Dental Amalgam Scientific FactsEditor : Bernard Windham, (Organization: Florida Public Service Commission ) RR2, Box 385A Tallahassee,Fl 32322 904-878-9024 E-mail DJRZ14A@prodigy.com l. Some Facts II. Systemic Mercury Intake Level from Amalgam Fillings III. Medical Studies Finding Health Problems Related to Amalgam Fillings. IV. Health Effects from Dental Personnel Exposure to Mercury Vapor. V. Results of Removal of Amalgam Fillings. VI. Scientists and Government Panels or Bodies That Have Found Amalgam Fillings to be Unsafe. References to this document More science : DAMS,Inc. (Dental Amalgam Mercury Syndrome,Support Group) : SUMMARY OF SCIENTIFIC FACTS I. Some Facts. 1. Dental amalgam contains about 50 % mercury. The average filling has 1/2 gram of mercury. 2.Mercury is the most toxic of the toxic metals. Mercury is: (a) cytotoxic (kills cells) (2,27,33) [106,147,148,150,160]. (b) neurotoxic (accumulates in the brain and damages brain cells) (27,34,48) [85,111,147,148,160,162] (c) immunotoxic (damages and weakens the immune system) (27,34,35,42,43,44,45,46,47,48,60) [77,78,105,117,127,128,146,155,160,226] (d) nephrotoxic (toxic to kidneys) (59),[157,203,211,223] (e) endocrine system-disrupting chemical (affects pituitary gland) [85,105,113,146,149] (f) reproductive and developmental toxin (2,3,4,20,22,24,31,37,38,39,49,41,49) [105,146,149,160,204]. (g) causes cardiovascular damage and disease including damage to vascular endothelial cells, increased white cell count, and decreased oxyhemoglobin level (47,201,202,205,232). (h) causes immune system damage resulting in alergies, asthma, and multiple sensitivities(228,230) 3. Mercury crosses the blood brain barrier and is selectively stored in the pituitary gland of the brain. [48,85,113,146,162] The pituitary gland controls the body's endocrine system and secretes hormones that control most bodily processes, including the immune system and reproductive systems[146]. 4. Mercury's biochemical damage at the cellular level include DNA damage, alteration of protein structure, alteration of the transport of calcium, induction of free radical formation, inhibition of glutathione peroxidase enzyme, endothial cell damage, and immune system damage. Only a few micrograms of mercury severely disturb cellular function and inhibit nerve growth(181). 98% of mercury found in the brain is in the methyl mercury form, the most toxic form(220). Most mercury in saliva was also organic. 5. Hormonal secretions of the pituitary gland that control bodily processes are at extremely low levels and extremely low levels of mercury are required to adversely affect hormonal secretions of the pituitary gland. Hormonal secretions affected at levels much lower than acute toxicity effects normally tested for[105,146]. 6. Because of the extreme toxicity of mercury, only 1/2 gram is required to contaminate a 10 acre lake to the extent that a health warning would be issued by the government to not eat the fish[151,160]. Over half the rivers and lakes in Florida have such health warnings[160]. 7. Some Florida panthers that eat birds and animals that eat fish containing very low levels of mercury(about 1 part per million) have died from chronic mercury poisoning[160]. Since mercury is an estrogenic chemical and reproductive toxin, the majority of the rest cannot reproduce. The average male Florida panther has higher estrogen levels than females, due to the estrogenic properties of mercury[105,160]. Similar is true of some other animals at the top of the food chain like alligators. 8. In addition to having estrogenic effects, mercury has other documented hormonal effects including effects on the reproductive system resulting in lowered sperm counts, defective sperm cells, and lowered testosterone levels in males and lowered levels of brain neurotransmitters dopamine, serotonin, and noreprenephrine[105,107,140,141], 9. An average amalgam filling contains 1/2 gram of mercury, and the average adult had at least 5 grams of mercury in fillings(unless most has vaporized). Mercury in solid form is not stable and vaporizes continuously, so that within 10 years more than half has been transferred to the brain and body of the host(34,47)[182]. 