This is a first publishing from 2001, with some corrections, made in 2004.
Dies ist eine Erstveröffentlichung aus 2001, mit Korrekturen aus 2004.
NOTHING TO SMILE ABOUT by Michael Ferrio Restorative dentistry (amalgam, etc.) I began to write about this subject because of the permanent health problems which dentistry has given me. These problems became most severe in 1982, with a dental accident which is de- scribed in the text. Gradually, over the next several years, I began to read all that I could about a material which the dental industry continues to put in other peoples' teeth. The nature of dental amalgam Those "silver" fillings in your mouth are actually only 40 to 50 percent silver. To make such a filling, the dentist starts with a pre-mixed capsule of a metal powder. The name "silver" is mis- leading, and comes from the historical fact that the first such dental powders used in the U.S. in 1833 really were made from powdered silver (Talbot, 1882). However, later the dental indus- try experimented with powders made from other metals such as gold, silver, platinum, and tin, and from metal combinations such as tin-silver (ibid.), and even tin-cadmium (Tuthill, 1899). The metal powder for modern fillings is made largely of Ag3Sn and Cu3Sn (Samans, 1953); although, as with the first metal powders in dentistry (Talbot, 1882, op. cit.), there are probably numerous varieties among different manufacturers. In order to make a tooth filling, the dentist first empties the pre-mixed capsule of metal powder; the contents are then combined in a mortar with MERCURY. Mercury is a metal which not only happens to be a liquid at room temperature, but it also has the property that other metals (such as the metal powder) will actually dissolve in the mercury. An excess of mercury is deliberately used in the preparation of the filling in order to ensure proper amalgamation (Tuthill, op. cit.). Sometimes the dentist will squeeze out the excess mercury with a pair of heavy pliers, and allow it to pass through a cham- ois cloth (ibid.); other times the dentist will take the metallic mass in one palm, and press out the free mercury with the thumb of the other hand (McCord, 1961). Thousands of tiny mercury globules fall onto the floor; and this may go on doz- ens of times each day, six days per week (ibid.). This liquid mercury then evaporates until these tiny droplets can be found in every corner of the room. Large spills of liquid mercury in dental offices evaporate in the same way: In August, 1974, a dental assistant spilled 500 grams of mer- cury while pouring it into the well of a mechanical amalgamator; about 100 grams fell behind a workspace and was not recovered. This mercury slowly evaporated; mercury vapor levels continued to increase throughout the entire building, and eventually ex- ceeded the threshold limit value of 0.05 mg/m^3 in the immediate vicinity of the spill (Merfield et al., 1976). A similar effect occurred in another dental suite, when vandals maliciously spilled 20 pounds of liquid mercury all over the floors (Pagnotto and Comproni, 1976). This case was compli- cated by the fact that the floors were carpeted; so that as the dental staff tried to vacuum up the mercury, it contaminated the vacuum cleaner bag and the motor housing, which only perpetuated the contamination further. Eventually mercury vapor levels in the building were measured to be 0.09 mg/m^3, and were found to have increased to 0.4 mg/m^3 merely by scuff- ing the feet across the carpet (ibid.). When a dentist makes a "silver" tooth filling, at first the metal mixture has a plastic-like consistency, but it immediately begins to harden; during this "plastic" phase it can be easily shaped, and it is at this stage that the metal is placed in your mouth. Once the material completely hardens, this alloy is called DENTAL AMALGAM. It is generally believed that the hardening of the filling ma- terial is a chemical reaction; that once the filling sets, the mercury is locked into the amalgam and becomes harmless. For instance, the metal powders Ag3Sn and Cu3Sn are believed to be changed by the mercury into Ag3Hg4, SnHg3, and Cu3Hg2 (Samans, op. cit.). There are many natural examples in which combining toxic sub- stances together really DOES render them harmless: in ordinary table salt, for instance, free sodium (a metal which bursts into flames when immersed in water) combines with chlorine (a pale- green, poisonous gas); the result is ordinary table salt -- which obviously does NOT explode in water and does NOT emit poi- sonous gas. But the mercury is NOT locked in amalgam. The dental indus- try has known this since at least 1882, when a Chicago dentist named Eugene S. Talbot demonstrated, by a series of simple ex- periments, that even an amalgam filling sixteen years old con- tinues to slowly release mercury vapor (Talbot, 1882, op. cit.; Talbot, 1883). More quantitative measurements find this a- mount to be about 20 nanograms per 10 breaths (Gay et al., 1979). Chew a piece of gum for 15 minutes, and that amount increases three to even twelve times (ibid.), depending upon the food's temperature and hardness. This is a contradiction: on the one hand, the mercury is locked into amalgam, and yet mercury vapor escapes from both historical and modern amalgam. One explanation may be that the escaping mercury vapor is the EXCESS mercury added to ensure proper amalgamation. For the general public, the exact origin of the mercury vapor is irrelevant; the poisonous mercury is still sitting inside of the filling, slowly evaporating off. In your mouth, this mercury from dental amalgam is inhaled and distributed to every organ of your body, and some of