The World Health Organization Dental Amalgam Review

The World Health Organization recommends a global phase out of dental mercury.   In the WHO’s  newly released  2009 report on “Future Use of Materials For Dental Restorations”.  This is a great article by Charlie Brown from Consumers for Dental Choice.  You can find a full view of the WHO Dental Materials report here.

10/2011

In a clear sign that dentistry’s amalgam era is fading, the World Health Organization (“WHO”) just released its long-awaited report on dental amalgam. In Future Use of Materials for Dental Restoration, WHO urges “a switch in use of dental materials” away from amalgam.

“[F]or many reasons,” WHO explains, “restorative materials alternative to dental amalgam are desirable.” The report describes three of these reasons in detail:

  • WHO determines that amalgam releases a “significant amount of mercury”: WHO concludes that amalgam poses a serious environmental health problem because amalgam releases a “significant amount of mercury” into the environment, including the atmosphere, surface water, groundwater, and soil. WHO says “When released from dental amalgam use into the environment through these pathways, mercury is transported globally and deposited. Mercury releases may then enter the human food chain especially via fish consumption.”
  • WHO determines that amalgam raises “general health concerns”: While the report acknowledges that a few dental trade groups still believe amalgam is safe for all, the WHO report reaches a very different conclusion: “Amalgam has been associated with general health concerns.” The report observes, “According to the Norwegian Dental Biomaterials Adverse Reaction Unit, the majority of cases of side-effects of dental filling materials are linked with dental amalgam.”
  • WHO determines that “materials alternative to dental amalgam are available”: WHO concludes that “Materials alternative to dental amalgam are available” – and cites many studies indicating that they are superior to amalgam. For example, WHO says “recent data suggest that RBCs [resin-based composites] perform equally well” as amalgam. And compomers have a higher survival rate, says WHO, citing a study finding that 95% of compomers and 92% of amalgams survive after 4 years. Perhaps more important than the survival of the filling, WHO asserts that “Adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself.”

We have come a long way. Less than a year ago, dental trade groups were circulating an unedited and unreviewed draft of this report to government officials, implying that it was WHO’s final position. But the draft was riddled with factual errors and scientifically unsupported claims. Consumers for Dental Choice – working with non-governmental organizations, scientists, and environmentalists from around the globe – organized a letter-writing campaign to insist that the draft be immediately withdrawn, accurately rewritten, and properly reviewed.

And it worked! Now WHO has removed all claims of amalgam’s safety. Now WHO has committed itself to “work for reduction of mercury and the development of a healthy environment.” Now “WHO will facilitate the work for a switch in use of dental materials.”

Thank you to everybody who urged WHO to take this important step to protect future generations from dental mercury.

Dr. Scott Taylor Addresses FDA Director Dr. Shuren

On September 22, 2011 Dr. Scott Taylor addressed the FDA Director over Mercury use in Dentistry at a San Francisco FDA town hall meeting.  Dr. Taylor spoke directly on the need for FDA accountability to the established dangers associated with dental amalgam (mercury) fillings.

Here is a report issued from Charlie Brown of Consumers for Dental Choice covering the FDA town hall meeting.

FDA Director Shuren Confronted at Town Hall Meeting, Says Amalgam Announcement Coming Back

FDA agrees to amalgam announcement this year.

The U.S. Food and Drug Administration’s Director of the Center for Devices has agreed that FDA will issue an “announcement” on amalgam by the end of this year.
Dr. Jeff Shuren, who signed the appalling 2009 amalgam rule, agreed to this timeline as he presided at an FDA town hall meeting in San Francisco on September 22. It was the third FDA town hall meeting this year – and for the third time, our movement showed up in force to confront Dr. Shuren about the dangers of mercury fillings. The first town hall meeting was in Texas, the second in Florida, and now the third in California – these states represent a quarter of the U.S. population!

California grassroots director Anita Vazquez Tibau presented testimony on behalf of Consumers for Dental Choice. She highlighted amalgam’s devastating impact on the Latino community. “Many Spanish speakers told me that their dentists have never ever used the word ‘mercurio’ in a discussion,” Anita explained to Dr. Shuren. “Instead, it is deceptively called la amalgama plata – ‘silver fillings.’ I’d like to see you tell everyone that mercury is toxic, and please post it in Spanish as well.”