10. The level of mercury in people with amalgam fillings causes a body burden of mercury much higher than they could get from eating contaminated fish from Florida waters with government health warnings. (WHO,183) 11. Running shoes with 1/2 gram of mercury in the heels were banned by several states, because the amount of mercury was considered dangerous to public health and created a serious disposal problem. Mercury from dental offices and human waste from people with amalgam fillings has much higher levels and is a major source of mercury in Florida waters. One study found dental offices discharge into waste water between 65 and 842 milligrams per dentist per day(231), amouting to several hundred grams per year per office. This is in addition to air emissions. * More detailed descriptions and references are contained in [105,160]. References in parentheses were compiled by the Australasian Society of Oral Medicine and Toxicology. References in brackets were compiled by Bernard Windham. II. Systemic Mercury Intake Level from Amalgam Fillings 1. Mercury in solid form is not stable and evaporates continuously from amalgam fillings in the mouth, being transferred over a period of time to the host(211). Mercury vapor from amalgam is the single largest source of systemic mercury intake for persons with amalgam fillings. (16,17,19,57,) [78-82,94,111,126,129,130,138,161,183,211,216]. Amalgam also releases significant amounts of tin and copper which also have toxic effects, with organic tin formed in the body being much more neurotoxic than mercury[185,222]. 2. Mercury vapor is absorbed at a rate of 80% through the lungs into the arterial blood and is also absorbed my oral mucosa. (18,31,40) [77,79,84,94,96,117,133,211,222] 3. On average for a person having amalgam fillings, vapor from amalgam fillings amounts to about 80% of total systemic intake. [78-82,93,94,179,211] 4. Having dissimilar metals in the teeth(e.g.-gold and mercury) causes electrical currents and much higher mercury vapor levels and levels in tissues. (19,27,30) Average mercury levels in gum tissue near amalgam fillings are 250 ppm, but are often 1200 ppm near a gold cap on an amalgam filling(30,25,47)[186,194]. Concetrations of mercury in oral mucosa for a population of patients with 6 or more amalgam fillings taken during oral surgery were 20 times the level of controls[174]. The level of mercury and copper released from high copper amalgam is as much as 50 times that of low copper amalgaums[191]. High levels of mercury vaporize and are picked up by the body and bloodstream during dental work(high-speed grinding) on amalgam fillings, which results in much higher levels in the heart, brain, liver, and kidneys(219,205,etc.). 5. The average level of mercury in the urine of a person with amalgam fillings(1.9 parts per million) is approximately twice that of the FDA and EPA Action Level for bans on eating fish and food due to high mercury level(1 ppm) and can be as much as 50 times the EPA Critical Level. [134, 154,etc.,160] The U.S. Agency for toxic Substnces and Disease Registry standard (MRL) for acute inhalation exposure to mercury vapor is 0.02 mcg Hg/m3 and the MrL for chronic inhalation exposure is 0.014 mcg Hg/m3. Common levels found in persons with amalgam fillings are over 100 times these MRLs(217,209). Thus persons with amalgam fillings have levels of intraoral mercury vapor higher than the level considered to have significant health risk. 6. There is only a weak correlation between blood or hair mercury levels and body burden or level in a target organ[157]. Feces has a significant mercury burden in people with amalgam fillings, having a higher correlation to systemic body burden than urine or blood, which tend to correlate with recent exposure level.(47) [79,80] As damage occurs to kidneys over time, mercury is less effeciently eliminated[157]. 7. Mercury accumulates in the brain, liver, kidneys, heart,and oral mucosa(1,20,31,34) [77,79,84,85,94 ,111,149,205,211,219] 8. The number of amalgam surfaces has a statistically significant correlation to : (a) blood plasma mercury level (17) [84,133,211] (b) urine mercury level (16) [76,77,138] (c) oral mucosa and saliva (18)[77,79,94,117,199,211,222] (d) feces mercury [79,94,117] (e) pituitary gland (14,16,19,25) [85,113] (f) brain occipital cortex (14,16,19,25,34) [85,111,149,211] 9. A person with amalgam fillings has daily systemic intake from mercury vapor of between 3 and 70 micrograms of mercury, with the average being at least 12 micrograms per day.[77,83,85,179,211]. Total intake is proportional to the number and extent of amalgam surfaces, but other factors such as chewing gum and drinking hot liquids influence the intake significantly.(18,28,31,56) [135-139,193,211]. Vapor emissions range up to 200 mcg/M3 (47)[193] and are much higher after chewing. Approx. 39% of those having amalgam fillings tested in a large German study had ingested mercury levels exceeding the WHO mercury standard(199). 10. The blood and kidney mercury load of a person with amalgam fillings is often 5 times that of a similar person without.