it eventually shows up in the urine (Hoover and Goldwater, 1966). Sources of mercury Here are some of the ways in which mercury is a contaminant of the diet: Table 1 -- Some dietary sources of mercury ppm mcg (*) dental amalgam ... ~46 (approx.) fish (various) << 4.5 pig kidney 0.04 0.4 pig liver 0.02 0.2 flour < 0.007 < 0.07 beef < 0.005 < 0.05 chicken < 0.005 < 0.05 ham/bacon < 0.005 < 0.05 carrots 0.003 0.03 brussels sprouts 0.003 0.03 cabbage 0.003 0.03 potatoes 0.001 0.01 (*) = For foods, assumes a serving size of 100g for meat and vegetables, and 1 cup for flour (Tolan and Elton, 1972). For dental amalgam, uses an average of the measurements from (Gay et al., op. cit.) of 2 ng/breath * 16 breaths/ min * 1,440 min/day = 46,000 ng/day. The dietary sources of mercury come from the use of mercurial fungicides in cattle feed and on flour grains, and from mercurial pesticides used on fruits and vegetables. Mercury is also a part of many other non-foodstuffs, mostly from medical and medical-like products: cosmetics such as skin- lightening cremes (Summa, 1975; Saffer et al., 1976), artificial hair-waving solutions (Yamamoto et al., 1978), hair bleaches (Wustner et al., 1975), and red tattoos (Goldstein, 1967); as a questionable "sanitizer" in paints, floor waxes, furniture polishes, fabric softeners, and air-conditioner filters (Goldwater, 1964), and also in anti-bacterial soaps (Peters-Haefeli et al., 1976); and in other medical products such as mercurial diuretics (Wall- ner and Herman, 1950), preservatives in vaccines and contact- lens solutions containing thimerasol (Hoover and Goldwater, op. cit.); and, in fact, in any mercurial product which kills fungi, bacteria, or insect pests. Although measurements of mercury exposure from non-dietary sources obviously vary tremendously, noone is exposed to all of these at once, and noone is exposed to many of these for any more than a short period of time. The mercury from dental amal- gam is the only one which is inhaled for distribution to all body organs, and the only one to which you are CONSTANTLY exposed. This mercury should be of concern to you, but the ADA doesn't want it to be -- they simply put mercury-containing amalgam in your mouth (and the mouths of your family) without your knowledge or consent, and for financial rather than health considerations. Effects of mercury In 1976, free liquid mercury was accidentally spilled in a dental suite by a careless employee (Merfield et al., op. cit.). Initially, the spill was thought to be trivial, and went unre- ported (ibid.). But gradually, the entire dental staff began to complain of vague, poorly defined symptoms: Table 2 -- Effects of subacute mercury toxicity Case 1 (dental surgeon) -- occasional severe headache -- fatigue -- nausea -- irritability -- insomnia -- difficulty with eye focus -- fine tremor of hand (with illegible handwriting) Case 2 (dental assistant) -- headache -- backache -- nausea -- diarrhea -- occasional giddiness upon first arising -- loss of confidence in intellectual ability -- loss of memory Case 3 (dental surgeon) -- headache -- nausea -- diarrhea -- difficulty with eye focus -- insomnia Case 4 (dental assistant/receptionist) -- occasional mild headache -- metallic taste Some of the dental staff visited their own practitioners, all of whom consistently failed to make the proper diagnosis. It was only when the two dental surgeons, in adjoining dental suites, questioned each other that they themselves began to suspect that a poisonous agent was responsible (ibid.). A deputy dental assistant eventually confessed to having caused the mercury spill; mercury toxicity was diagnosed in the entire dental staff, and clean-up began: To relieve these symptoms, in each case the entire dental suite first had to be evacuated, and a decontamination team had to be called in; the rugs then had to be removed and disposed of in a landfill, and the bare floors had to be covered with plastic (ibid.; Pagnotto and Comproni, op. cit.). It is worth noting that symptoms of mercury intoxication were experienced when mercury vapor levels within the dental suite reached only 0.02 to 0.03 mg/m^3 (Merfield et al., op. cit.); this level is considerably less than the "standard" threshold limit value of 0.05 mg/m^3 (ibid.). Also significant is the fact that the receptionist experienced symptoms, even though she was present for only a few minutes every hour (ibid.). A similar mercury spill occurred in another dental suite when liquid mercury was deliberately spilled all over the walls of a dental suite during a vandalism break-in (Pagnotto and Comproni, op. cit.). Dentists can also be affected by the mercury spilled onto the floor during the repeated preparation of amalgam fillings: A study conducted by the University of Pennsylvania found mercury toxicity in one-third of the 300 dentists studied. Dr. Barbara Uzzell, a neuropsychologist, reported that the dentists who had elevated levels of body mercury showed "a definite diff- erence" in "visual perception, memory, getting things done, de- cision-making or concentrating...more stress" (Anon., 9/1/81). The dentists averaged 20 years' exposure to dental mercury (ibid.). In THE NEW YORK TIMES for November 1, 1981, Dr. Barry Rumack of the Rocky Mountain Poison Control Center in Denver, Colorado, made comments about a similar study done "a few years ago", when "someone noticed a lot of dentists aged 40 or 45 have gotten divorced", Rumack said (Anon., 11/1/81). "They had be- come irritable", the TIMES continues, "...a little crazy" (ibid.). In late 1973, a 53-year-old dentist who had been otherwise healthy suddenly visited a physician and complained of emo- tional