Then Anita reminded Dr. Shuren of his own famous boast: “We don’t use our people as guinea pigs in the U.S.” She held high a photograph of a Latino kindergartener whose mouth is filled – top and bottom – with mercury fillings. “FDA admits that amalgam can cause neurological harm in young children. Their developing neurological systems are ‘more sensitive to the neurotoxic effects of mercury vapor’ says FDA. And FDA admits there is no evidence that amalgam is safe in children under age six: ‘No clinical information is available’ says FDA.” So stop treating Latino children like guinea pigs, Anita concluded.

Dr. Shuren responded. “What I can tell you is we intend to come out with an announcement by the end of the year.”

The clock is running: FDA has 97 days left to act.

I congratulate all the Californian consumers and dentists who confronted Dr. Shuren at the San Francisco town hall meeting – and everyone who has spoken up for mercury-free dentistry in their community. It was the grassroots movement rising up all across America that put amalgam at the top of FDA’s “to do” list. Thank you.

So what will FDA do? Will FDA act as its own scientists recommended: (1) end amalgam use in children, pregnant women, and hypersensitive adults and (2) make sure that every parent knows amalgam is mercury, not silver? Or is FDA simply going to “announce” that it will do something at a later date?

As many of you have been doing since 2009, I urge that you write Director Shuren at jeff.shuren@fda.hhs.gov:

First, thank Dr. Shuren for agreeing to act on amalgam this year.

Second, ask Dr. Shuren to take real action this year – don’t just announce that FDA might act sometime in the future. As Anita explained, our children are being subjected to mercury fillings now – they cannot wait another year.

Third, tell Dr. Shuren to take the advice of the FDA scientists he convened in December 2010. Stop amalgam use in children, pregnant women, and hypersensitive adults immediately. And warn every consumer that amalgam is mercury – a neurotoxin.

Charlie
27 September 2011

Charles G. Brown
National Counsel, Consumers for Dental Choice
President, World Alliance for Mercury-Free Dentistry

Join Former US Attorney General in a Dental Mercury Call to Action

Finally, we have two strong public figures advocating for patients dental rights.  It is time for the U.S. to move away from using mercury in dental fillings.    There are many people in  America, primarily low income individuals and families and members of the military, who do not have a choice in their dental filling materials.  This article address this injustice and how we can try to influence our leaders the make Dentistry less toxic.  Thank you Dr. Mercola and Charlie Brown.  We have called and sent a letter.

By Dr. Mercola With Consumers for Dental Choice

 

That American dentistry became mired in mercury is a story of profits first, people last. Amalgam is a primitive, pre-Civil War, pollution product that is half mercury. The 50 percent of North American dentists still using amalgam likely do so for the quick and easy profits – while handing us the bill for the health effects and environmental disaster.

Now is the time for those dentists still using amalgam to switch, and join their brother and sister dentists who practice mercury-free dentistry. Now is the time for you to decide that henceforth you will not allow mercury in your mouth or your child’s mouth – no matter what a pro-mercury dentist might say. Now is the time for you to tell your neighbor, cousin, or best friend: Don’t get a mercury filling.

And what is a mercury filling?

It is what the mainstream press calls “silver fillings.”

Mercury Amalgams More Commonly Used in Minorities and the Poor…

Just like the one-size-fits-all strategy of medicating community water supplies with fluoride, the use of mercury amalgams disproportionally affects minorities and the poor, as they frequently are left without options—even when they know better and want a safer alternative.

As explained by Charlie Brown in the featured interview:

“People on these very limited dental insurance plans or on Medicaid often have no bargaining power with their dentists. They are being told by the dentists, “This is what I’m going to do.” The dentist may not even tell them what they’re going to do. They just put in fillings. Some dentists treat their patients and those teeth like dollar signs.

 

There’s a disproportionate impact on working [class] American families—whether in Appalachia, where I’m from, or in inner-cities. Working [class] families: white, African-American, Latino, and Native Americans are much more likely to get a mercury filling.

