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Abstract
This paper is intended to find out that the restorative material known as the Dental Amalgam has caused poisonous or similar disorders to the human body. The dental amalgam is substance which is used as restorative fillings in the tooth cavities of which large or half or more than half of the proportion is comprised of mercury. This substance or technique has been in use for more than hundred and fifty years, and now it has been a decade ago that people have grown suspicious about its use in the dentistry techniques. However in order to find out that what reality is this paper is written. In order to do this, first the paper briefly introduces the topic along with its history. Then it includes the improper and illusionary tests and research done to misinterpret the results to the patients who are already suspicious of this technique.
Dental Amalgam and Toxicity in the Body
Background and History
One of the oldest techniques used in dental medicine is Dental amalgam i.e. from nearly about 150 years. The contents of the amalgam material are two basic elements which are liquid mercury of about 43-54 percent and an alloy of about 57-46 percent, which is comprised of small percentages of copper, silver, tin and at times palladium or indium and zinc. However the element mercury is said to be hazardous for the human body, but the form of mercury used in preparation of the amalgam substance is stabilized so that it does not reacts with other metals and thus is safer to be used in medical and dental use. (Bagedah, 1997)
The difference between the stabilized and un-stabilized chemical materials can be understood by a basic evaluation. The hydrogen gas is an explosive gas, while on the other hand elemental oxygen is suitable for incineration purposes, however if these two gases are combined together they turn out to form forms of water which therefore doesnt possesses the characteristics of explosiveness or combustion. Therefore it can reasonably be argued that dental amalgam is not harmful to the human body and health (Bagedah, 1997).
Probably due to the so called controversies over the amalgam use, dental amalgam is thoroughly tested and studied. I comparison to other material used in tooth fillings it is more easy to use, inexpensive and long-lasting. It has been concluded by many recognized and registered institutions that the use of amalgam is safe for dental use, for example World Health Organization, The American Dental Association, the U.S. Public Health Service, Consumers Union, the U.S. Food and Drug Administration and many others. Therefore it may not be wrong to say that if a better material, used for restorative purposes, is developed the dental medicine might use and adopt it (Bagedah, 1997).
Amalgam Safety
According to experts the amount which is absorbed by the human body from the amalgam element installed into the tooth is negligible. As mercury can be found in Earths crust, thus everyone always have measurable but small urine and blood levels (Baratz, 2001).
As industrial and factory workers are usually exposed to different chemical compounds the maximum limit is 59 micrograms per cubic meter of air which is suitable for 8 hours per day and 50 weeks a year. However at regular exposure levels this can be 135 micrograms per litre in urine, which may be very higher than the levels of the general public, then too these levels are considered to be safe and havent produced any suspicious symptoms (Baratz, 2001).
In majority people, who do have amalgam fillings, they have 5 micrograms or less per litre of urine. Whereas the dentists who usually are exposed to the amalgam fillings as they during their practice remove and install amalgam fillings and themselves have amalgam fillings installed in their teeth. Therefore, even with this level of exposure to the amalgam, the dentists are found to have only the mercury levels slightly higher that their patients and then too these levels are too far less than then those levels which are said to be even slightly injurious to health (Baratz, 2001).
Until today despite extensive use of amalgam in dentistry, there are no illnesses which are diagnosed to be associated to amalgam use, apart from certain allergies which are highly subjective. Furthermore there is not sufficient evidence and argument that restorative substances other than the dental amalgam have lesser health issues (Baratz, 2001).
Improper Claims
Even though amalgam is proven as harmless for the human health, then too there are some dentists that advice people to use other restoration materials or have their amalgam fillings replaced with other materials. The approach of the dentists which oppose the use of amalgam may be referred to as mercury-free dentistry, biological or holistic dentistry (Baratz, 1999).
There are often dentists who diagnose amalgam toxicity or illness in patients who suffer from other similar symptoms. According to a study people suffering from symptoms associated to amalgam fillings, didnt had blood or urine levels which could be regarded as alarming levels. A number of researches have discovered that many symptoms associated to amalgam fillings are usually emotional and are largely exaggerated by the information from the media and or offbeat dentists. Other than this, dubious diagnoses of mercury toxicity are also offered by many physicians who provide with the Chelation Therapy, which is quite costly and a therapy including intravenous infusions (Baratz, 1999).
According to Hal Huggins, D.D.S., of Colorado Springs, Colorado, a leading anti-amalgamator that some sensitive patients can diagnose psychometric issues, for example irritability, depression or anxiety, moreover neurological problems such as multiple sclerosis, facial twitches, epilepsy and muscle spasms along with cardiovascular problems such as unidentified chest pains rate, unexplained rapid heart. Apart from these collagen diseases (lupus erythematosus, scleroderma, arthritis, digestive troubles including regional ileitis and ulcers and moreover immunological disorder which according to him included leukemia, mononucleosis and Hodgkins disease (Baratz, 1999).
