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The following excellent article is Copyright, Bernard Windham. For more info please visit: http://www.home.earthlink.net/~berniew1/

Mercury Exposure

Article

Dental Mercury Toxicity and Health effects Bibliography

by Bernard Windham

 
I. Toxicity and Health Effects of Mercury 904-878-9024
II. Systemic Mercury Intake Levels from Amalgam Filling Exposure
III. Medical Studies Finding Health Problems Related to Amalgam Fillings
IV. Health Effects from Dental Staff Exposure to Mercury
V. Documented Results of Removal of Amalgam Fillings
VI. Scientific Panel and Government Bodies That Have Found Amalgam Fillings Unsafe

I. Toxicity and Health Effects of Mercury

1. Dental amalgam contains about 50 % mercury. The average filling has 1 gram mercury and leaks mercury vapor continuously, resulting in significant xposure(see Section II). Mercury vapor is transmitted rapidly thoughout he body and like methyl mercury has significant toxic effects at much Ilower levels than other inorganic mercury forms(38,265,281,287). According to he U.S. EPA & ATSDR, mercury is among the top 3 toxic substances adversely ffecting large numbers of people(217), and amalgam is the number one source f exposure for most people.

2. Mercury is the most toxic of the toxic metals. Mercury (vapor) is:

(a) cytotoxic(kills cells) (2,27,33, 106,147,148,150,160,210,301)

(b) neurotoxic(accumulates in the brain, damages brain cells and nerve cells, and inhibits production of neurotransmitters by inhibiting dihydroteridine reductase and effect on phenylalanine, tyrosine and tryptophan transport to neurons) (27,34,69,70,85,111,147,148,160,162,181,207,255,257,258,262,288,290) immunotoxic(damages and weakens the immune system) (27,34,35,38,42,43,44, 45,46,60, 77,78,105,117,127,128,146,155,160,199,226,270,301) and induces ANA anitbodies and autoimmune disease(38,45,91,234,269,270).

(c) nephrotoxic(toxic to kidneys) (14,59,111,157,203,211,223,260,268)

(d) endocrine system-disrupting chemical(affects pituitary gland and disrupts enzyme production processes and hormonal function at very low levels) (85,105,107,113,140,141,146,149,199,210)

(e) penetrates the blood-brain barrier rapidly resulting in damage to brain and impairment of blood-brain barrier reletive to other toxic chemicials (& reduced amino acid uptake to brain) (38,85,113,146,162,262)

(f) exposure to mercury vapor or methyl mercury causes rapid transmital through the placenta to the fetus, and much more exposure and damage to fetus than for maternal exposure to inorganic mercury(265,281,287,38,61).

(g) reproductive and developmental toxin; damages DNA and inhibits DNA & RNA synthesis;damages spermatozoa, lowers sperm counts and reduces motility; causes menstrual disturbances; reduces bloods ability to transport oxygen to fetus and transport of essential nutrients including magnesium, zinc and Vit B12; depresses eenzyme isocitric dehydrogenase(ICD) in fetus, causes reduced iodine uptake & hypothyroidism & learning deficits, causes learning disabilities and impairment, and reduction in IQ (2,3,4,20,22,23,24,31,37,38,39, 41,49,61,105,146,149,160,199,255,259,263, 264,271,272,274,275,276,279,281,305) .

(h)prenatal/early postnatal exposure affects level of nerve growth factor in the brain and causes imbalances in development of brain(38,61,175,255,305)

(i) causes cardiovascular damage and disease including damage to vascular endothelial cells, damage to sarcoplasmic reticulu, sarcolemma, and contractile proteins, increased white cell count, decreased oxyhemoglobin level,and increased risk of acute myocardial infarction (35,201,202,205,232,306) .

(j) causes immune system damage resulting in allergies, asthma, and multiple sensitivities (228,230,199a) and neurtophil functional impairment

(k) causes interruption of the cytochrome oxidase system/ATP energy function and progressive coproporphyrinuria, resulting in low energy, digestive problems, and porphyrins in urine (34,210,232,260)

(l)inhibits nitric oxide synthase in brain and other locations{259).

(m) mercury causes significant destruction of stomach epithelial cells, resulting in damage to stomach lining(leaky gut) and accumulation of heliobacter pylori, a suspected major factor in stomach ulcers and stomach cancer(256) .