(16)[79,80,82,84,93,111,136,138 The average blood level for one large population was 24.8 nmol/l[176]. Normal blood levels are less than 20 ppb, but health effects have been observed in patients in the upper part of this range[196]. A Swedish study estimated the total amount mercury swallowed per day from intra-oral vapor was 10 micrograms per day[177]. Other studies have found similar amounts(211). 11.Teeth are living tissue and have massive communication with the rest of the body via blood, lymph, and nerves. Mercury vapor (and bacteria in teeth ) have paths to the rest of the body. (34,etc.) One German study of mercury loss from vapor in unstimulated saliva found the saliva of those with amalgams had 5 times as much mercury as for controls[179]. 12. Mercury crosses the blood brain barrier and is stored preferentially in the pituitary gland, hypothalamus, and occipital cortex in direct proportion to the number and extent of amalgam surfaces.(1,13,19,20,25,34,55a) [85,111,113,149] Thus mercury has a greater effect on the functions of these brain areas. 13. Some mercury entering nasal passages is absorbed directly into the olfactory lobe and brain without coming from blood.(34,47,55a). 14. Mercury is transported along the axons of nerve fibres (33,34,47,50). 15. Mercury from amalgam is transported freely via the blood after entering the blood through the lungs (19,34,35). 16. Mercury has a long half life in the body and brain, and chronic low level intake results in a slow accumulation in body tissues. (20,26,34,47) [etc.] 17. Methyl mercury is more toxic to some body processes than elemental mercury. Mercury from amalgam is methylated by bacteria and candida albicans in the mouth and intestines(51,53,54) [81.185,225]. Methyl mercury is 1000 times more potent in causing genetic damage than any other known chemical(Ramel, in(47)). 18. The level of mercury in the brain tissue of the fetus, new born, and young children is directly proportional to the number of amalgam surfaces in the mother's mouth. (61,etc.) [112,113,114,204] 19. Mercury from amalgam in pregnant women crosses the placenta and appears in amniotic fluid and fetal blood, liver, and pituitary gland within 2 days of placement(18,31) [113,162,204]. Mercury is often stored in breast milk and the fetus at much higher levels than that in the mother's tissues (18,19,22,23,40,41,61) [112,114,204]. The highest level is in the pituitary gland of the fetus which affects development of the endocrine,immune, and reproductive systems. 20. There is a significant correlation between the number of amalgam fillings of the mother and the level of the fetus and older infants[112,113,114,204], and also with the level in mothers milk(18,19,61) [112,113]. Fertile women should not be exposed to vapor levels above 10 mcg/M3 (38,61)[195]. III. Medical Studies Finding Health Problems Related to Amalgam Fillings 1. Toxic/allergic reactions often result in lichen planus lesions in oral mucosa or gums and play a roll in pathogenesis of periodontal disease. Removal of amalgam fillings usually results in cure of such lesions. [82,86,87,90,94,101,133,145,192] 2. Numerous studies have found long term chronic low doses of mercury cause neurological, memory, behavior, and mood problems(34) [71,74,107,108,109, 115, 119,140,141,196,222]. Organic tin compounds formed from amalgam are even more neurotoxic than mercury(222). 3. Studies of groups of patients with amalgam fillings found significantly more neurological, memory, mood, and behavioral problems than the control groups. (34) [107,108,109,140,141,196,222] 4. Mercury binds to hemoglobin in the red blood cells thus reducing oxygen carrying capacity(1,16,17,21,26,35,47), and at 1 ppm can destroy the membrane of redblood cells(35,47,22,17) and damage blood vessels- reducing blood supply to the tissues(34). These effects often result in fatigue and reduced enery levels [115,119,140,141,202,212,235]. Mercury also accumulates in the heart and damages mycardial and heart valves(Turpayev, in 47)& 205). 5. Mercury amalgam exposure adversely affects the immune system(27,34,48) [77,78,118,199,226]. One of several effects is to increase the average blood white cell count by 2000 to 10000 (47). The increased white count usually normalizes after amalgam removal. Mercury also blocks the immune function of magnesium and zinc [197]. 6. Mercury from amalgam interferes with production of cytokines, disabling early control of viruses and leading to enhanced infection[131]. 7. A group of patients with amalgam fillings and complaints of systematic symptoms including central nervous system problems and a group of controls were given MRI tests. 