instability, senility, and depression. Over the next few months, his condition deteriorated further, when he noticed tingling and numbness of both feet, difficulty distinguishing hot and cold, and diminished position sense in the lower ex- tremities. After some "detailed persistent questioning", the physician discovered that the dentist had been handling amal- gam tooth fillings in his work for about twenty years. The diag- nosis of mercury poisoning was made, and his case was success- fully treated (Iyer et al., 1976). A more serious case was reported in 1969, when a 42-year-old dental assistant, who also had been formerly healthy, suddenly became ill with vomiting, pain in the right abdomen, edema of the face and legs, and the passing of dark urine; after six days of hospitalization, she started to develop kidney failure. Even- tually, after another 17 days, she was then transferred to anoth- er hospital unit; but despite kidney dialysis and other treatment, her condition continued to deteriorate. After another 4 days, she died (Cook and Yates, 1969). In fact, when a small quantity of mercury was once carried in a leathern bag left hanging against the breast, the result was another fatal case of mercury poisoning (Anon., 1882). It is very important to realize that both of these deaths, and the effects experienced by these victims, were clearly not the re- sults of some kind of mercury sensitivity or allergy, but rather the effects of mercury POISONING. Can you also experience effects from the mercury of the amal- gam fillings in your mouth? Certainly, if you're allergic to it. Allergy to mercury in amalgam is well-known (Feuerman, 1975; Shovelton, 1968; Strassburg et al., 1967). Even the ADA's own journal has reported allergy among some dental students han- dling mercury (White et al., 1976). Usually, this reaction is in the form of a skin rash (ibid.). Sometimes, however, the effects of allergy to the mercury es- caping from amalgam can be more serious: "THE DENTAL REGISTER, January, 1872, has the following case of poisoning from mercury in a tooth filling: 'John T. Smith died from salivation, caused from having a tooth filled with amalgam. Dr. Sprague attended the case, and afterwards called Drs. Davis and Buffin, all of whom agreed that he was suffering from the effects of mercury present in the amalgam used in filling one of his teeth. The filling had salivated the unfortunate man, and, as the inside of his mouth, throat, and windpipe swelled, respiration was hin- dered, and finally ceased altogether. Dr. Davis made the post-mortem examination in the presence of the coroner and jury of inquest, opening the chest, taking out the lungs, and extracting the filled tooth. No signs of any other dis- eases were found, except that caused by the mercury, and it was made clear to the jury by the Doctor that this caused his death...'" (Talbot, 1882, op. cit.) Of course, some people are also allergic to peanuts, and re- actions similar to this one have also resulted in death. But the case does show that the amount of mercury vapor escap- ing from amalgam fillings is enough to adversely affect the human body. In 1882, the Chicago doctor and dentist Eugene S. Talbot de- scribed a series of simple experiments with amalgam fillings on plants and insects. In one such experiment, an amalgam filling placed at the base of a plant for four days caused the leaves to change color; in ten days, the plant was dead (ibid.). In anoth- er experiment, three roaches were put in three separate bottles, which contained pure mercury, an amalgam filling, and nothing, respectively. The roaches lived for two, four, and fifteen days, respectively; with another set of roaches, the results were nine, eleven, and sixteen days, respectively (ibid.). Although Talbot announced some of his results again (Talbot, 1883, op. cit.), his results were generally ignored. In a more recent survey of human subjects with amalgam fill- ings in their mouths (Hoover and Goldwater, op. cit.), six out of 114 patients were found to have had measurable levels of mer- cury in the urine; five of these levels were directly attributed to the presence of their amalgam fillings. (One patient had been taking a mercurial diuretic). Two of the highest levels of 15 mi- crograms per liter were directly attributed to amalgam. These authors concluded that such body levels of mercury were safe. Unfortunately, they presented no evidence whatsoever to support their conclusion. Perhaps these authors should have noted that the dentist who suffered from obvious neurological signs of mercury poisoning from handling amalgam fillings in his work had urinary mercury levels of from 33 to 40 micrograms per liter before beginning treatment (Iyer et al., op. cit.), and that this level is only twice as much as the highest "normal" level from amalgam fillings. What are the nervous symptoms being experienced by the gen- eral public, "only" 2 out of 114 of whom are being only half- poisoned? Before my own removal of about twenty-three amalgam fillings, I was extremely talkative and irritable, and in a constantly agitated state. In frequent arguments, I made the slightest point while sputtering loudly and hysterically; I was also sub- ject to fits of extreme rage, which I would usually take out on inanimate objects. Gradually, during the year-long removal of my amalgam fillings, these effects completely subsided. Does this kind of excitability sound like any friends, enter- tainers, or abusive spouses whom you know of? In the 1920's, one Dr. Alfred Stock described his own health problems, which he directly ascribed to subacute mercury poi- soning from the amalgam fillings in his teeth (Stock, 1926; Stock, 1928). In 1899, a physician in Brooklyn, New York, described several cases of neurosis, which he believed to have been caused by amal- gam fillings. The following case is typical: "Miss K., a young lady of culture and refinement, was brought to my office December 1st, 1887, suffering from extreme nervousness, which had continued for three years. She was restless and could not apply herself for any length of time to any one thing, sleepless, irritable, hysterical, etc. Having made a thorough examination of her case and being assured that all of her functions were normal, I examined her teeth and found sixteen amalgam fillings. Believing this to be a cause of mercurial neurosis I told her...Following my advice the fillings were removed and the young lady has improved very rapidly to the present time, all her nervous feelings having disappeared..." (Tuthill, op. cit.) In 1896, Henry Sheffield, M.D., of Nashville, Tennessee, de- clared that he had been replacing amalgam fillings with gold for forty years, and also with resulting improvement in general health in almost every case (Sheffield, 1896). In 1882, the Chicago doctor and dentist Talbot similarly wrote, "I am in possession of numberless cases of poisoning from mer- cury in amalgam fillings". (Talbot, 1882, op. cit.). Here is one of these cases, which he describes later: "January 18, 1878, Mrs. W_____, 29 years of age, had sever- al amalgam fillings inserted by me. At that time, and for three succeeding years, she was under a physician's treatment for antroversion of the uterus, when she was dismissed by him as cured. During this time she consulted me at intervals in regard to her teeth. For a year past she has complained of trembling at times, coldness, headache, swelling of the limbs, enlargement of the glands, and pain about the jaws, tongue swollen and sore, teeth loose and tender upon pressure, marked salivation, and a metallic taste in her mouth; appe- tite poor, and bowels irregular; symptoms gradually increas- ing until six weeks ago when she was completely prostrated, and confined to her bed part of the time. Wishing to obtain the opinion of others, I consulted three able physicians, all of whom pronounced it a case of mercurial poisoning. Four weeks ago I replaced all the amalgam fillings at one sitting, and replaced them with gutta percha. A slight improvement was noticeable within a week, and a few of the symptoms dis- appeared. I have refilled some of the teeth with gold, hand pressure being required on account of the soreness. The me- tallic taste has disappeared, the tongue is normal in size, and where before she was irritable and nervous, she is now bright and cheerful, and gaining steadily in weight". (Tal- bot, 1883, op. cit.) Now, the question which remains is this: if mercury ("silver") tooth fillings are so non-toxic, then why are so many of these alleged toxic effects (metallic taste, salivation, irritability, excitability, personality changes, feelings of dread, memory loss, etc.) common to these accounts? Isn't the true test of any hypo- thesis the ability to make consistent predictions over time? Many of these effects are directly explainable in terms of mer- cury poisoning: irritability, excitability, and uncontrolled emo- tional outbursts ("erethism"), for instance, are well-known as early signs of mercury exposure. These signs usually go undi- agnosed because they are usually attributed to the pressures of personal problems (Pagnotto et al., op. cit.). Actually, this effect of subacute mercury poisoning from amalgam has nothing at all to do with psychology, but rather is analogous to the hyperactivity which children often suffer from "non-toxic, safe" levels of lead. This single symptom of amalgam toxicity has profound implications for our society (aggressive drivers, child and spousal abuse, one explanation for why so many American schoolchildren have to be sedated for 180 days per year on dan- gerous narcotics like Ritalin, and so on) -- implications which, I predict, other writers from many diverse fields will write about at length in the distant future. Some of the other alleged poisonous effects of amalgam fill- ings, such as skin rashes and subnormal body temperature, are also directly explainable as being due to the effects of mer- cury. Mercury can also cause the bacteria of the mouth to mutate in- to other, more dangerous forms (Till, 1978). This leads to the conjecture then when this same mercury from amalgam fillings is swallowed, it causes the friendly bacteria of the gut to mutate into other unfriendly forms; this impairs digestion and brings about multiple food and chemical sensitivities. Could dental amalgam be responsible for some cases of environmental illness? My own case of severe asthma completely disappeared upon amal- gam removal. Although my own single claim is easy to dismiss as anecdotal, it is a fact that the mercury from dental amal- gam is inhaled as a vapor. And other metals are known to be triggers of asthmatic attacks (Sterling, 1967). Couldn't at least some cases of asthma (millions in this country alone) be caused by mercury vapor escaping from amalgam fillings? The dentist who was poisoned from handling amalgam fillings in his work (Iyer et al., op. cit.) reported symptoms strongly resembling the beginning of multiple sclerosis. Other nervous effects, such as tics and tremors, are also well-known features of mercury poisoning. Could some cases of epilepsy, stuttering, etc., actually be caused by dental amalgam? Some people who still have amalgams in their mouths find it puzzling that one substance (mercury) can have so many adverse effects. However, toxicologists know