3. Mercury (especially mercury vapor) rapidly crosses the blood brain barrier nd is selectively stored in the pituitary gland of the brain. (34,38,85,113,146,162,262,265,281) The pituitary gland controls the body's :endocrine system and secretes hormones that control most bodily processes, lincluding the immune system and reproductive systems(146).

4. Mercury's biochemical damage at the cellular level include DNA damage, linhibition of DNA and RNA synthesis, alteration of protein structure, ~lteration of the transport of calcium, induction of free radical formation, linhibition of glutathione peroxidase enzyme, endothelial cell damage, and limmune system damage{4,34,38,301,etc.) Only a few micrograms of mercury Iseverely disturb cellular function and inhibit nerve growth(181,61). Much ercury in saliva and the brain is also organic, the most toxic form{220).

5. Hormonal secretions of the pituitary gland that control bodily processes re at extremely low levels and extremely low levels of mercury are required 0 adversely affect hormonal secretions of the pituitary gland. Hormonal Isecretions affected at levels much lower than acute toxicity effects normally ested for(105,146,199).

6. Because of the extreme toxicity of mercury, only « gram is required to icontaminate a 10 acre lake to the extent that a health warning would be issued y the government to not eat the fish(151,160). Over half the rivers and Ilakes in Florida have such health warnings(160).

7. Some Florida panthers that eat birds and animals that eat fish containing ery low levels of mercury{about 1 part per million) have died from chronic .ercury poisoning(160). Since mercury is an estrogenic chemical and Ireproductive 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 nimals at the top of the food chain like alligators. The level of mercury in eople with amalgam fillings causes a body burden of mercury much higher than Ithey could get from eating contaminated fish from Florida waters with overnment health warnings. (WHO,183 & Health Canada, 217)

8. In addition to having estrogenic effects, mercury has other documented ormonal effects including effects on the reproductive system resulting in lowered sperm counts, defective sperm cells, and lowered testosterone levels in malesj menstrual disturbances and infertility in womenj and increased eurological problems related to lowered levels of neurotransmitters dopamine, serotonin, and noreprenephrine (4,38,105,107,140,141,275,276,288,290).

9. An average amalgam filling contains over « gram of mercury, and the average ladult had at least 5 grams of mercury in fillings {unless most has vaporized). IMercury in solid form is not stable and vaporizes continuously, so that within 110 years up to half has been found to have been transferred to the and body of the host (34, 35, 182).

10. Most persons with amalgam fillings receive an average daily exposure of ercury exceeding EPA and other government agency exposure guideline and above the level documented by govern studies to cause serious health damage (261,183,209,2,217). Elemental mercury vapor is more rapidly transmitted Ithroughout the body than most other forms of mercury and has more toxic leffects on the CNS and other parts of the body according to the World Health :Organization and other studies(38,183,265,282,287). Mercury vapor rapidly Icrosses the blood-brain barrier, and placenta of pregnant women (38,85,113, 1146,162,231,262,265,281,287,304,etc) Developmental learning and behavioral leffects have been found from mercury vapor at much lower levels than for iexposure to methyl mercury (287) .

11. Running shoes with « gram of mercury in the heels were banned by several states, because the amount of mercury was considered dangerous to public ealth and created a serious disposal problem. Mercury from dental offices land human waste from people with amalgam fillings has much higher levels and lis a major source of mercury in Florida waters. One study found dental offices ischarge into waste ater between 65 and 842 milligrams per dentist per day(231), amounting to several hundred grams per year per ffice. This is in addition to air emissions.

II. Systemic Mercury Intake Level from Amalgam Fillings

1. Mercury in solid form is not stable and evaporates continuously from malgam fillings in the mouth, being transferred over a period of time to the ost(18,83,211,182,183,217,298,299,303,etc.). The daily exposure of mercury If rom fillings is from 3 to 70 micrograms per day, with the average being above 110 micrograms per day(183,199,209,18,83,77, etc. below) This level of daily lexposure for most who have fillings exceeds the U.S. EPA mercury exposure .ealth guideline and that of other agencies(2,261,209,217,183).