He recommends replacing amalgam with other materials and taking vitamins and other supplements to prevent trouble after amalgam removal [18]. There is no scientific evidence that amalgam fillings cause or contribute to the development of these diseases.
Hugginss dental license was revoked in 1996. During the revocation proceedings, the administrative law judge concluded:
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Huggins had diagnosed mercury toxicity in all patients who consulted him in his office, even some without mercury fillings.
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He had also recommended extraction of all teeth that had had root canal therapy.
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Hugginss treatments were a sham, illusory and without scientific basis.
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A practitioner who does not wish to use amalgam can still practice ethically by giving appropriate advice and referring patients elsewhere when amalgam is the best choice. But advertising a practice as mercury-free is unethical because it falsely implies that amalgam fillings are dangerous and that mercury-free methods are superior (Baratz, 1999).
Dubious Tests
There are a number of test which are used by the practitioners who oppose the use amalgam, wrongly misinterpret their results to warn people to use the amalgam as fillings (Lindberg, 1994).
Breath Tests
Under this method the mouth of the patient is probed by a vacuum device after the subject has chewed a gum for a certain time period. This causes the small amounts of mercury to be released from the mercury fillings and then to be accumulated on the gold foil attached to the device. However, as people do not chew chewing gums for all 24 hours a day thus these results are inaccurate as they give out the rate which is higher than the average rate released per 24 hours. In addition to this the mounts collected at the foil are artificially higher as the device measures the same air exhaled by the mouth more than once. Moreover the readings are also misleading as they also include the mercury release from the other sources as well as food remains, bacterial gases and other material found in the mouth (Lindberg, 1994).
Urine Tests
As we discussed already that mercury vapours are every where in our environment, the body therefore is always in a state ready to absorb these amounts. Therefore it can be said that body will always have some amount of mercury. Mercury can also be detected in the blood streams as it is the only medium to transport material within the body. According to numerous studies it can be concluded that in general public mercury levels are fewer than 10 micrograms per litre. On the other hand industrial workers and dentists who are more exposed to mercury compounds are said to have low and negligible values, even though they are regularly exposed to even dangerous forms of mercury elements. The urine tests are although fair enough detectors of the chronic exposures, which is based on the 24 hour aged urine sample. It should further be noted that with the help of two substances i.e. DMPS and DMSA the mercury levels present in the urine can be raised temporarily. After the introduction of these chemicals tiny amounts of mercury are accumulated from within the body and then forced to flow out of the body which boosts the absorbed rate of the mercury vapours. In simpler words it can be said that the amount of mercury present in the body is collected and then suddenly compelled to get out of the body, therefore under such circumstances urine levels are raised artificially, thus the use of these two chelating elements should be regarded as illusionary (Lindberg, 1994).
Blood Tests
Usually mercury is also pressured out of kidneys which help to filter blood. However, the levels found in blood are smaller than those in urine thus difficult to measure. Then too even at the large number of exposure to the mercury compounds in case of industrial workers their concentration can be measured in parts per billion ranges which are usually fewer than 5 parts per billion. In these class ranges the amounts are considered to be insufficient to detect the type and source of the mercury. The urine testing is however a better and accurate then the blood testing as the quantities of mercury is more concentrated (Lindberg, 1994).
Skin Tests
The dentistry market is full of anti-mercury practitioners which make use of the patch test to mislead patients about the symptoms of amalgam fillings. Under this test a patch dipped in attenuated suspension of acerbic mercury salts is placed on the skin which causes the skin to swell and redden in addition bearable irritation. These results are then misinterpreted as amalgam toxicity (Lindberg, 1994).
Stool Testing
The amounts found in the stool are not good reflectors of what is required. They actually detect the amounts actually eaten not absorbed by the body, and moreover anything which flows out with stool. In other words the stool test may indicate the amounts of mercury that entered the intestine, but however cannot provide a precise measure of what is actually absorbed by the body (Lindberg, 1994).
Hair Analysis
Under this method a sample of hair is sent to the lab, where it is detected through computerized devices that what is the number of micrograms in the hair and whether this certain count is harmful or not. This method can be regarded as completely misleading as hair can have micrograms stuck into them from other source as well for example water, air and food etc this is because mercury is a content of earths crust thus it is always present in out environment (Lindberg, 1994).
Electro Dermal Testing
Market is full of practitioners who make use of fake devices to misinterpret mercury amalgam use. Under these methods electro magnetic discrepancies are measured. Using this device one wire is attached to a brass stick which the patient is supposed to hold. Another wire from the device is connected to a probing device which is inserted in to the mouth to register the current flow, this therefore completes a low voltage circuit, and then readings from this device are regarded as harmful artificially by the operator (Lindberg, 1994).