that the effects of low doses of any of the heavy metals (lead, mercury, cadmium, etc.) are very numerous and subtle -- it is not as simple as 'x' micro- grams of the metal causing disease 'y' after 't' years of exposure. Everyone is hit at a different point because everyone is biochem- ically different. And because there are so many varieties of amalgams, every- one's fillings are chemically different, too. Another explanation for why only a small percentage of amal- gam victims are made ill by their fillings comes back to the possi- bility that the escaping mercury vapor really is the excess mer- cury from the amalgamation process: since this excess would vary widely from one person's fillings to the next, only a "small" per- centage of persons will be made ill. And even if you do not appear to be suffering any adverse ef- fects from your amalgam fillings, this is not evidence of amal- gam safety. After the methylmercury poisoning in the Mina- mata Bay incident in 1953, for instance, even women who had been completely symptom-free gave birth to grievously handi- capped children (Waldbott, 1978). The point that ANY expos- ure to a poison is not a good idea has not yet been learned by the dental industry. The most serious amalgam hazard There is also yet another hazard from dental amalgam -- one which is not only the most serious hazard, but also the easiest one to verify: what if a person were to actually swallow an amalgam filling? While I was in the process of having my own amalgam drilled out, at one point I swallowed before the dentist could apply suc- tion; immediately, the dentist and his assistant looked at each other in alarm. But from swallowing this rather small amount of amalgam, I did not experience any ill effects at all. Other amalgam victims who have had their amalgams drilled out would agree -- swallowing sufficiently small fragments of amal- gam does not pose any serious, long-term health risk. However, I have had my amalgams drilled out because of what had happened to me in 1982, while I was a student at Chariho Regional High School in Wood River Junction, Rhode Island. (It is because of this incident that I have written the present article): Table 3 -- Effects of swallowing a large amalgam filling FIRST EFFECTS (minutes/hours later): -- palpitations/"popping" in ears (intermittent) -- ringing in ears/hearing difficulty (intermittent) -- excessive salivation (with frequent swallowing) -- metallic taste (more intense with intermittent belching) -- metallic urinary odor LATER EFFECTS (days later): -- colored saliva (light gray tint) -- chronic headache -- insomnia from uncontrollable thoughts -- acute memory lapses, "blanking out" on intellectual tasks -- communication in hysterical anger -- breathing spasms, especially upon inhaling deeply -- metallic body odor -- loss of appetite -- vomiting (intermittent) -- mild diarrhea (intermittent) -- whole, undigested food in stools -- urinary retention -- partial subsidence of many above effects for a few days LATER EFFECTS (weeks/months later): -- purplish gums and lining of mouth -- dazed, despondent facial expression -- glassy eyes -- yellowish skin -- dark, "gray" vision -- variable ringing in ears, with intermittent deafness -- constant feeling of being cold -- sluggishness in walking -- slight tremors of fingers, face, eyes (intermittent) -- acute dislike of intellectual work -- acute inability to communicate, except in faint whisper -- uncontrollable, racing thoughts (acute delirium for 3 mos.) -- avoidance of food for long periods without discomfort -- inability to keep food down for more than a few minutes -- severe weight loss/anorexia -- irrational behavior/nervous breakdown LONG-TERM EFFECTS (*mostly* subside in 12-15 years): -- vegetarianism (for next three months only) -- sensitivities (food, then chemical) -- inability to express strong emotions (esp. joy or anger) -- difficulty "hearing" certain letter combinations while reading -- hearing "echo" upon listening (esp. humor) -- lack of assertiveness -- feign ignorance when asked to perform intellectual tasks -- clumsiness -- occasional tremors in fingertips -- inability to write all letters in own signature w/o pause -- insomnia, sleeping late, then awakening with acute fatigue -- acute lack of ambition -- chronic underweight Regarding the possible hazard of swallowing a "silver" amalgam tooth filling, I was confused by what the opposition had to say on the subject: "...ingestion of a small amount of mercury, as from a bit of silver amalgam a dentist uses to fill a cavity, is not con- sidered a serious hazard; the metal passes through the sys- tem without undergoing chemical change." (Brown and LeMay, 1977) This statement is probably based on the fact that old experi- ments with amalgam fillings could not get them to dissolve in stomach acid and saliva in a test tube (Talbot, 1882, op. cit.; Tuthill, 1899, op. cit.). However, I would point out that the human stomach contains many other corrosives, and again that dental amalgam itself also comes in many varieties. I've given these somewhat technical details so that a consumer group read- ing this can investigate all amalgam manufacturers further on the hazard of swallowing a large amalgam filling. The effects which I've described (first heart sounds and "popping" in the ears, and then the gradual development of the above effects) are easily verified by the next amalgam victim. DENTAL AMALGAM IS THE SINGLE MOST UNSAFE PRODUCT ON THE MARKET TODAY. AS LONG AS YOU CONTINUE TO HAVE A MOUTHFUL OF "SILVER" FILLINGS, YOU ARE AT RISK. The other hazard from dental alloys -- beryllium Other dental alloys, especially those which contain