As much as 50% of mercury in fillings has been found to have vaporized lafter 5 years and 80% by 20 years(182,204). Mercury vapor from amalgam is Ithe single largest source of systemic mercury intake for persons with amalgam Ifillings, ranging from 50 to 90 % of total exposure. (16,17,19,57,78-82,94, 1111,126,129,130,138,161,183,191,211,216,303). Amalgam also releases Isignificant amounts of tin and copper which also have toxic effects, with iorganic tin compounds formed in the body being even more neurotoxic than lercury (185,222) Studies have consistently found modern high copper non gamma-two amalgams .ave greater release of mercury vapor than conventional silver amalgams (298,299). While the non gamma-two amalgams were developed to be less icorrosive and less prone to marginal fractures than conventional silver lamalgamS, they have been found to be instable in a different mechinism when subjected to wear/polishing/chewing/brushing: they form droplets of mercury on It he surface of the amalgams(182,297). This has been found to be a factor in Ithe much higher release of mercury vapor by the modern non gamma-two amalgams. .ecent studies have concluded that because the the high mercury release levels lof modern amalgams, mercury poisoning from amalgam fillings is widespread Ithroughout the population" (199). Numerous other studies also support this If inding .

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) (77,79,83,84,94,133,209,211,216,222) Elemental mercury vapor is transmitted throughout the body via the blood and readily enters cells and crosses the blood-brain barrier and placenta of pregnant women (38,262,265,287), at much higher levels than inorganic mercury compounds.

3. On average for a person having amalgam fillings, vapor from amalgam amounts to about BO% of total systemic intake(7B-B3,93,94,179,lB3,191,211,216,303).

4. Having dissimilar metals in the teeth(e.g.-gold and mercury) causes galvanic action, electrical currents, and much higher mercury vapor levels and levels in tissues. (19,27,30,48) Average mercury levels in gum tissue near amalgam fillings are about 200 ppm, but are often 1200 ppm near a gold cap on an amalgam filling(30,25,35,48,58,186,194). These levels are among the highest levels ever measured in tissues of living organisms, exceeding the highest levels found in chronically exposed chloralkali workers, those who died in Minamata, or animals that died from mercury poisoning. Concentrations 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 amalgams(191). High levels of mercury vaporize and are picked up by the body and bloodstream during dental work(high-speed grinding) on amalgam f~llings, which results in much higher levels in the heart, brain, liver, and kidneys(183,219,205,262,273,274,34,38,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(l ppm) and can be as much as 50 times the EPA Critical Level. (134,154,160,2) The U.S. Agency for toxic Substances and Disease Registry (ATSDR) standard (MRL) for acute inhalation exposure to mercury vapor is 0.02 micrograms Hg/m3 and the MrL for chronic inhalation exposure is 0.014 ug/m3(217). This translates to approx. .004 ug/kg of body weight or 0.3 ug/day for an average adult. The corresponding tolerable daily exposure developed in a report for Health Canada is .014 ug/kg body weight or 1 ug/day for average adult. The U.S. EPA health standard for elemental mercury exposure (vapor) is 0.3 micrograms per cubic meter of air. For the average adult breathing 20 M3 of air per day, this amounts to an exposure of 6 ug/day(2). The EPA health standard for methyl mercury is 0.1 ug/kg body weight per day or 7 ug for the average adult(2). since mercury is methylized in the body, some of both types are present in the body. Common levels found in persons with amalgam fillings are as much as 100 times these MRLs and for many above the EPA health guideline(217,209,183,199,2). Thus persons with amalgam fillings have levels of intraoral mercury vapor and body exposure levels higher than the level considered to have significant health risk.

6. There is only a weak correlation between blood or urine mercury levels and body burden or level in a target organ(157,183,278). 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. (35,79,BO,183,278) The median level of mercury in feces of those with fillings is approx. 10 times that of a similar group without fillings(79). As damage occurs to kidneys over time, mercury is less efficiently eliminated(157,260). Hair has been found to offer a better indicator of mercury body burden than blood or urine(279),though still not totally reliable. A new test approved by the FDA for diagnosing damage that has been caused by toxic metals like mercury is the fractionated porphyrin test(260), that measures amount of damage as well as likely source. Provocation challange tests after use of chemical chelators such as DMPS or DMSA also are effective at measuring body burden(57), but can be dangerous to some people- especially those still having amalgam fillings or those allergic Ito sulfur drugs or sulfites. Another chelaltor used for clogged arterites, IEDTA, forms toxic compounds with mercury and can damage brain function(307). IUse of EDTA may need to be restricted in those with high Hg levels.