 

… It’s unscrupulous dentistry and it’s terribly unfair to these families… One group that is particularly badly treated are children with disabilities… [T]here was just an all-out battle in Philadelphia, because we succeeded in getting a fact sheet law, so the parents were reading the fact sheets, saying, “I don’t want amalgam.” The dentists serving children with disabilities were telling the parents, “You will get the filling I decide on”… Parents were forced to leave the office or accept a mercury filling! These dentists were backed up by the Pennsylvania Dental Association. That was condemnable.

 

… The ADA in fact issued an apology recently for its history of racism. That appears to continue with their attitude that those who are disabled have no rights to mercury-free dentistry. That’s one of the battles that we’re [facing]… to protect those who are less able to fend for themselves in this economic society.”

Consumers for Dental Choice Paves the Way for Mercury-Free Dentistry Worldwide

Leading the charge against mercury fillings is Consumers for Dental Choice, a nonprofit group founded by Charlie Brown that merits your support. With its worldwide Campaign for Mercury-Free Dentistry, we get closer – year-by-year, and day-by-day – to ending this abominable 150-year historical mistake. But to win, we need action in communities across the United States and around the world.

Here’s what you can do right in your community or your workplace:

If your dentist has not switched to mercury-free dentistry, this is the time for him or her to do so. Call your dentist and ask. If they use mercury and insist on sticking with it, re-consider your choice of dentists.

If you work for a company that covers dental fillings, ask if they will cover composites, ART, or other alternatives to amalgam. Consider the stellar example of the Cleveland-based Parker Hannifin company, which fully covers composite but does not pay for amalgam! Parker-Hannifin employees and their families are getting non-toxic dental fillings.

If you have dental insurance, ask about ending primacy for amalgam. That’s what United Concordia has done with its policies.

If you know your Mayor or a member of your City or Town Council, consider asking if they will do what is happening in some California cities: pass a resolution calling for an end to amalgam and a request that dentists in your town stop using amalgam.

What You Can Do to Help Abolish Mercury Amalgams

Charlie Brown, who runs Consumers for Dental Choice, is headed to Nairobi in October to lead a worldwide delegation participating in the world mercury treaty negotiations. With him will be a team of dentists, consumers, attorneys, and scientists fighting to get amalgam into that treaty. With the world deciding whether we continue allowing mercury in children’s mouths, much is at stake.

During this Mercury-Free Dentistry Awareness Week, I urge you to take action.

Here’s what you can do:

Americans: Our number one problem is the Food and Drug Administration (FDA), which has partnered with the American Dental Association (ADA) to cover up the mercury; to make you think you are getting silver instead of toxic mercury in your mouth. The FDA intentionally conceals the warnings about amalgam deep in its regulation — so parents will never see them. On its website, the FDA gives dentists the green light to continue to deceive consumers with the term “silver fillings”

“Americans are ready for the end of amalgam.” This was the theme of the testimony to the U.S. Department of State on August 18 by former West Virginia state Senator Charlotte Pritt. Yes, Americans are ready. But FDA is not. So let’s send them a message.Nine months ago, FDA scientists advised the agency to disclose the mercury to all patients and parents, and to stop amalgam for children and pregnant women. Yet FDA sits – sits actually in the pocket of the American Dental Association – ignoring its own scientists.

Please write the Director of FDA’s Center for Devices, Jeff Shuren, jeff.shuren@fda.hhs.gov Ask Dr Shuren why the FDA continues to ignore scientists and covers up the mercury from American parents and consumers. Ask when the FDA is going to get in step with the world on mercury.

Dr. Jeff Shuren, Director
Center for Devices, U.S. Food & Drug Admin.
10903 New Hampshire Ave.
WO66-5431, Room 5442
Silver Spring, MD 20993-0002
Telephone:  301-796-5900
Fax:  301-847-8149
Fax:  301-847-8109

 

Dr. Mercola Announces Mercury-Free Dentistry Week

Hoffman Estates, IL (PRWEB) September 04, 2011

During the week of September 4th-10th, Dr. Joseph Mercola and the nonprofit group Consumers for Dental Choice / ToxicTeeth.org are launching their first-ever “Mercury-Free Dentistry Week,” with in-depth newsletters and interactive articles on various mercury (amalgam) topics.

Together, the team will launch an intensive and informative program to help consumers understand the health and environmental dangers of mercury dental fillings.

