There was an important law suit that was decided about Silver Mercury Amalgam fillings in the State of Connecticut that most people do not know about. The law suit was brought by an environmental group that sought to ban silver-mercury fillings in the state of Connecticut based on previous rulings that banned the transport of mercury throughout the state as an environmental hazard. They argued that transporting silver-mercury filling materials should be covered under the same law and should be stopped. The judge ruled that the intent of the prior law was to deal with a perceived danger of mercury spills and that the intent was not to regulate the use of silver-mercury dental filling materials, thereby side stepping the controversy, but offering no help.
The court suggested that the dentists and patients discuss that pros and cons of materials to be used on an individual bases. As a result of that case the State of CT requires dentists to give patients options for fillings that include other materials that do not contain mercury.
Since the subject of mercury in fillings is an important issue a review of that subject is timely. If you go to Google and enter amalgam, silver-mercury filling, mercury filings and that sort of thing you will find literally tens of millions of references, so this is indeed a hot subject. The readers are certainly encouraged to do their own research.
Since this is a very controversial issue, I want to reveal my personal opinion on this subject right up front. I have not personally placed a silver-mercury amalgam filling in a tooth for nearly 20 years. If there is a dental reason to remove an old silver-mercury filling, such as a new cavity under an old filling, and there often are, then we remove them, clean out the cavity and fix the tooth with a non-mercury filling. If a patient requests that an old filling be removed and replaced for cosmetic reasons we will do that as well. Unless there is a dental reason to remove an existing silver-mercury filling I do not suggest replacing them as a solution for other health reasons.
The question however is whether silver-mercury fillings are safe and should continue to be used for dental patients. On one side is the American Dental Association, many researchers and many dentists who believe that they are safe. On the other side are many other dentists, environmentalists, medical doctors and researchers of all sorts, who believe that the silver-mercury fillings do indeed pose a threat to our patients.
Amalgam fillings typically comprise 50% pure elemental mercury, 35% silver, 13% tin, 2% copper, and a trace of zinc. The metal powders react with liquid mercury to produce an amalgam (or alloy) that provides a flexible material that can be easily packed and shaped in the tooth to replace decayed tooth structure. Amalgam fillings are often called silver fillings because of their silvery appearance and composition.
Their first reported use in dental restorations was in 1818. Opponents of amalgam have challenged its use in dentistry since its introduction nearly 200 years ago. Since then, concerns over the toxic effects of mercury have persisted. The American Society of Dental Surgeons, formed in 1840, so abhorred the use of amalgam that it required its members to sign pledges that they would not use it. In 1848, The Society of Dentists of the City and State of New York suspended eleven of members for “malpractice” because they used amalgam. Internal strife over the use of mercury in dentistry led to the formation of the ADA, whose leaders did not oppose its use.
The ADA adamantly defends mercury usage in tooth restorations whenever others suggest that it poses a potential health threat on the basis that it has been used “safely” over the past 150 years. The ADA prefers the use of amalgam because fillings are inexpensive and durable, while gold and other composite materials are more expensive and more difficult to fit. Because of its flexibility, the use of amalgam arguably requires less skill. Thus, dentists can usually fill a cavity in less time.
The position of the ADA had been that the mercury in silver-mercury fillings is trapped in the alloy once it is placed into teeth but the newer research that is generally accepted disputes this. The question is not if the mercury is released, but if it is “significant”.
…Research has demonstrated that mercury vapor is continuously released from amalgam fillings in measurable quantities from the moment fillings are inserted into teeth. Mercury is inhaled, swallowed and absorbed directly in the mouth. [see: Vimy MJ & Loncheider FL. J.Trace ElemExper. Med. 3:111(1990). Skare I. Engqvist A. Arch.Env.Hlth. 49:384(1994) and Lorscheider FL. et al. FASEB J. 49:504(1995)…]
The ADA does recognize that mercury can pose an environmental hazard. In 1998 they issued an advisory pertaining to “safe” handling of silver-mercury filling materials in the dental office such as dental personnel not handling the material with bare hands and making sure that the rooms are well ventilated and scrap mercury filling materials are disposed of by state licensed medical waste companies. In addition in Connecticut it is required that every dental office be equipped with a special filter in their waste lines so that none of the mercury filling materials that are placed or removed from your mouth are discharged into the severs or septic systems. Address reprint requests to the ADA
Council on Scientific Affairs, 211 E. Chicago Ave., Chicago, I11. 60611.
1126 JADA, Vol.130, July 1999 https://dentalcarestamford.com/mercury1.html
Mercury has been known to be a poison for thousands of years, whether “ingested, inhaled, or absorbed through the skin.” In the 1800’s, British workers who used mercury in the hat making process developed symptoms of mental deterioration on an industry-wide basis. The expression, “mad as a hatter,” originated from that. Today, according to those involved in research, human exposure to mercury is primarily through dental amalgam.