7. Mercury accumulates in the brain, liver, kidneys, heart,and oral Imucosa(l,20,31,34, 77,79,84,85,94 ,111,149,205,211,219,260,262,273,274)

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, 76,77,138,303) oral mucosa and saliva (18,77,79,199,211,222,292) (d) feces mercury (79,94,117) (e) pituitary gland (14,16,19,25, 85,99,113,273,274) (f) brain occipital cortex (14,16,19,25,34, 85,111,149,211,273,274) (G) fetal and infant liver/brain levels (61,231) related to maternal fillings.

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 10 licrograms(up) per day. (18,77,83,85,179,183,199,211). In a large German study, the median daily exposure for those with fillings through saliva was approx. 10 ug/day, 4% of those with fillings had daily expousre through aaliva of over 80 ug/day, and 1% had over 160 ug/day(199) . The methods and results of the ubingen study(199) were similar to those of other German studies(292). Total intake is proportional to the number and extent of amalgam surfaces, but other factors such as chewing gum and drinking hot liquids significantly influence the intake. (18,28,31,56) (135-139,183,193,199,209,211,292). Vapor emissions range up to 200 up/M3 (35, 193) and are much higher after chewing. After chewing, those with amalgams had levels over 50 times higher than those ithout, and the average level of expsoure was 29 ug/day for those with at Ileast 12 occlusal surfaces(18). At least 30% of those having amalgam fillings Itested in a large German study had ingested mercury levels exceeding the WHO IPTWI mercury standard of 43 ug/day (199,183), and over 50% of those with 6 or lore fillings had dily exposures more than the U.S. EPA health guideline level (199) of 0.1 ug/kg body weight/day(199). The median daily exposure through saliva for those with 10 or more fillings was over 10 times that of those with no fillings. Mercury level in saliva has been found to give much etter indication of body levels than blood or urine levels. Most people with fillings have daily exposure levels exceeding the U.S. EPA health guideline levels(2,183,199,209,261,292)

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, 1303) The average blood level for one large population was 24.8 nmol/I(176). ormal blood levels are less than 20 ppb, but health effects have been lobserved in patients in the upper part of this range(196). A Swedish study lestimated the total amount mercury swallowed per day from intra-oral vapor was 110 micrograms per day (177) ,and a large German study(199) found median exposure Ithrough saliva alone for those with fillings to be about 10 ug/day, with many Ihaveing several fillings with over 10 times that level. Other studies have Ifound similar amounts(18,83,211,183,209).

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.) German studies of mercury loss from vapor in unstimulated saliva found the saliva of those with amalgam had least 5 times as much mercury as for controls(179,199).

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. (l,13,19,20,25,34,38,55a) (85,99,111,113,149,273,274) Thus mercury has a greater effect on the functions of these areas.

13. Some mercury entering nasal passages is absorbed directly into the olfactory lobe and brain without coming from blood. (34,35,55a).

14. Mercury is transported along the axons of nerve fibres (5,33,34,35,50).

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 over 20 years in the brain, and chronic low level intake results in a slow accumulation in body tissues. (20,26,34,35,38) (etc.)

17. Methyl mercury is more toxic to some body processes than elemental Imercury. Mercury from amalgam is methylated by bacteria and candida albicans lin the mouth and intestines(51,53,54, 81.185,225,254). Methyl mercury is 1000 Itimes more potent in causing genetic damage than any other known chemical (Ramel, in(35».

18. The level of mercury in the tissue of the fetus, new born, and young Ichildren is directly proportional to the number of amalgam surfaces in the Imother's mouth. (20,23,40,61,112,113,114,210) The level of mercury in lumbilical cord blood and placenta was higher than that in mother's blood(61(b)) .

19. Mercury from amalgam in pregnant women crosses the placenta and appears in lamniotic fluid and fetal blood, liver, and pituitary gland within 2 days of Iplacement(18,20,23,31,l13,126,162,281). Dental amalgams are the main source of Imercury in breast milk(112,231,304). Mercury is often stored in breast milk land the fetus at much higher levels than that in the mother's tissues (18,19,20,22,23,40,41,61,112,114,210,231,287,304). The highest level is in the pituitary gland of the fetus which affects development of the endocrine, immune, and reproductive systems. The fetal mercury content after maternal inhalation of mercury vapor was found to be approx. 40 times that for maternal expsoure to an equivalent dose of inorganic mercury(265,281,287), and developmental behavioral effects from vapor have been found at levels considerably below that required for similar effects by methyl mercury(287).