81% of the group with health complaints had pathological MRI results including signs of degeneration of the basal ganglia of the brain, but none in the controls. 60% of the symptom group tested positive for immune system reaction to mercury. The authors concluded that immune reactions have an important role in development of brain lesions ,and amalgam fillings induce immune reactions in many patients[118]. 8. Among a group of patients testing positive as allergic to mercury, low level mercury exposure was found to cause adverse immune system response, including reduction of in vitro production of tumor necrosis factor TNF alfa and interleukin-1. [152] 9. Patch tests for hypersensitivity to mercury have found from 2% to 42% to test positive[87,154,178]. In a study of medical students, 12.8% tested positive as allergic to mercury, and those testing positive had significantly higher average number of amalgam fillings than those not testing positive(and higher levels of mercury in urine[132]. Other studies have found increasing allergy to mercury related to amount of exposure and time period of exposure[156,etc.]. If this is a good estimate of the percent of Americans allergic to mercury, this would be about 30 million people especially vulnerable to increased immune system reactions to amalgam fillings. However, patch tests do not measure the total population getting toxic reactions from mercury. The most sensitive reactions are immune reactions, DNA mutations, and systemic effects(47). 10. Low level mercury exposure including exposure to amalgam fillings has been found to be associated with increased auto immune diseases , including lupus,Chrons disease, lichen planus, endometriosis (1, 14, 17, 19, 21, 25,27,34,35,42,43,44,45,47,49,55,60) [77,78,215,226]. Silver, like mercury, is released from amalgam fillings and stored in the body and has been shown to cause immune reactions and autoimmunity in animal studies [77, 78, 129,226] 11. People with amalgam fillings have an increased number of intestinal microorganisms resistant to mercury and many standard antibiotics. (47,58)[116,117] Studies have found a significant correlation between mercury resistance and multiple antibiotic resistance[116,117,161]. 12. Mercury from amalgam binds to the -SH (sulphydryl) groups, resulting in inactivation of sulfur and blocking of enzyme function, producing toxicity. Sulfur is essential in enzymes, hormones, nerve tissue, and red blood cells. These exist in almost every enzymatic process in the body. Mercury also blocks the metabolic action of manganese and the entry of calcium ions into cytoplasm. Mercury from amalgam thus has the potential to disturb all metabolic processes(25,33,47,60)[180,197}. Mercury is transported throughout the body in blood and can affect cells in the body and organs in different ways. 13. Several studies found adverse health effects at mercury vapor levls of 1 to 5 mcg/M3 (47). 14. Mercury accumulates in the kidneys with increasing levels over time. Mercury exposure has been shown to adversely affect kidney function in occupational and animal studies(59,203,211,etc.). The Governent's toxic level for mercury in urine is 30 mcg/L [189], but low levels in urine often mean high mercury retention and chronic toxicity problems. 15. Amalgam fillings produce electrical currents which increase mercury vapor release and may have other harmful effects(19,27,28,29,35,47,56)[194]. These currents are measured in micro amps. The central nervous system operates on signals in the range of nano-amps, which is 1000 times less than a micro amp(28). Negatively charged fillings or crown apear to cause higher mercury vapor losses(47). 16. Mercury from amalgam fillings is transferred to the fetus of pregnant women and children who breast feed at levels often higher than those of the mother(18,19,31,61) [112,113,114,195,204]. Mercury has an effect on the fetal nervous system at levels far below that considered toxic in adults, and background levles of mercury in mothers correlate significantly with incidence of birth defects and still births[204,38]. 17. Since mercury is documented from studies of humans and animals to be a reproductive and developmental toxin[105,146,224], mercury can reduce reproductive function and cause birth defects and developmental problems in children. (2,3,4,20,24,31,37,38,39,40,41,49)[224]. Clinical evidence indicates that amalgam fillings leads to hormone imbalances that can reduce fertility(199,38). Some researcher's advise pregnant women should not be exposued to mercury vapor levels abouve 10 mcg/M3 (61)[195] and several governments have bans or restrictions on use of amalgam by women of child-bearing age. 18. Mercury causes breaks in DNA (41,42,)[197]. Low non-cytotoxic levels of mercury induce dose dependent binding of mercury to DNA and significantly increased cell mutations[142] and birth defects[197,38]. 