Historically numerous common products were thought to be safe; for example asbestos, lead, and DDT. In each case the scientific concerns were immediately discounted by the industry responsible for the production or use of the material and often the assertions of safety were initially supported by the responsible government agencies. After a period of time as the evidence became overwhelming and legal liability impossible to ignore, they were regulated or withdrawn from the market. Each of these products demonstrated pathology after a latency period of chronic low dose exposure.
The fact is that controlled studies which would give totally irrefutable evidence that silver-mercury fillings are a health hazard are very difficult to do because there are so many variables and some health issues do not become apparent for many years. In addition different people have varying degrees of resistance to pathologic agents.
BALTIMORE, MARYLAND. Several studies have shown that regular fish consumption protects against cardiovascular disease. Other studies have shown that consuming mercury-contaminated fish increases the risk of coronary heart disease. The beneficial effect of fish consumption is believed to be due to the presence of the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the tissue of fish and shellfish. …recent studies have attempted to answer the question “Are the beneficial effects of fish oils (EPA and DHA) outweighed by the negative effects of mercury”?…
…carried out by a team of researchers from eight European countries, Israel and the United States, involved 684 men who had suffered a first non-fatal heart attack and 724 matched controls… The researchers point out that the main sources of mercury are occupational exposure (dentists), exposure to silver-mercury amalgam in dental fillings, and fish consumption. They conclude that the health benefit of fish consumption is significantly diminished if the fish is high in mercury. Guallar, E, et al. Mercury, fish oils, and the risk of myocardial infarction. New England Journal of Medicine, Vol. 347, November 28, 2002, pp. 1747-54
Many OB/GYN physicians caution pregnant women to avoid mercury containing foods during pregnancy.
Fish serves as a good source of protein and certain essential Fatty Acids (Omega-3 fatty acids). These nutrients are important for growth and development of the fetus in the womb. What we may not realize though, is that our efforts to eat well, may leave us with more than we bargained for! Certain types of seafood, mainly Swordfish and Shark have excessively high Mercury content. At present, it is recommended that these fish be eaten only once a month during pregnancy. For more information on mercury, fish and pregnancy and nursing you can go to the FDA web site.
Seymour L. Gottlieb, BS, BDS, DDS, member of NOHA’s Professional Advisory Board, with a private practice in Dentistry in Northbrook, Illinois; former Research Assistant and Instructor, College of Dentistry, University of Illinois and Researcher in Microbiology, United States Public Health Service, Center for Disease Control.
The silver amalgam filling is the most commonly used dental material in the United States. It contains 50% mercury, 35% silver, 11-12% copper, 3% tin, and sometimes 1% zinc. Many studies have confirmed that mercury is released from the fillings by chewing and corrosion… One average silver amalgam filling contains enough mercury over its lifetime in the mouth to exceed the United States Environmental Protection Agency Adult Intake Standard. Animal and human autopsies demonstrate that mercury builds up in the body over time. It is detected highest in the kidney, stomach, jaw, and liver. It can pass through the placental barrier to the unborn child.4…
…Several countries have limited the use of silver amalgam fillings. The Swedish parliament recently voted for a new dental insurance system starting January 1999, in which silver amalgams will not be subsidized. Use of silver amalgams had previously been banned for pregnant women and children. The French Superior Council for Public Hygiene has just issued a series of recommendations to regulate the use of silver amalgams. Dental use is being targeted because of the long-term risks of renal or nervous problems. It is reported that restrictions are underway in England. In addition, the Canadian legislature limited the use of silver amalgam fillings in adults while prohibiting its use in children, pregnant women, and people with kidney problems. A letter to this effect was sent in August, 1996 by Health Canada to every dentist in that country. As early as 1992, the German Ministry of Health restricted silver amalgams to back teeth. Further, none were to be placed in pregnant women and children up to 6 years of age or anyone with kidney problems.
There is no question that nearly 200 years ago when silver-mercury amalgam filling materials first appeared that there was concern even then about the safety of the materials. At the same time, there were few if any other good alternative materials for dentists to use. The state of the art of scientific medical research was such that they had to do the best with what was available at that time. At this time there are other reasonable alternative materials available to the dental profession and the public.
Although many of the reported studies as to the safely of silver-mercury filling materials might not withstand the rigors of scientific inquiry and double blinded studies, and much of the reported “systemic health effects” of mercury in our patients appears to be more anecdotal, we do not use them in our office and we agree with the court in the above mentioned case that each patient should discuss the filling materials for themselves and their family with their dentist.