20. There is a significant correlation between the number of amalgam fillings of the mother and the level of the fetus and older infants(20,23,112,l13,l14, 231,304), and also with the level in mothers milk(18,19,20,38,40,61,112,l13, 304). Fertile women should not be exposed to vapor levels above 10 mcg/M3 (38,61,195,282) or have amalgams placed or removed during pregnancy(231,304).

III. Medical Studies Finding Health Problems Related to Amalgam Fillings

1. Many thousands of people with systems of mercury toxicity have been found in tests to have high levels of mercury, and many thousands who have had amalgam fillings removed(most) have had health problems and symptoms alleviated or greatly improved(see Section 4). From clinical experience some of the symptoms of mercury sensitivity/mercury poisoning include chronic fatigue, dizziness, frequent urination, insomnia, headaches, chronic skin problems, metallic taste, gastrointestinal problems, asthma, stuffy nose, drycrusts in nose, rhinitis, plugged ears and ringing ears, chest pain, hyperventilation, diabetes, spacy feeling, chilly, chronic skin problems, immune and autoimmune diseases, and neurological problems (34,35,38, 45,47, 69,70,71,91,109, 126,148,165,204,212, 199,252,255,268-270, 290,294). Neurological problems are among the most common and serious and include memory loss, moodiness, depression, anger and sudden bursts of anger/rage, self-effacement, suicidal thoughts, lack of strength/force to resolve doubts or resist obsessions or compulsions, etc. Mercury causes decreased lithium levels, which is a factor in neurological diseases such as depression and Alzheimer's. Lithium protects brain cells against excess glutamate and calcium, and low levels cause abnormal brain cell balance and neurological disturbances (280,294, etc.). Medical texts on neurology (97,258,295,296) point out that chronic mercurialism is often misdiagnosed as dementia or neurosis or functional psychosis. "Early manifestations are likely to be subtle and diagnosis difficult: Insomnia, nervousness, mild tremor, impaired judgment and coordination, decreased mental efficeincy, emothional lability, headache, fatigue, loss of secual drive, depression, etc. are often mistakenly ascribed to ssychogenic causes".

2. Toxic/allergic reactions often result in lichen planus lesions in oral mucosa or gums and playa 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)

3. Numerous studies have found long term chronic low doses of mercury cause neurological, memory, behavior, sleep, and mood problems(34,69,70, 71,74,107, 108,109,115, 119,140,141, 196,199,222,252, 255,257,258, 282,290). Neurological effects have been documented at very low levels of exposure(urine Hg< 4 ug/L), levels commonly received by those with amalgm fillings(290). One of the studies at a German University(199) assessed 20,000 people. There is also evidence that fetal or infant exposure causes delayed neurotoxicity evidenced in serious effect at middle age(255). Organic tin compounds formed from amalgam are even more neurotoxic than mercury(222). Studies of groups of patients with amalgam fillings found significantly more neurological, memory, mood, and behavioral problems than the control groups. (34) (107,108,109,140,141,196,199,222,290)

4. Mercury binds to hemoglobin in the red blood cells thus reducing oxygen carrying capacity(1,16,17,21,26,35), and at 1 ppm can destroy the membrane of redblood cells(35,22,17) and damage blood vessels- reducing blood supply to the tissues(34). Mercury also interupts the cytochrome oxidase system, blocking the ATP energy function(35,232). These effects often result in fatigue and reduced energy levels (35,115,119,140,141,182,202,212,232,235). Mercury also accumulates in the heart and damages myocardial and heart valves (Turpayev,in (35»&(201,205,306). The interruption of the ATP energy chemistry results in high levels of porphyrins in the urine(260). Mercury, lead, and other toxics have different patterns of high levels for the 5 types of porphyrins, with pattern indicating likely source and the level extent of damage. The average for those with amalgams is over 3 time that of those without, and is over 20 times normal for some severely poisoned people(232,260). The FDA has approved a test measuring porphyrins as a test for mercury poisoning. However some other dental problems such as nickel crowns and root canals also can cause high porphyrins.

5. Mercury amalgam exposure adversely affects the immune system(27,34,38,77, 78,91,118,199,226,270,301). One of several effects is to increase the average lood white cell count by 2000 to 10000 (35). The increased white count sually normalizes after amalgam removal. Mercury also blocks the immune function of magnesium and zinc (197,38).

6. Mercury from amalgam interferes with production of cytokines, disabling learly control of viruses and leading to enhanceq infection(131,251).