inert gold, have been suggested as alternatives to amalgam. Unfortunately, in recent years the dental industry has made use of more economical metals. BERYLLIUM is used as a cheap substi- tute for gold in bridges, inlays, crowns, and other dental alloys. Beryllium is supposed to make the alloys harder, more resistant to fatigue and corrosion, and to improve their elastic properties (Stokinger, 1966). I am unable to locate an exact percentage for the beryllium content of specific alloys because, as with amalgam, manufacturers consider the exact composition of a material in your own mouth and the mouths of your family to be a "trade secret"; however, Dr. Joseph P. Moffa and his colleagues at the U.S. Public Health Services Hospital in San Francisco reported that nine out of ten dental alloys contain from 0.5 to nearly 2.0 percent beryl- lium (Moffa et al., 1973). Beryllium was once used in fluorescent lamps containing beryl- lium phosphors, the cathodes and filaments of electronics tubes, neon signs, and in the ceramics industry (Anon., 1966). In more recent times, beryllium finds other uses in the nuclear, aero- space, and computer industries (Brody, 1974). Unfortunately, beryllium is highly toxic: on the skin, it caus- es a contact dermatitis; if inhaled, the result is "beryllium dis- ease", characterized by breathlessness, fatigue, and weight loss. The symptoms often do not occur until twenty-five years after beryllium exposure; the disease itself is usually misdiagnosed as sarcoidosis, it is untreatable, and it is usually fatal (Anon., 1966, op. cit.). Beryllium is so toxic, in fact, that workers in industry must protect themselves from the metal dust by providing adequate ventilation, bringing a change of clothes, and utilizing on-site shower facilities. In 1948, the U.S. Atomic Energy Commission (one of the largest customers of beryllium) set the maximum concentration of beryllium in the workplace at only 2 MICRO- GRAMS per cubic meter of air over an 8-hour workday (ibid.). When dentists finish and polish dental alloys without ade- quate ventilation, they are routinely exposed to from three to five times this safety level of beryllium, and ten times this level in the breathing zone (Hinman et al., 1975). Although the wearing of one brand of surgical mask was found to give complete protection, another brand did not (ibid.). Furthermore, the den- tal patient who is having these alloys ground or polished in his mouth does not have the option of any surgical mask at all (Bro- dy, op. cit.). Fatal beryllium disease has been contracted by workers whose only known exposure to beryllium was from cutting a 2% beryl- lium alloy (Snedden, 1955; Gordon, 1960; Tepper et al., 1961; Israel and Cooper, 1963; Lieben et al., 1964). Could this same kind of beryllium poisoning be occurring in dental patients who are having these alloys ground and polished in their mouths? Could this explain some cases of "lung cancer" or "emphysema" among non-smokers? Given the proven toxicity of beryllium, and given that beryllium toxicity is difficult to diagnose and mimics other lung diseases, the possible danger should not be ignored. Your teeth may be radioactive Dental porcelain is commonly used in making the artificial teeth of dentures, and in porcelain veneers (dental repair work); it has also been suggested as yet another alternative to amalgam. How- ever, this material was originally not used very often in dentistry because it didn't look very realistic -- that is, it didn't duplicate the 'gleam' of naturally white teeth very well. Natural teeth get their white gleam from ultraviolet light. This phenomenon is called FLUORESCENCE. Many natural rocks and minerals fluoresce in ultraviolet light, too. One of them is fluorite (hence, the term 'fluorescence'). Another is uranium. Then came the breakthrough. One enterprising dental profes- sional reasoned like this: since dental porcelain didn't gleam very well, and since uranium does gleam in ultraviolet light, uranium could be added to dental porcelain to make it gleam and look more realistic. The patent to add uranium to dental porcelain for this very purpose was granted in 1942 (Dietz, 1942). Unfortunately, uranium fluoresces with a dull yellow-green col- or -- and while radioactive teeth are perfectly acceptable to the dental industry, green teeth are unacceptable. Fortunately, the bluish glow of cerium (another radioactive element) combines with the greenish glow of uranium to give the white gleam that dentists were looking for. The patent to add radioactive cerium to dental porcelain was granted in 1959 (Lee and Muller, 1959). In 1969, a decade after this material had already been implant- ed in unsuspecting peoples' mouths, an article in a Swiss dental journal warned that wearers of this porcelain were getting radia- tion doses which could exceed the legal limits of radiation expo- sure in Switzerland (Nally et al., 1969). Theoretical calculations and practical measurements have shown that a person with six porcelain crowns will receive about 600 rem/yr (O'Riordan and Hunt, 1974). Normal background radiation from all other sources is only about 0.10 rem/yr (ibid.). Then in 1974, two dentists blasted the dental industry for the use of uranium, and strongly urged a search for alternatives (Moore and MacCulloch, 1974). Yet a 1981 survey of forty-eight dental porcelains from five different manufacturers revealed that uranium was still being added to dental porcelains, at a concen- tration of from 80 to 1000 ppm (Noguchi et al., 1981). Even more disturbing, though, was their finding that, contrary to an opinion which they found in another medical journal, in all of the