MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

By guest blogger Hans-Werner Bertelsen

Veronika Hackenbroch wrote in an article for the German news website Der Spiegel about clusters of cases where children were born with severe birth deformities. (1) The only common factor that researchers in the Paediatrics department of the University Medical Center Mainz were able to identify through intensive communication with the mothers was that they had all visited a dentist whilst pregnant. The fetus is particularly sensitive to exogenous stimuli during early pregnancy, which is why this period is also known as the “teratogenetic determination period” (Koberg).

The data regarding the workplace exposure limit for mercury is outdated – it is based on information collected about 50 years ago in some cases. Since that time, there have been considerable advances, in particular in the fields of measuring technology and analysis. Unfortunately, these advances have yet to be utilized to provide meaningful figures on exposure to mercury vapour when removing old fillings or drilling into teeth with mercury amalgam fillings for the purpose of acute pain management. In addition to patient protection, the focus when processing existing mercury amalgam fillings is therefore also on occupational health and safety. This has not gone unnoticed by many female employees in dental surgeries that mercury amalgam can pose serious risks to unborn children. For example, a study in Norway reported an increased risk of perinatal death associated with a high number of mercury amalgam fillings. (2)

Sylvia Gabel from the German Association of Medical Professions (Verband medizinischer Fachberufe e.V.) even called for an immediate ban on toxic mercury amalgam: “Vapours pose a danger to dental professionals’ health!”. Mrs Gabel added: “The processing of amalgam in dental surgery releases mercury vapour. As 99 per cent of the dental nurses and hygienists in Germany are female and mercury has harmful effects on both fertility and the unborn child, we are exposed to a particular risk.”(3)

Researchers in Norway documented a considerable increase in the concentration of mercury in the blood after the removal of fillings as far back as 2006. (4) Toxicologists are in unanimous agreement that these peaks, which are the result of inhalation, are extremely harmful and may well have a teratogenetic effect in early pregnancy. (5) Consequently, what I am calling for is this: until such time as we know how high the mercury vapour concentrations are and as long as we “remain in the dark”, we should refrain from removing existing fillings containing mercury and performing dental drilling procedures in women of child-bearing age for ethical reasons so as to exclude the risk of deformities (see Der Spiegel article: “Waren die Schwangeren beim Zahnarzt?”, V. Hackenbroch, 20.09.19). (6)

An immediate ban on the use of mercury amalgam would be advantageous not solely with regard to the exposure to toxins of cancer patients, as the field of “alternative medicine” often recommends expensive, unnecessary and subsequently also very harmful “detox” treatments. (7) A more than questionable business from an ethical perspective: cancer patients are often looking for additional, so-called complementary therapy methods. This often sees them fall into the clutches of healers and doctors, who have no dental expertise but can identify mercury amalgam fillings very easily due to their dark colour. As I myself experienced in a so-called “alternative” dental surgery, the frightened patients, who are often in the middle of chemotherapy cycles, are then informed that they absolutely must have the mercury amalgam removed and then undergo a “detoxification therapy”. Introjects are not spared in the process: “Your body, already devastated by the chemotherapy, should not be subjected to additional chemicals.” Of course, this “detoxification” will be performed (with maximum consideration!) as a “homoeopathic” therapy. I had to observe this very lucrative “business model” often enough – and not once has a cancer patient objected. Once they fall under the charlatan’s spell, patients will allow themselves to be treated with all manner of things. Even live cells. In one patient, a single mother of two, this method triggered a fatal anaphylactic shock. (8) However, cancers and other chronic diseases are not the only reasons that bring patients with mercury amalgam fillings within the reach of dubious individuals with promises of salvation and charlatans. (9) An unfulfilled desire to have children has also led countless desperate women to ask to be parted irrevocably from their mercury-containing fillings. German health insurance companies approve these interventions, which appear logical from a toxicological perspective, and thus contribute not only to the replacement of the fillings but also to the release of mercury vapours and thus toxic peaks resulting from inhalation. Such actions can even have fatal consequences in the early stages of pregnancy.

However, the focus with mercury amalgam is not only on protecting patients from dishonest therapists and unnecessary teratogenetic risks – female staff could also benefit in general. For example, an immediate ban of the use of mercury amalgam could significantly increase job satisfaction among female employees in the dental surgery. According to Sylvia Gabel: “Strike measures were considered in the surgeries continuing use.”(10)

Each new mercury amalgam filling brings with it numerous side effects. It:

  • – increases the risk of toxic exposure resulting from inhalation during removal;
  • – increases the risk of corrosion products developing in the long term;
  • – increases demand in the field of detox beliefs and homoeopathic charlatanry;
  • – promotes the conspiracy narrative of “the dangers of conventional medicine”; and, in doing so,
  • – often undermines patients’ confidence in treatments appropriate for the indication and, along with it, the often-vital compliance;
  • – fills not only the cavity in the tooth but also the charlatans’ pockets.