7. A group of patients with amalgam fillings and complaints of systematic symptoms including central nervous system problems and a group of controls 'ere given MRI tests. 81% of the group with health complaints had athological MRI results including signs of degeneration of the basal ganglia :of the brain, but none in the controls. 60% of the symptom group tested ositive for immune system reaction to mercury. The authors concluded that limmune reactions have an important role in development of brain lesions ,and lamalgam fillings induce immune reactions in many patients (91,118) (270,286).

8. Among a group of patients testing positive as allergic to mercury, low Ilevel mercury exposure was found to cause adverse immune system response, lincluding reduction of in vitro production of tumor necrosis factor TNF alfa land interleukin-1. (152)

9. Patch tests for hypersensitivity to mercury have found from 2% to 44% to test positive(87,154,156,178,266,267), much higher for groups with more amalgam fillings and length of exposure than those with less. In studies of ledical and dental students, those testing positive had significantly higher average number of amalgam fillings than those not testing positive(and higher levels of mercury in urine(132,156). Of the dental students with 10 or more fillings at least 5 years old, 44% tested allergic. Based on these studies and statistics for the number with 10'or more fillings, the percent of mericans allergic to mercury just from this group would be about 17 million eople especially vulnerable to increased immune system reactions to amalgam fillings. However, the total would be much larger and patch tests do not leasure the total population getting toxic reactions from mercury. The most sensitive reactions are immune reactions, DNA mutations, developmental, and systemic effects(4,35,38,61,270,305).

10. Low level mercury exposure including exposure to amalgam fillings has Ibeen found to be associated with increased autoimmune diseases, including Ilupus,Chrons disease,lichen planus, endometriosis (1,14,17,19,21,25,27,34,35, 138,42,43,44,45,49,55,60,77,78,91,215,226,234,268,269,270). 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. (35,116,117) 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 letabo1ic processes(25,33,35,60, 180,197}. Mercury is transported throughout Ithe 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 levels of 1 Ito 5 mcg/M3 (35). A large study of 20,000 subjects at a German university Ifound a significant relation between the number of amalgam fillings with eriodonta1 problems, neurological problems, and gastrointestinal rob1ems(199). Allergies and hair-loss were found to be 2-3 times as high in la group with large number of amalgam fillings compared to contro1s(199,199a). ILeve1s of mercury in follicular fluid was significantly higher for those with lama1gam fi11ingss. Higher levels of hormone disturbances, immune disturbances, Ire current fungal infections were also found in the amalgam group. The results lof hormone tests, cell culture studies, an intervention studies agree(199a).

14. Mercury accumulates in the kidneys with increasing levels over time. ercury exposure has been shown to adversely affect kidney function in loccupationa1 and animal studies(59,203,211,260,etc.). The Government's toxic 11eve1 for mercury in urine is 30 mcg/L (189), but low levels in urine often ean high mercury retention and chronic toxicity problems.

15. Amalgam fillings produce electrical currents which increase mercury vapor Irelease and may have other harmful effects(19,27,28,29,30,3S,56,194). These Icurrents are measured in micro amps. The central nervous system operates on Isigna1s in the range of nano-amps, which is 1000 times less than a micro lamp(28). Negatively charged fillings or crown appear to cause higher mercury apor losses(35).
16. Mercury from amalgam fillings is transferred to the fetus of pregnant omen and children who breast feed at levels often higher than those of the Imother(18,19,23,31,38,61, 112,113,114,195,281). Mercury has an effect on the Ifeta1 nervous system at levels far below that considered toxic in adults, and Ibackground levels of mercury in mothers correlate significantly with incidence 10£ birth defects and still births(3,23,38,197,210,272,287). Mercury vapor lexposure causes impaired cell proliferation in the brain and organs, resulting lin reduced volume for cerebellum and organs and subtle defiencies(38,305).

17. Since mercury is documented from studies of humans and animals to be a Ireproductive and developmental toxin(38,61,105,146,224,255,305), mercury can Ireduce reproductive function and cause birth defects and developmental Iprob1ems in children. (2,3,4,20, 24,31,37,38, 39,40,41, 49,61,199,224, 255). Clinical evidence indicates that amalgam fillings leads to hormone imbalances Ithat can reduce fertility(199,38,4). Some researcher's advise pregnant women Ishould not be exposed to mercury vapor levels above 10 mcg/M3 (61,195,282) and Isevera1 governments have bans or restrictions on use of amalgam by women of Ichild-bearing age.