“Dental amalgams are a major source of dental toxicity, and the environmental dangers of mercury fillings from dental offices, human waste and cremation is alarming, “ said Dr. Mercola, founder of Mercola.com, one of the most popular alternative health websites in the world. “I’m very excited that as part of this educational week we will be able to encourage more effective government oversight on amalgam.”

Consumers for Dental Choice was established in 1996 by consumer advocates, mercury poisoning victims, scientists and mercury-free dentists. It is a 501(c)(3) nonprofit that works to counter studies by non-independent or unqualified researchers that urge continuation of amalgam in dentistry. Dr. Mercola has been a mercury-free dentistry advocate for many years, and has written many articles about its potential health threats.

“Amalgam is 50 percent mercury, and its time that more people understood that there are non-toxic alternatives to having this put in your mouth when you visit the dentist,” Dr. Mercola said. “Last year I ran an article calling for volunteers to get involved in a grassroots campaign to convince the FDA to reassess the safety of mercury fillings, and the response was wonderful. Now, we hope to build on that momentum to work toward banning amalgam altogether – a goal that I believe we can reach with this education program.”

About Dr. Mercola and Mercola.com:

Dr. Joseph Mercola’s mission is to bring people practical solutions to their health problems. A New York Times best-selling author, Dr. Mercola was voted the 2009 Ultimate Wellness Game Changer by the Huffington Post. He has been featured in major publications such as Time magazine and the LA Times, and on CNN, Fox News, ABC News, the Today Show and CBS’ Washington Unplugged.

He is board certified in family medicine, and served as chairman of the Family Medicine Department at St. Alexius Medical Center for five years. He is trained in both traditional and natural medicine. Over 2 million people, including 40,000 health care professionals, currently receive the website’s free email health newsletter, which offers practical health and wellness information covering nutrition, medicine, lifestyle choices, emotional therapy and other health topics.

Dental Mercury Waste in Our Water, Land and Air

How Does Amalgam Waste Affect The Environment?

If improperly managed by dental offices, dental amalgam waste can be released into the environment.  Dentists should use dental amalgam separators to catch and hold the excess amalgam waste coming from office spittoons. Without dental amalgam separators, the excess amalgam waste will be released to the sewers via drains in the dental offices.  While Publicly-Owned Treatment Works (POTWs) have around a 90% efficiency rate of removing amalgam from wastewaters, a small amount of waste amalgam is discharged from POTWs into surface waters around the plants.

At the treatment plant, the amalgam waste settles out as a component of sewage sludge that is then disposed:

  • in landfills
  • through incineration
  • applied to agricultural land as fertilizer

If the amalgam waste is sent to a landfill, the mercury may be released into the groundwater or air. If the mercury is incinerated, mercury may be emitted to the air from the incinerator stacks. And finally, if mercury-contaminated sludge is used as an agricultural fertilizer, some of the mercury used as fertilizer may also evaporate to the atmosphere. Through precipitation, this airborne mercury eventually gets deposited onto water bodies, land and vegetation. Some dentists throw their excess amalgam into special medical waste (“red bag”) containers, believing this to be an environmentally safe disposal practice. If waste amalgam solids are improperly disposed in medical red bags, however, the amalgam waste may be incinerated and mercury may be emitted to the air from the incinerator stacks.  This airborne mercury is eventually deposited into water bodies and onto land.

You can read this article in it’s complete form on the governments Environmental Protection Agency’s website:  http://www.epa.gov/hg/dentalamalgam.html#contamination

 

Mercury Fillings Are Alive and Strong Among Young Dentists

US Dentists’ Amalgam Use Surprises Researchers

June 17, 2011 — Despite improvements in resin-based composite technology, US dentists are placing more amalgam restorations than composites, and amalgam is still emphasized by US dental schools, according to the results of 2 studies published in the June issue of the Journal of the American Dental Association.

“I thought that most people were using composite,” researcher Sonia K. Makhija, DDS, MPH, an assistant professor of dentistry at the University of Alabama at Birmingham, told Medscape Medical News. “It was surprising that so many people are using amalgam.”

Dr. Makhija and colleagues in the Dental Practice-Based Research Network, a collaboration of practicing dentists who participate in research, analyzed reports from 182 US dentists on 5599 restorations of carious lesions in posterior teeth.

Overall, the dentists used amalgam for 3028 of these restorations, and composite in 2571 others. (The researchers collected no data on the 930 restorations these dentists made out of gold, glass ionomer, or anything else other than composite and amalgam.)

