In May of 1985, I began my dental career as a freshman dental student. I was just twenty at the time, and I was extremely excited about the possibilities of the journey that I was embarking on. I came into the dental school not knowing what to expect, and wow, did I get off to a surprising start!
One of the classes we had that first year was a “dental materials” class, and the very first topic we discussed was dental amalgam. Dental amalgam fillings are the so-called “silver” fillings that many of us have had from youth. Given that dental amalgam actually is made up predominantly of elemental mercury (50 to 54 percent by weight)—along with silver, copper, tin and zinc—some have suggested that amalgams should be called “mercury fillings.”1
As it happens, I had been in an undergraduate organic chemistry lab the semester before starting dental school. Our entire building was evacuated after we experienced a thermometer break, and a HAZMAT (hazardous materials) team had to come to the building to do the remediation. Thus, the presence of mercury in amalgam rang a few alarm bells for me.
In addition, I had taken an inorganic chemistry class the year before commencing dental school, and in that class, I had come to understand what makes a compound or chemical stable or not. In my dental materials class, I instantly recognized the fact that the concoction of metals present in amalgam could in no way be stable. When I challenged my professor and stated emphatically that “there is no way that the amalgam material can be stable chemically or electrically,” he first asked me what I meant and then told me I was wrong. I had a few choice words, telling him that he didn’t know what he was talking about.
It didn’t take long for word of my classroom challenge to get to the dean of the dental school, who called me in the next morning and told me to sit down, shut up and learn what I needed to learn. Otherwise, I could rest assured that I would not make it through dental school. Reluctantly, I did what I needed to do to get through my training—and continued to get indoctrinated that amalgam was safe and stable.
After graduation from dental school in May of 1989, I began to practice general, traditional dentistry. Fortunately, I had kept my rebellious, questioning side, and after about three years, I started having serious reservations about the practice of putting mercury in people’s mouths.
My first approach was to attack the fact that amalgam expands and contracts more than tooth structure, which causes catastrophic structural failure of the tooth over time. This happens through a cascading series of events. The tooth, initially weakened by the decay, is further weakened when the dentist cleans out (drills) the cavity and again undermined with the placement of an amalgam filling that, through expansion and contraction, inevitably compromises the structural integrity of the tooth. Eventually, the tooth cracks, resulting in the need for a crown and often a root canal. Although this issue of “dimensional stability”2—as it pertains to amalgam—still gets little attention from the dental profession, one study has noted that the use of amalgam (and gold) restoration materials dramatically increases the occurrence of longitudinal tooth fractures as compared to resin or porcelain.3
Despite questioning the structural implications of amalgam, it wasn’t until 1996 that I definitively reconnected with the question of safety and mercury exposure. I put it all together and experienced a paradigm shift when mercury touched my life personally. That year, my son was diagnosed on the autism spectrum and my fifty-six-year-old mother-in-law was diagnosed with early-onset dementia. There is no doubt that when something slaps us in the face personally, most of us take another look at our belief system. I did, and what I went on to discover rocked my world.
First, I found a network of physicians, dentists and scientists dedicated to the scientific safety of dental and health care: the International Academy of Oral Medicine and Toxicology (IAOMT), founded in 1984. The motto of this modest group is, “Show me the science.” Discussing what has come to be known as biological dentistry, the IAOMT states that biological dentistry represents “a thought process and an attitude that can apply to all facets of dental practice and to health care in general: to always seek the safest, least toxic way to accomplish the goals of modern dentistry and of contemporary healthcare.”4
What I came to deeply realize is that mercury is toxic to every cell in the human body and is particularly toxic to the central nervous system.5 In fact, mercury is only slightly less toxic than radioactive uranium (plutonium). Dental amalgam’s convenient mixture of metals makes it a nice slow-release vehicle for mercury—the only metal that is liquid at room temperature. This slow release allows mercury to build up in the body, and especially in the central nervous system and organs, because mercury is attracted to fatty protein-rich tissues. Unfortunately, the insidious release of mercury from amalgam makes it hard to draw a direct correlation to any specific dysfunction of the body. The fact that symptoms of toxicity are variable and nonspecific has helped perpetuate the debate over amalgam’s dangers.6
Of course, it is not just the mercury in fillings that is poisoning human beings. Mercury is in vaccines, the air, the soil, fish, light bulbs and other medical and consumer products. Although we can’t completely avoid exposure to all these sources, at a minimum we can choose what we allow to be placed or injected into our bodies.
THE IMPORTANCE OF SAFE REMOVAL
With all of the knowledge that I gained from the IAOMT and many other individuals and groups, I made the decision to offer my patients safe removal of mercury fillings. This process is quite different from what traditional dentists are taught and do daily. Safe mercury removal involves attention to many details to protect the patient, the dentist and the dental staff.7
On the patient side, the teeth that have mercury to be removed have to be isolated with a non-latex rubber dam (surgical drape), which keeps mercury particulate and vapor from being swallowed or inhaled. The patient also needs a separate breathing source (oxygen through a mask or special cannula), skin protection to prevent splatter from getting absorbed and gut protection for any small amount of mercury that does get through (this is done with activated charcoal or a similar product that binds mercury). Finally, the patient needs nutritional support to ensure good digestion and liver function.