18. Mercury causes breaks in DNA (4,38,41,42, 197). Low non-cytotoxic levels of mercury induce dose dependent binding of mercury to DNA and significantly increased cell mutations (142,4) and birth defects (197,38).

19. Mercury by its effect of weakening the immune system contributes to increased chronic diseases and cancer(91,222,234,38,etc,). Expsosure to mercury vapor casuses decreased zinc and methionine availability, depresses rates of methylation, and increased free radicals-all factors in increased susceptibility to cancer(38). Amalgam fillings have also been found to be positively associated with mouth cancer(206,241).

20. In addition to the endocrine system disrupting effects of high mercury laccumulation in the pituitary gland, mercury causes a reduction in thyroid IProduction and an accumulation in the thyroid of radiation. Mercury's adverse influence on thyrocytes can playa major role in thyroid cancer etiology(144). IMercury has been found to affect hormone production at very low Iconcentrations (199).

21. There has been no evidence found that there is any safe level of mercury lin the body that does not kill cells and harm body processes(WHO,183,189, letc.). Mercury levels of 10ppm severely disturb cellular function, and growth lof nerve fibers are affected at much lower levels(181). This is especially so If or the pituitary gland of the developing fetus which is the most sensitive to Imercury (2-4,19-24,30,31,36 -44,61) .

22. Low levels of toxic metals have been found to inhibit dihydroteridine reductase, which affects the neural system function by inhibiting transmitters through its effect on phenylalanine, tyrosine and tryptophan transport into neurons(257,258,289). This was found to cause severe impaired amine synthesis and hypokinesis. Tetrahydrobiopterin, which is essential in roduction of neurotransmitters, is significantly decreased in patients with lalzheimer's, Parkinson's, and MS. Such patients have abnormal inhibition of Ineurotransmitter production. Such symptoms improved after administration of 15-formyltetrahydrofolate (257) .

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(1,3,6-12,34,36,38,72,122,123,124,171,172,173,240,249,290,303) Studies note that carpeting in dental offices should be avoided as it is a .ajor repository of mercury(188). Mercury levels in urine of dental personnel laverage about 2 times that of controls(123,124,171,249) and was 43 nmol/liter Ifor a population surveyed in Sweden(171), which is above the Swedish loccupational exposure guideline. Much higher body burden levels in dental ersonel were found based on challange tests than for controls(303). A review lof several studies of mercury level in hair of dentists and dental workers Ifound median levels were 50 to 300% more than those of controls(38, p287-288 & 13). Allergy tests given to a group of dental students found 44% of them were lallergic to mercury (156) .

2. Drilling old amalgam fillings with only a saliva extractor and no other Iprecautions 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). Dentists were found to score significantly worse than a comparable control group on neurobehavioral tests of motor speed, visual scanning, visuomotor coordination, concentration, verbal memory, visual memory, emotional lability, mood scores, and visuomotor coordination speed(249, 252, 253, 69,70,260,290). Adverse neurobehavioral effects were found even for dental personel receiving low exposure levels(less than 4 ug/l Hg in urine) (290). Such levels are also common to non dental personel with several fillings.

4. Both dental hygienists and patients get high doses of mercury vapor when !dental hygienists polish or use ultrasonic scalers on amalgam surfaces(240). Ipregnant women or pregnant hygienist especially should avoid these practices uring pregnancy or while nursing since maternal mercury exposure has been shown to affect the fetus and to be related to birth defects, SIDS, etc. (38, 61,272), and breast milk contains up to 6 times higher mercury than in the other's blood(20). .

5. Body burden increases with time and older dentists have median mercury rine levels about 4 times those of controls, as well as higher brain and body urdens(13,34, 69-74,122). Some older dentists have mercury levels in some arts of the brain as much as 80 times higher than normal levels(14,34).

6. Dentists and dental personnel experience significantly higher levels of Ineurological, memory, musculoskeletal, mood, and behavioral problems, which lincrease with years of ,exposure(13,34,49,69-74,88,122,188,246,247,248,249,252 1290). Even dental personel with relatively low exposure(urine Hg<4 ug/l) were Ifound to have significant neurological effects(290) and was found to be Icorrelated with body burden of mercury. Most studies find dentists have Ihigher suicide rates than the general white population(284), but one study Ifound rates in same range as doctors.