Although the dentists were not a statistical sample, previous studies have suggested that they are generally representative of what dentists are doing in the United States, Dr. Makhija said.

In the second study, researchers from universities in England, Wales, and Ireland and from the Georgia Health Sciences University in Augusta, surveyed 67 dental schools in the United States and Canada about how they teach students to restore posterior teeth.

At the 49 schools that responded, almost half the restorations placed in 2009 and 2010 were resin-based composites. Although this was a 30% increase from a similar survey done 5 years earlier, the study authors wrote that US and Canadian schools “lag” schools in Britain and Ireland, where composite gets more attention.

Not only is composite prettier, it is less invasive because it does not require as much cavity preparation, and in recent studies it has proved at least as durable, the authors write. “These tooth-friendly features of resin-based composites make them preferable to amalgam, which has provided an invaluable service but which, we believe, now should be considered outdated for use in operative dentistry.”

They called for new national guidelines that would emphasize the superiority of composite.

However, Dr. Makhija said such guidelines are premature. “I think we don’t have enough data yet,” she said. “You can find longevity studies on both that are good.” The Dental Practice-Based Network is following up on the 5599 restorations participants placed to see how they fare in coming years.

 

Glass Ionomer: Pros vs Cons

Offering another perspective, Douglas A. Young, DDS, EdD, MBA, associate professor of dental practice at the University of the Pacific, San Francisco, California, told Medscape Medical News that composite itself is becoming outmoded by glass ionomer. “The selection of the restorative material should be based on its ability to fight disease,” he said.

Glass ionomer binds better to teeth because of the ionic substitution that takes place between the fluoride in the glass ionomer and the calcium phosphate in the tooth, he said. In his experience, it is just as durable as composite resin, and the fluoride that it releases helps teeth remineralize, he said. “I like to use it on dentin and cementum, especially in sealants and small restorations.”

Dr. Young also argued in favor of using glass ionomer in combination with composite in the “open sandwich” technique, which he said helps lesions remineralize underneath restorations. The authors of the study on dental schools specifically rejected this approach, arguing that dentin regenerates better with phosphoric acid rinse.

So what are dental schools teaching? In the survey, 44 of the 49 schools said they taught the total etch technique for cavities in the outer third of the dentin, whereas the other 5 taught the glass ionomer cement approach only.

For cavities in the middle third of the dentin, 24 schools taught the total etch approach, and 24 the glass ionomer approach, whereas 1 taught calcium hydroxide and glass ionomer. For those restorations in the inner third of the dentin, 6 schools taught total etch and 30 glass ionomer, with 24 schools teaching calcium hydroxide and glass ionomer.

However, dental schools teachings are only one factor in what dentists practice, Dr. Makhija found. Surprisingly, older dentists were more likely to place composite restorations, even though they were more likely to have attended dental school when this approach was less emphasized (P = .02)

Dentists who graduated in the past 5 years placed amalgam on 61% of the lesions they treated. One explanation may be that younger dentists are more likely to be in large group practices where they work on salary, rather than fee-for-service, said Dr. Makhija. The type of material might be dictated by managers of the group practice. In large group practices (4 dentists or more), 79% of the restorations were amalgam (P < .001). “It’s quicker, it’s easier and it’s cheaper to use amalgam,” Dr. Makhija said.

Dr. Makhija, Dr. Young, and the authors of the dental school survey have disclosed no relevant financial relationships.

J Am Dent Assoc. 2011;142;612-620. Abstract

J Am Dent Assoc. 2011;142;622-632. Full text

Medscape Medical News © 2011 WebMD, LLC

 

Global Mercury Treaty May Include Ban on Mercury in Medicine

SILVER SPRING, Md., August 1, 2011 /PRNewswire-USNewswire/ – CoMeD –

On Friday, July 22, 2011, the United Nations Environment Programme (UNEP) distributed a revised text for its comprehensive global treaty on mercury. Advocates for mercury-free drugs were gratified to see pharmaceuticals listed in “Annex C (Mercury-added product not allowed)” of the proposed treaty.