U.S.A. brands, the uranium of the dental porcelains was de- pleted. This means that IN THE U.S.A., SPENT NUCLEAR FUEL IS DISPOSED OF BY PLACING IT IN YOUR TEETH! In the literature, there is no evidence that this practice has ever been discontinued; nor is there any evidence that any kind of recall has even been issued for this product. It should also be noted that only dental porcelain contains radioactive fluorescers. Although other dental materials also contain fluorescers, these are much safer non-radioactive mater- ials, such as zinc sulfide phosphors. Radioactive uranium is the only fluorescer that the dental industry can find for dental porce- lain because only uranium can survive the high heat of porcelain manufacture (O'Riordan and Hunt, op. cit.). Perhaps the dental industry should look for suitable fluorescers a little bit harder. Selection of amalgam alternatives Once you do decide to have your poisonous amalgams drilled out, you first face the difficult task of finding a suitable replacement material. One of the potential problems with any dental material is its mechanical characteristics. Some of the alternative materials, for instance, may settle too much with time (especially in large fillings of the posterior teeth); other materials may roughen with time and become uncomfortable. In this regard, amalgam is probably one of the LEAST suitable, since amalgams which are inefficiently mixed during the preparation of the filling can expand due to continuing reactions within the tooth (Samans, op. cit.). Anyone who has had the painfully unpleasant exper- ience of having a tooth "mysteriously" split should examine the tooth carefully; it was probably filled with amalgam. Another problem is the possibility of allergy. Technically, this is a possible problem with ANY new dental material; it is, therefore, very important that you find out about any possible allergy BEFORE having the new material placed. If, for instance, you find out later that you are sensitive to the new material, it is usually very difficult (and expensive) to remove all traces of a material from your mouth which is as hard as natural teeth. (The alternate material which I have in my mouth is a brand name called CONQUEST -- but I must not recommend it to everyone because some people may be allergic to it. Again, eve- ryone is different). Some of the new materials are even toxic themselves. Silicate cements and composite resins, for instance, slowly and continu- ously release fluorides (Forsten and Paunio, 1972), as do glass ionomer cements (Kent et al., 1979). Some dental advertisers actually claim this to be a cavity-fighting effect; yet how many dentists give this same information to their patients (especially those who are allergic to fluoride)? Fortunately, there are superior and safer alternatives to amal- gam currently available: there are composite resins, with glassy grains which "make it easier for the dentist to create a smooth surface, and facilitate X-ray examination" (Jones, 12/26/81); and there are chemical fillings which "harden at room tempera- ture, and offer more strength and less toxicity than present ma- terials" (Jones, 8/22/81). Even though publicly the ADA opposes amalgam removal, privately the ADA is aware of the superiority of some of these newer materials, because one of them was actual- ly developed by a chemist at the ADA's own health foundation (ibid.); and the ADA's above claim about "the toxicity [of] pres- ent materials" is especially revealing about their own concerns about a material which may be currently in your own mouth. These older references were deliberately selected to show that alternatives to dental amalgam have been available for a long time; in fact, glass ionomer cements have been available since the 1970's, composite resins since the early 1960's, and silicate cements since the 1950's (Forsten and Paunio, op. cit.). Removing your amalgam Now that you have ruled out the toxic dental materials and have finally found a suitable amalgam-free dental material, it is time to have your poisonous amalgams drilled out. It is very important that your dentist should be properly trained in the amalgam removal process. To prevent the dan- ger of swallowing large chunks of amalgam, the dentist needs to use a rubber dam during the removal. (He will do this by putting the equivalent of a shower cap in your mouth). And to keep inhalation of mercury vapors to a minimum, your den- tist will also need to do lots of frequent air suction. You must, of course, be careful that during your amalgam "removal", the dentist really does remove ALL of your amal- gam. (A dental X-ray is a good way to check -- although some alternative materials contain other toxic metals such as alum- inum, which is also opaque on X-rays). My own amalgam-free dentist has related several accounts of patients whose new den- tal material was simply patched over large chunks of amalgam. (This has usually happened in so-called "shopping mall" den- tal clinics). These victims have then had to endure the uncom- fortable (and expensive) process of having all of their dental work re-done. (I was one of these victims myself, and now at least two of my teeth are significantly damaged). For professional advice about amalgam removal, contact an ex- perienced anti-amalgam dentist who has been trained in the prop- er procedures. How did this happen? In analyzing the hazards of any unsafe product, it is always instructive to try to figure out how it ever got on the market in the first place. Dental amalgam was invented by Traveau (Taveau?) of Paris in 1826, and first brought to and advertised in the United States a few years later by two Frenchmen named