I believe it is time to give dental health a helping hand with an intelligent combination of contemporary prevention concepts and harmless filling materials. Currently, the political will is merely a small seed. The seed must now germinate and grow.

REFERENCES

1. “Waren die Schwangeren beim Zahnarzt?”, V. Hackenbroch, 20.09.19 2. https://www.zwp-online.info/zwpnews/dental-news/wissenschaft-und-forschung/schwangerschaft-und-amalgam-risiken-bei-hohen-mengen 3. https://www.dzw.de/amalgam-ausstieg-ngo 4. https://pubmed.ncbi.nlm.nih.gov/29320025/

5. Prof. Eschenhagen, Toxicology Hamburg-Eppendorf in personal correspondence dated 23.01.2020 6. Comment dated 05.07. https://onkelmichael.blog/2021/07/03/ist-eine-entfernung-bestehender- amalgam-restaurationen-problemlos-und-bedenkenlos-durchfuhrbar/comment-page-1/? unapproved=4000&moderation-hash=d5b63e66f5045bfa12d829a88eddf1b0#comment- 4000 7. Prof. E. Ernst: https://www.theguardian.com/lifeandstyle/2014/dec/05/detox-myth-health-diet-science-ignorance 8. http://scienceblogs.de/kritisch-gedacht/2012/02/08/insider-bericht/

9. Prof. Jutta Hübner (Oncology, Jena) in personal correspondence dated 21.01.2020

10. Sylvia Gabel in personal correspondence dated 18.06.21

9 Responses to Dental Amalgam

  • clusters of cases

    Clusters of cases can be important in highlighting a previously unknown problem, as here. However, it is important to remember that random events also cluster – if they were evenly distributed they wouldn’t be random.

  • Dentists still use mercury amalgam? I would need to check but I thought that here in Canada we had stopped use it it back in the 1970’s.

    And as Dr Julian Money-Kyrle says “random events also cluster”. We had a number of cancer clusters near high-voltage power lines in the1980’s that eventually seemed random, though I suppose, concievable there were other environmental factors that come with high voltage power lines. For example few wealthy neighbourhoods have them in the backyards.

  • There should of course be safeguards for those working with mercury amalgams, however banning mercury fillings would be a retrograde step for several reasons: (1) it is not based on sound science – studies linking mercury fillings to disease are weak and sporadic; (2) it would prevent the use of what is the most cost-effective and durable form of filling available; and (3) -worst of all- it would be playing into the hands of ‘altmed’ enthusiasts, who in my experience harbour a near-universal hatred on these types of tooth filling. Ban mercury amalgams and it would allow and inspire ‘altmed’ types to persuade many more people to go and get all their fillings removed – a folly which is not only a waste of patients’ time and money, it is also, ironically enough, a process that’s likely to give them their highest doses of mercury vapour that they’ll ever encounter.

  • Historically, those most exposed to mercury vapour were those in the dental surgery involved in the placement and removal of amalgam restorations. During the 60s and 70s when the advent of the Borden air rotor meant that cavity preparation became faster and easier, amalgams were placed worldwide in their billions. Amalgam was then not triturated in capsules but manually by nurses using a pestle and mortar to mix the alloy powder and liquid mercury, often finishing by “mulling” the amalgam paste in the palm of their hand. The resultant amalgam had a much higher free mercury content than modern amalgams. Millions were placed in the teeth of pregnant mothers in the U.K. who were encouraged to visit the dentist because NHS dentistry was provided at no charge to them.

    The number of fillings placed dropped dramatically during the 70s and 80s as the use of fluoride toothpastes became the norm.

    To my knowledge, there was no alteration in the frequency of birth defects during this shift and no evidence of harm to those working in the dental surgery or higher rate of birth defects has ever been conclusively demonstrated.

    The risks of dental amalgam – other than the environmental ones – remain largely theoretical.

    (It is a material I now use very rarely. Not through any health fears but because I think that modern composite resins are the better materials)

  • A dear friend of mine with multiple sclerosis had his mercury amalgam fillings removed for a dear price. He and his wife asked me beforehand what I thought of the handout offering the treatment. My heart sank as I read it. I knew of their desperation. I simply said that they should do what they thought best. He died 15 years ago.

  • I am a general dentist working in The Netherlands for 10 years. I never place an amalgaam filling , I was teached only composite technique in patients but I have removed a lot of them in 10 years onder the rubber Dam . I see a lot of patients going to a biological dentist and having fear to the amalgaam .My clinical experience is that replacing a diep amalgaam filling has in common cases sensitieve or irreversibles púlpitis. So I do not advice to remove all of them due to this argument.Nice blog I am really happy that I found it !

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