19. Mercury by its effect of weakening the immune system contributes to increased chronic diseases and cancer[222,234,etc,]. Amalgam fillings have also been found to be positively associated with mouth cancer(206). 20. In addition to the endocrine system disrupting effects of high mercury accumulation in the pituitary gland, mercury causes a reduction in thyroid production and an accumlation in the thyroid of radiation. Mercury's adverse influence on thyrocytes can play a major role in thyroid cancer etiology[144]. Mercury has been found to affect hormone production at very low concentrations(199). 21. Allergies and hair-loss were found to be 2-3 times as high in a group with large number of amalgam fillings compared to controls(199). Higher levels of hormone disturbances, immune disturbances, rececurrent fungal infections were also found in the amalgam group. 22. There has been no evidence found that there is any safe level of mercury in the body that does not kill cells and harm body processes(WHO,183, etc.). Mercury levels of 10ppm severely disturb cellular function, and growth of nerve fibers are affected at much lower levels[181]. This is especially so for the pituitary gland of the developing fetus which is the most sensitive to mercury(2-4,19-24,30,31,36,37,39-44). 23. The level of mercury released by amalgam fillings is often more than the levels documented in medical studies to produce adverse effects(see previous text). IV. Health Effects from Dental Personnel Exposure to Mercury Vapor. 1. Dentists and dental personnel who work with amalgam are chronically exposed to mercury vapor.(1,6-12,32,34,36) [72,122,123,124,171,172,173] Studies note that carpeting in dental offices should be avoided as it is a major repository of mercury[188]. Mercury levels in urine of dental personnel average about 2 times that of controls(123,124,171) and was 43 nmol/liter for a population surveryed in Sweden(171), which is above the Swedish occupational exposure guideline. 2. Drilling old amalgam fillings with only a saliva extractor and no other precautions produces mercury vapor levels 2 to 15 times occupational threshold limit values(30 micrograms/cubic meter)[120,219]. 3. The average dental office exposure affects the body mercury level approximately the same as having 19 amalgam fillings[123,124,173]. 4. Body burden increases with time and older dentists have median mercury urine levels about 4 times those of controls, as well as higher brain and body burdens(13,34) [70-74,122]. Some older dentists have mercury levels in some parts of the brain as much as 80 times higher than normal levels(14,34). 5. Dentists and dental personnel experience significantly higher levels of neurological, memory, mood, and behavioral problems, which increase with years of exposure(13,34,49) [69-74,88,122,188]. 6. Female dental technicians who work with amalgam have significantly reduced fertility and lowered probability of conception(3,24,38)[121], and their children have significantly lower average IQ compared to the general population(13). The level of mercury excreted in urine is significantly higher for female dental assistants than dentists(171,172,173). 7. Many homes of dentists have been found to have high levels of mercury contamination aused by dentists bringing it home on shoes and clothes[187]. 8. Some studies have found increased risk of lung, kidney, brain, and CNS system cancers among dental workers(14,34)[143]. 8. Autopsies of former dental staff found levels of mercury in the pituitary gland averaged over 10 times that of controls(99), as well as higher levels in the occiptial cortex and renal cortex and thyroid. V. Results of Removal of Amalgam Fillings. 1. For the week following amalgam removal, body mercury levels increase approx. 30 % (unless Chelation is also used), but within 2 weeks levels fall significantly.[82,89] 2. Removal of amalgam fillings resulted in a significant reduction in body burden and body waste product load of mercury[75,82,88,89,93,95,96,125,200]. 3. Total reduction in mercury levels in blood and urine is often over 80% within a few months[82,89,93,96,200]. 4. There are extensive documented cases (many thosands) where removal of amalgam fillings led to cure of serious health problems such as periodontal diseases, immune system problems,allergies, asthma,multiple sensetivites, epilepsy, blood conditions, stomach pain, depression, mental confusion, infertility, lupus, MS, chronic fatigue syndrome(CFS),arthritis, tachycardia, universal reactors, etc. or significant improvement in symptoms [75,86-91,94- 103,125,148,165.167.168,170,180,182,192,199,200,222,229,233,234,235,237]. Interviews of a large population of Swedish patients that had amalgams removed due to health problems found that virtually all reported significant health improveents and that the health improvements were permanent(233).