correlated with
urine excretion levels(190). Dentists were also found to have a high
incidence of radicular muscular neuralgia and peripheral sensory
degradation(190,395).
4. Both
dental hygienists and patients get high doses of mercury vapor when dental
hygienists polish or use ultrasonic scalers on amalgam
surfaces(240,400). Pregnant women or pregnant hygienist
especially should avoid these practices during pregnancy or while nursing since
maternal mercury exposure has been shown to affect the fetus and to be related
to birth defects, SIDS, etc.(23,37,38,110,142,146,401,19,31). Amalgam has
been shown to be the main source of mercury in most infants and breast milk,
which often contain higher mercury levels than in the mother’s
blood (20,61,112,186,287). Because of high documented exposure
levels when amalgam fillings are brushed(182,222,348) dental hygienist are
advised not to polish dental amalgams when cleaning teeth. Face masks
worn by dental workers filter out only about 40% of small dislodged amalgam
particles from drilling or polishing, and very little mercury vapor(247).
Dental staff have been found to have significantly higher prevalence of eye
problems, conjunctivitis, atopic dermatitis, and contact urticaria(247,156,74).
An epidemiological survey conducted in Lithuania on women working in dental
A study
in Poland also found a significant positive association between mercury levels
and occurrence of reproductive failures and menstrual cycle disorders, and
concluded dental work to be an occupational hazard with respect to reproductive
processes(401).
5. Body
burden increases with time and older dentists have median mercury urine levels
about 4 times those of controls, as well as higher brain and body burdens(1,34,
68-74,99), and poor performance on memory tests(68, 69,70,249,290)
Some older dentists have mercury levels in some parts of the brain as much as
80 times higher than normal levels(14,34,99). Dentists and dental
personnel experience significantly higher levels of neurological, memory, musculoskeletal,
visiomotor, mood, and behavioral problems, which increase with years of
exposure (1,34,68-73,88,123,188,246,247,248,249,290,369,395). Even dental
personnel with relatively low exposure(urine Hg<4 ug/l) were found to have
significant neurological effects(290) and was found to be correlated with body
burden of mercury. Most studies find dentists have increased levels of
irritability and tension(1), high rates of drug dependancy and disability due
to psychological problems(15), and higher suicide rates than the general white
population (284), but one study found rates in same range as doctors.
6. Female
dental technicians who work with amalgam tend to have increased menstrual
disturbances (275,401,10,38), significantly reduced fertility and lowered
probability of conception (10,24,38,121), increased spontaneous abortions
(10,38,277,433), and their children have significantly lower average IQ
compared to the general population (1,279,38,110).
Populations with only slightly increased levels of mercury in hair had
decreases in academic ability(3). Effects are directly related to length
of time on the job(277). The level of mercury excreted in urine is
significantly higher for female dental assistants than dentists due to
biological factors (171,172, 173,247). Several dental
assistants have been diagnosed with mercury toxicity and some have died of
related health effects(32,245,246,247,248). From the
medical register of births since 1967 in Norway, it can be seen that dental
nurse/assistants have a clearly increased risk of having a deformed child or
spontaneous abortion(433). Female dentists have
increased rates of spontaneous abortion and perinatal
mortality(193,38,10,433)),compared to controls. A study in Poland found a much
higher incidence of birth defects among female dentist and dental assistants
than normal(10). A chronically ill dental nurse diagnosed
with mercury sensitivity recovered after replacement of fillings and changing
jobs(60), and a female dentist recovered from Parkinson’s after mercury
detox(248). Some studies have found increased risk of lung, kidney,
brain, and CNS system cancers among dental workers(14,34,99,143,283).
7. Many
homes of dentists have been found to have high levels of mercury contamination
used by dentists bringing mercury home on shoes and clothes(188).
VIII.
Scientists and Government Panels or Bodies That Have Found Amalgam Fillings to
be Unsafe.
1.
A World Health Organization Scientific Panel concluded that there is no safe
level of mercury exposure(183,189,208). The Chairman of the panel, Lars
Friberg stated that “dental amalgam is not safe for everyone to
use(208,238). A study of dental personnel having very low levels of
mercury excretion found measurable neurological effects including memory, mood,
and motor function related to mercury exposure level as measured by excretion
levels(290). and found no threshhold level below which effects were not
measurable.. Other studies have found measurable effects to the immune,
cardiovascular, hormonal, and reproductive systems from common levels of
exposure(Section IV). Studies have found significant measurable
adverse health effects at levels far below curren
2. In
1987 the Federal Dept. of Health in Germany issued an advisory warning against
use of dental amalgam in pregnant women(61). Most major countries other
than the U.S. have similar or more extensive bans or health warnings regarding
the use of amalgam, including Canada, Great Britain, France, Austria, Norway,
Sweden, Japan, Australia, New Zealand, etc.(164,435) A Swedish National
Mercury Amalgam Review Panel and a similar Norwegian panel found that
"from a toxicological point of view, mercury is too toxic to use as a
filling material"(164,435). Both countries have indicated plans to
ban or phase out use of amalgam. A major amalgam manufacturer,
Caulk Inc., advises that amalgam should not be used as a base for crowns or for
retrograde root fillings as is commonly done in some coutries(387). A
Swedish medical panel unanimously recommended to the government “discontinuing
the use of amalgam as a dental material”(282). The U.S. EPA found that
removed amalgam fillings are hazardous and must be sealed airtight and exposed
of as hazardous waste(214). Most European countries require controls on
dental waste amalgam emissions to sewers or air. A Canadian Government
study for Health Canada concluded that any person with any number of amalgam
fillings receives exposure beyond that recommended by the USPHS Standard(209).
Many of those researching amalgam related health effects including several very
prominent scientists have concluded that the health effects are widespread and
serious so that mercury should not be used as a filling material (1,18,19,20,
36,38,57,60,61,88,94,99,125,148, 153,164,170,183,208, 209,210,212,222, 227,236,
238,282).
3. The
use of mercury amalgams has been banned for children and women of child-bearing
age or put on a schedule for phase out by several European countries. The
use of amalgam is declining in Europe and Germany’s largest producer of amalgam
has ceased production, The director of the U.S. Federal program
overseeing dental safety advises against using mercury amalgam for new
fillings.
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