Crawcour (Tuthill, op. cit.): "Two adventurers, without skill or any claim to the title of dentist, suddenly appeared in New York and began dental practice amid such a shower of advertise- ments, a profusion of display, and a metaphorical flourish of trumpets, as caused our staid and dig- nified dental ancestry to bound with surprise and indignation". (Talbot, 1882, op. cit.) In the United States, the first use of amalgam in tooth fill- ings was in 1833. But from the beginning, dentists were ob- jecting to its unsightly appearance (ibid.). Soon, however, other, more serious objections to the mercury content were being raised: In 1840, one Dr. Harris, in his opening address to the first class of the Baltimore College of Dental Surgeons, called dental amalgam "one of the most objectionable articles for filling teeth that can be employed" (ibid.). In 1841, a committee of the American College of Dental Surg- eons investigated all substances, of which mercury was a part, for stopping teeth. The main part of their conclusion was that "...the use of all such articles was hurtful to the teeth and every part of the mouth...", and that inert gold was always an acceptable substitute. The report was unanimously adopted (ibid.). At a meeting of the same society on July 20, 1843, the use of amalgams was declared to be malpractice (ibid.). They also re- ferred the matter to another committee -- the Medical Society of Onondaga County, New York. Once again, the conclusion about amalgam was that "...no care in the combination or use of the [amalgam] paste will prevent its occasional bad effects" (ibid.). Other dental societies soon followed: in 1845, the Mississ- ippi Valley Association of Dental Surgeons "resolved that the use of Amalgam fillings was unprofessional and injurious, and would not be countenanced by its members" (ibid.). And from 1841 to 1847, the New York Dental Society similarly declared that "all who had not pledged themselves not to use amalgam were obliged to resign or were expelled" (Tuthill, op. cit.). Unfortunately, probably because dental amalgam was also the least expensive material at that time, "The actions of the various societies had very little effect; amalgam forced its way into the offices of the majority of dentists in the country. Many excellent practitioners were expelled, and others resigned from the societies to which they belonged". (Talbot, 1882, op. cit.) Once all of the amalgam opponents had left the dental socie- ties for good, in 1850 a vote was retaken. The unanimous res- olution of the American College of Dental Surgeons was unani- mously rescinded. But "It will be observed that no scientific researches were made to ascertain whether deleterious effects were produced by the mercury; the chief object of the disturbance was, apparently, to rid the profession of charlatans and their obnoxious mate- rials" (ibid.). Instead, the so-called Amalgam War had the opposite effect, by driving out all of the amalgam opponents; and it is solely because of this historical turn of events that dental amalgam is still used today. Conclusion Mercury is a "protoplasmic poison" (Goldwater, op. cit.) -- a scientist's way of saying that mercury is harmful to all forms of life as we know it. Even the "safe" doses of mercury vapor escap- ing from amalgam fillings have been proven to cause illness. It is true that, theoretically, every tooth filling material has its risks (the possibility of allergy, or of choking to death on it, for example). However, the risk of poisoning, no matter how slight, and no matter whether it affects dental personnel or their pa- tients, is not supposed to be a risk for ANY dental material. If the possibility of mercury poisoning from mercury ("silver") amalgam tooth fillings had been a recent discovery, then perhaps the dental industry could be forgiven for its greed and shortsight- edness. But remember that the dental industry has known since at least 1882 that mercury escapes from amalgam (Talbot, 1882, op. cit.; Talbot, 1883, op. cit.). Furthermore, the dental industry has always known that these fillings can cause illness. The following excerpt from a letter, written about another amalgam victim in about 1898, is very re- vealing: "While my husband was in one of the Western cities he happened to be in a large Dental Association and asked the president if he had ever heard of amalgam fillings causing nervous troubles. He replied, 'Yes we have. It is not common, but some people are poisoned by the mercury, as I can prove'..." (Tuthill, op. cit.) (The president of the dental association then quoted yet an- other case of irritability and hysteria which improved upon amalgam removal). In any other industry, admissions such as this would be con- sidered evidence of conspiracy and fraud. The time for dental amalgam has long past. This material, which has long since been tested for efficacy but not for safety, is an atavism -- a relic from the days when medicine had a ma- cabre fascination for mercury by using it in the treatment of syph- ilis, and in calomel (a universal "medication" which permanently disabled millions of Americans in the nineteenth century). In the current century, all of these "noxious nostrums" containing mercury are viewed as being badly outdated -- all except (for some reason) dental amalgam. The "Amalgam Wars", as they are actually called (Hoover and Goldwater, op. cit.) show that twentieth-century medical science has not yet caught up with medicine prior to 1850, because un- countable numbers of unsuspecting men, women, and children every day continue to have this poison implanted in their mouths. 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