Physical Harm
The removal of the mercury amalgam is usually resulted in inappropriate results. This is because the alternative filling material is more costly and thus wastage of money. In most cases it has resulted in weakening or loss of the tooth completely. In order to remove or replace the strong and intact amalgam filling it is necessary to drill around the edges of the tooth, this in turn is injurious. As the heat released from the drill damages the sophisticated gum and adjacent teeth tissues and if the filling is deep it often results in potential damaging or loss of the other teeth as well. Other additional risks should not be ignored which are due to anaesthesia and other mechanical disorders which may be uncommon but intolerable when the treatment is not required on the first place (Mackert, 1997).
In the year dollars hundred thousand were compensated to a fifty five year old lady whose amalgam fillings were removed. Moreover based on the results of the electromagnetic testing, a dentist herself has claimed that it caused sever disorder to her large intestine and moreover caused distorting impacts during the root canal therapy for the two teeth and removal of the other two (Mackert, 1997).
Doubtful Study
In 1990, scholars at the University of Calgary in Alberta, Canada, stated on an experiment in which they positioned 12 amalgam fillings in all of the six sheep. Within 2 months, the scholars declared, the sheep mislaid much of their kidney purpose although a control faction (2 sheep) had mislaid nothing. Newsweek, which acknowledged the information at face value, explained it as the initial indication that the quantity of mercury absconding from fillings and meandering up in body tissues is dangerous. (Newsweeks commentary was coauthored by very similar author who had potted fluoridation before in the year.) Though, specialists in biochemistry, toxicology, dentistry, and veterinary medication believe the sheep research worthless (Mackert, 1991).
Two weeks earlier than the 60 Minutes program took place; Dr. Baratz posted a forewarning to its maker:
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The Canadian scholars organized their amalgam with a technique that has been outmoded for more than forty years. The consequential amalgam enclosed surplus mercury and was softer and consequently more effortlessly damaged by chewing, particularly in a cud-chewing mammal such as a sheep.
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The amalgam fillings were filled in such way that they were in opposite teeth, this caused them to grind against each other, which in turn raised the release rate of the fillings.
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The rubber obstructions were actually not used in this so called experiment, due to which the crumb mercury entered sheeps mouths and consumed.
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The methods and techniques used to measure the amount of mercury absorbed were not accurate.
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However, the researchers asserted that the mercury levels in the body rose while the experiment was in process, but they hadnt stated the mercury levels at the beginning of this experiment. The results showed that large amounts of mercury were swallowed by the sheep during the process.
The claim by the researchers maintained that the kidney toxicity symptoms were based on the urine results, which is however to be opposite of results of it were to be on humans (Mackert, 1991).
Official and Political Action
In California and Maryland there have been complaints filed by people asserting that there are patients who have been harmed by the amalgam fillings and moreover that ADA (American Dental Association) and other state dental institutions have been involved in unlawful illusory trade practices, in addition to that are also involved in a plot by not addressing people if the amalgam filings that contain mercury are harmful. As a reaction to these facts ADA states that these suits are a synchronized effort by some individuals to have prejudices about the scientifically debatable matters and suppress the argument within the scientific lobby, most of whose senior members are not compatible with these statements. In a recent news report then, an ADA official referred to these Californian issues as an abuse of the official structure, the NCAHF agrees with this statement (Mackert, 1991).
A bill has been introduced by the U.S. Representative Diane Watson (D-CA), which prohibits the interstate distribution of mercury which is to be used in dental fillings by 2007. It seems as if she is unable understand the chemical characteristics can greatly differ from those of the content actually used. The Time magazines science writer Leon Jaroff referred to such behaviour as scientifically unsophisticated and had tried to urge Watson to give up her amalgam issue, and moreover to learn not to be moved by week and unauthenticated facts. It is hoped by the NCAHF that she will do so (Mackert, 1991).
References
Bagedahl-Strindlund M and others. (1997)A multidisciplinary clinical study of patients suffering from illness associated with mercury release from dental restorations: Psychiatric aspects.
Baratz RS. (2001)Key points about amalgam safety. Modified from testimony to the Florida Board of Dentistry.
Baratz RS. (1999) Serum compatibility testing. Quackwatch.
Lindberg NE, Lindberg E, Larsson G. (1994) Psychological factors in the etiology of amalgam illness.
Mackert JR Jr, Berglund A. (1997). Mercury exposure from dental amalgam fillings: absorbed dose and the potential for adverse health effects. Critical Review of Oral Biology and Medicine 8:410-436
Mackert JR. (1991) Dental amalgam and mercury. Journal of the American Dental Association 122:54-61.
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