 

The Coalition for Mercury-free Drugs (CoMeD) helped initiate this addition through its advocacy efforts at the United Nations (UN) negotiations held in Chiba, Japan in January 2011. CoMeD President Rev. Lisa Sykes, the mother of a son diagnosed with vaccine-related mercury poisoning, described to representatives of over 150 participating nations how: “… unnecessarily injecting mercury into pregnant women and children, as part of a vaccine or other drug, is an ongoing and often unrecognized crisis.”

 

Thimerosal (49.6% mercury by weight), still used as a vaccine preservative and in-process sterilizing agent, is an unnecessary, and sometimes undisclosed, component in many vaccines. Its use is associated with neurodevelopmental disorders, cancer, birth defects and miscarriage. Those harmed most by Thimerosal in vaccines are the unborn and newborn.

 

Addressing the diplomats attending the UN meeting in Chiba, Dr. Mark R. Geier of CoMeD observed: “For this treaty to be fully effective, it must make clear that the intentional exposure of humans, especially pregnant women and young children, to mercury, will not be tolerated.”

 

Dr. Geier’s comments were especially well-received by the diplomats from developing nations. CoMeD representatives met with regional working groups in closed-door sessions and explained the feasibility of using 2-phenoxyethanol, a much less toxic alternative to Thimerosal, in vaccines and other drugs.

 

Dr. Geier challenged the inequity of providing wealthy nations with vaccines having reduced levels of mercury while poor nations still receive vaccines containing dangerously high levels of mercury: “Children around the world, no matter their place of birth or their income level, deserve safe mercury-free vaccines. The practice of providing mercury-reduced and mercury-free vaccines to developed countries while insisting that developing nations take mercury-containing ones is wrong.”

By the end of negotiations in Chiba, diplomats from developing countries requested the Secretariat to assess the safety of mercury in drugs.

 

A team of scientists and advocates from CoMeD will attend the next treaty negotiation in Nairobi, Kenya from October 31 through November 4, 2011, to support keeping this global ban on mercury-containing drugs in the finalized UN treaty.

Press Release from CoMeD (the Coalition for mercury free drugs)

 

The U.S. Calls for the Phase-Out of Amalgam Ultimately

The U.S. Calls for the Phase-Out  of  Amalgam Ultimately.

In an extraordinary developments that will change the global debate about amalgam, the United States government has announced that it supports a “phase down, with the goal for eventual phase out by all Parties, of mercury amalgam.” This statement- a radical reversal of its former position that “any change toward the use of dental amalga is likely to result in poitive public health outcomes” — is part of the U.S. government’s submission for the upcoming third round of negotiations for the world mercury treaty.*

While couched in diplomatic hedging — remember it is still early in the negotiations — this new U.S. position makes three significant breakthroughs for the mercury-free dentistry movement:

The U.S. calls for the phase-out of amalgam ultimately and recommends actions to “phase down” its use immediately.  Incredibly, the government adopted three actions that the World Alliance for Mercury-Free Dentistry and Consumers for Dental Choice proposed at the negotiating session in Chiba, Japan.  Our key ally, The Mercury Policy Project, laid the groundwork for this success at a World Health Organization meeting in 2009!

The U.S. speaks up for protecting children and fetuses from amalgam, recommending that the nations “educate patients and parents in order to protect children and fetuses.”

The U.S. stands up for the human fight of every patient and parent to make educated decisions about amalgam.

What does this mean?  Our position — advocating the phase-out of amalgam — is now the mainstream because the U.S. government supports it.  Who is the outlier now?  It’s the pro-mercury faction, represented by the World Dental Federation and the American Dental Association.  With the U.S. continuing its leadership role in this treaty, we will broadcast the U.S. position to other governments around the world, encouraging them to support amalgam “phase downs” leading to phase-outs not only globally, but within each of their countries.

 

We applaud the U.S. government.  But tough work lies ahead.  For example, we must demonstrate to the world that the available alternatives — such as composites and the adhesive materials used in  atraumatic restorative treatment (“ART”) — can cost less than amalgam and will increase access to dental care particularly in developing countries.

 

For now though, let’s mark this watershed in the mercury-free dentistry movement: the debate has shifted from “whether to end amalgam” to “how to end amalgam.”

 

5 April 2011

Charles G. Brown

National Counsel, Consumers for Dental Choice

President, World Alliance for Mercury-Free Dentistry