(study period 17 years) A compilation of an even larger population found similar results (237). For example 89% of those reporting alergies had significant improvements or total elimination; extrapolated to U.S. population this would represent over 17 million people who would benefit regarding allergies alone. 5. Some studies of patients with major neurological or degenerative diseases such as Alzheimers ,ALS,MS,Parkinson's,etc. have found evidence amalgam fillings may play a major role in development of that condition (66,67,92,97,98,100,102,145,148,158,159,163,166,169,170,175,183,184,207,213,218,221,228].< BR> Very high levels of mercury are found in brain memory areas such as the cerebral cortex and hippocampos of patients with diseases with memory related symptoms[158]. Studies have found mercury related mental effects to be indistinguishable from those of MS(207). Mercury at extremely low levels interfers with formation of tubulin producing neurofibrillary tangles in the brain simiar to those observed in Alzheimers patients with high levels of mercury in the brain(207). Also mercury binds with cell membranes enterferring with sodium and potassium enzyme functions, causing excess membrane permiability, especially in terms of the blood-brain barrier [159,207]. Less than 1ppm mercury in the blood stream can impair the blood-brain barrier. Mercury was also found to accumulate in the mitochodria and interfer with their vital functions, and to inhibit cytochrome C ensymes which affect energy supply to the brain. Persons with extra Apo-E4 gene copies are especially susceptible to this damage(207,221). In many cases (many thousand documented)removal of amalgam fillings and treatment for metal toxicity led to "cure' or significant improvement in health[97,100,102,148,170,207, 213,222,234,237]. There is some evidence that some forms of leukemia are abnormal response to antigenic stimulation by mercury or other such toxics and removal of amalgam has led to remission in some cases(47)[180]. 6. Mercury exposure through fillings appears to be a major factor in chronic fatigue syndrome(CFS) through its promotion of growth of candida albicans in the body and the methylation of inorganic mercury by candida to the extremely toxic methyl mercury form which crosses the blood brain barrier and also damages and weakens the immune system [225,226,234,235,237,etc.]. Methyl mercury has also been shown in animal studies to induce autoimmune reactions and disease through its affects on immune system T cells(226,etc.) VI. Scientists and Government Panels or Bodies That Have Found Amalgam Fillings to be Unsafe. 1. A World Health Organzation Scientific Panel concluded that there is no safe level of mercury exposure(183,208,238). The Chairman of the panel, Lars Friberg stated that "dental amalgam is not safe for everyone to use(208,238). 2. In 1987 the Federal Dept. of Health in Germany issued an advisory warning aginst use of dental amalgam in pregnant women(61). A Swedish National Mercury Amalgam Review Panel found that "from a toxicological point of view, mercury is too toxic to use as a filling material"[164]. The U.S. EPA found that removed amalgam fillings are hazardous and must be exposed of as hazardous waste(214). Most European countries require controls on dental waste amalgam emissions to sewers or air. A Canadian Government study for Health Canada concluded that any person with any number of amalgam fillings receives expsoure beyond that recommened by the USPHS Standard(209). Many of those researching amalgam related health effects including several very prominant scientists have concluded that the health effects are widespread and serious so that mercury should not be used as a filling material (1,18,19,26,36,38,61) [88,94,99,100,113,115,125,126,148,153,164,170,183,208, 209,210,222,227,236,237,238,239]. 3. The use of mercury amalgams has been banned for children and women of child-bearing age or put on a schedule for phase out by 4 European countries. The use of amalgam is declining in Europe and Germany's largest producer of amalgam has ceased production, The director of the U.S. Federal program overseeing dental safety advises against using mercury amalgam for new fillings. References to this document 
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