On the office and staff side, the practice environment where amalgam removal is taking place needs to be protected with capture devices. The dental office staff also need protection—both skin and inhalational. The wastes have to be carefully handled for recapture and encapsulation of mercury. Ventilation in the office has to be adequately cleaned and changed. In short, a safe removal office has to cover many bases to adequately protect all parties involved.
Another important aspect of safe amalgam removal is that each person needs to be assessed individually, and the removal plan must be tailored to work for their needs. In other words, not everyone can tolerate having removal done in the same way. For example, some people are really sensitive chemically and electrically and may be able to handle the removal of only one mercury filling at a time. Others may be critically ill but want to remove as much at one time as possible to become amalgam-free quickly so that they can move on to working with health providers to restore their health. The typical patient has their dental amalgams removed one quadrant at a time.
Sometimes, patients think they have had all their mercury removed, only to discover that another dentist simply covered it up with other fillings or crowns. Mercury under metal crowns causes a galvanism that increases the release of mercury. Mixed metals in the mouth connected by fluid (saliva) create a measurable battery effect that is thousands of times greater than the body’s natural electrical system.
While removing mercury from the teeth is very important, it is only the start of the detoxification process. Once the patient has eliminated the amalgam exposure, it is important to go through a program or protocol for detoxifying the body. In my opinion, this should be done gently in most cases. Detoxification should start with liver and colon cleanses and may also include saunas, hot baths with baking soda or Epsom salts and careful oral chelation. Detoxification should not be done without proper knowledge and supervision.
More than 80 percent of the patients in my practice come specifically for mercury and toxin removal. My average patient comes from more than one and a half hours away to seek this care. Many travel from states far away. This is because there are so few dentists who do this work in a truly safe manner. There is such a demand for safe removal of mercury fillings that patients are willing to make these journeys.
When patients choose to work with a holistic dentist, they do so because they want to avoid not just mercury but other toxins as well. Traditional dentistry does not recognize the toxic load it places on humans, and to this day, the profession has devoted very little thought to ending the use of toxic materials such as mercury amalgam.
I have noted a growing trend for dental practices in more affluent metropolitan areas to phase out the use of mercury fillings, but this is due to clients’ demand for more esthetically pleasing dentistry8 and not for any other reason. A survey of five hundred pediatric dentists reported that parents’ top concern about dental materials related to esthetics.9 Dental practices in poorer and more rural areas still are more likely to use mercury fillings versus other types of fillings.9
When the demand for amalgam eventually drops to such an extent that manufacturers can no longer produce it for a profit, then and only then will we see, finally, the end of mercury fillings. To hasten amalgam’s demise, the IAOMT membership currently is leading an initiative to challenge mercury usage in dentistry not only to alleviate human health risks but for the sake of the environment.10 Other organizations such as Consumers for Dental Choice11 and the World Alliance for Mercury-Free Dentistry12 also have called attention to the wide variety of reasons to eliminate mercury from dentistry. All of these movements are gaining ground around the world, as evidenced by the European Parliament’s partial ban of amalgam as of 2018 following ratification of the Minimata Convention on Mercury.13
My journey toward holistic dentistry has been one of both personal and professional challenges. On the personal level, I learned the hard way about the impact that toxins such as mercury are having on our children—and on the most vulnerable members of our society. On a professional level, I have learned that until our beliefs are challenged by these types of personal experiences, we often cannot see the truth. Fortunately, the word about mercury amalgam is getting out, and more and more dentists are waking up to its dangers and embracing less toxic alternatives.
1. Bengtsson UG, Hylander LD. Increased mercury emissions from modern dental amalgams. Biometals 2017;30:277-283.
2. Hermesch CB, Wall BS, McEntire JF. Dimensional stability of dental restorative materials and cements over four years. Gen Dent 2003;51:518-523.
3. Seo DG, Yi YA, Shin SJ, Park JW. Analysis of factors associated with cracked teeth. J Endod 2012;38: 288-292.
5. Carocci A, Rovito N, Sinicropi MS, Genchi G. Mercury toxicity and neurodegenerative effects. Rev Environ Contam Toxicol 2014;229:1-18.
6. Homme KG, Kern JK, Haley BE et al. New science challenges old notion that mercury dental amalgam is safe. Biometals 2014;27:19-24.
7. Colson DG. A safe protocol for amalgam removal. J Environ Public Health 2012;2012:517391.
8. Puckett AD, Fitchie JG, Kirk PC, Gamblin J. Direct composite restorative materials. Dent Clin North Am 2007;51:659-675.
9. Zimmerman JA, Feigal RJ, Till MJ, Hodges JS. Parental attitudes on restorative materials as factors influencing current use in pediatric dentistry. Pediatr Dent 2009;31:63-70.
10. IAOMT. A comprehensive review of the toxic effects of mercury in dental amalgam fillings on the environment and human health, 2016 update. https://iaomt.org/wp-content/uploads/Comprehensive-Review-Dental-Mercury.pdf.
13. European Parliament votes to partially ban amalgam. http://www.toxicteeth.org/pressRoom_recent-News/March-2017/European-Parliament-votes-to-partially-ban-amalgam.aspx.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Spring 2018.