7. Female dental technicians who work with amalgam have increased menstrual Idisturbances(275,38), significantly reduced fertility and lowered probability lof conception(3,24,38,121), increased spontaneous abortions(3,38,277), and Itheir children have significantly lower average IQ compared to the general opulation(13,279,38,110). Populations with only slightly increased levels of Imercury in hair had decreases in academic ability. Effects are directly Irelated to length of time on the job(277). The level of mercury excreted in lurine is significantly higher for female dental assistants than dentists due Ito biological factors (171,172, 173,247). Several dental assistants have been Idiagnosed with mercury toxicity and some have died of related health leffects(32,245,246,247,248). Female dentists have increased rates of Ispontaneous abortion and perinatal mortality93,38).

8. Many homes of dentists have been found to have high levels of mercury contamination used by dentists bringing it home on shoes and clothes(187).

9. Some studies have found increased risk of lung, kidney, brain, and CNS system cancers among dental workers (14,34, 143,283).

10. Autopsies of former dental staff found levels of mercury in the pituitary gland averaged over 10 times that of controls(99,38), as well as higher levels in the occipital 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 thousands) where removal of amalgam fillings led to cure of serious health problems such as periodontal diseases(56,82,86,87,90,94,101,133,145,168,192,212), immune system problems (270,91,212,229,35), allergies(212,229), asthma(75), migraines(212,229), multiple chemical sensitivities(229,35), epilepsy(5,309,229), blood conditions(212,35), stomach problems(212,229,35), MS(102,291,302,35,229,308), ALS(97,229,35), Alzheimer's(204), lupus(229), Parkinson's(248,229,35), schizohprenia(294), depression(107,294,212,229,35) ,chron's disease(229), anxiety & mental confusion (229) ,anger(212),infertility(199a,38,229), arthritis, endometriosis(229,38), Chronic Fatigue Syndrome (293,229), tachycardia and heart problems(205,306,212), dizzyness(212) ,etc., or in significant improvement in symptoms ( 34,35,38,57,86-91,94-103,125,148,165. 167.168,170,180,182,192,199,200,204,212, 222 229,233,234,235,237,252,282,289). In a large German study of MS patients after amalgam removal, extraction resulted in 85% recovery rate versis only 16% for filling replacement (302,308). Other cases have found that recovery from serious autoimmune diseases, dementia, or cancer may require more agressive mercury removal techniques than simple filling replacement due to body burden. This appears to be due to migration of mercury into roots & gums that is not eliminated by simple filling replacement. Among those with chronic immune system problems with related immune antibodies, the types showing the highest level of antibody reductions after amalgam removal include glomerular basal membrane, thyreeoglobulin, and microsomal thyroid antigens(91) Interviews of a large population of Swedish patients that had amalgams removed due to health problems found that virtually all reported significant health improvements and that the health improvements were permanent(233). (study period 17 years) A compilation of an even larger population found similar results(237,282). For example 89% of those reporting allergies 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 have found evidence amalgam fillings may playa major role in development of conditions such as such as Alzheimersz(66,67,158,166,204,207,221,239,242,244, 258,296,300), ALS(92,97), MS(170,285,291,302),Parkinson's(98,169,218,248,250, )258),schizophrenia(294,295),depression(107,109,294,295 ,etc. (34,35,57,100,102, 145, 148,159,163,175,184,199,213,228,242,243,244,248,252,257,289). One study(169) found blood and urine mercury levels to be very strongly related to Parkinson's with odds ratios of approx. 20. Medical textbooks on neurology note that "inorganic mercury as a cause of pyschiatric syndrom is often not recognized by diagnosticians, with a conclusion that a pateints symptoms are due to neurois or functional psychosis or just nerves. "The manifestations of mercury are likely to be subtle and diagnosis is difficult(295,296)." Very high levels of mercury are found in brain memory areas such as the cerebral cortex and hippocampus of patients with diseases with memory related symptoms (158,34, 207,etc.} Mercury penetrates and damages the blood brain barrier alowing penetration of the barrier by other substances that are neurotoxic (38,85,113,146,162,262). Such damage to the blood brain barrier's function has been found to be a major factor in chronic neurological diseases such as MS(286,289,291,302). Studies have found mercury related mental effects to be indistinguishable from those of MS(207,244,289,191,302). Low levels of toxic metals have been found to inhibit dihydroteridine reductase, which affects the neural system function by inhibiting brain transmitters through its effect on phenylalanine, tyrosine and tryptophan transport into neurons(257,258). This was found to cause severe impaired amine synthesis and hypokinesis. Tetrahydro -biopterin, which is essential in production of nerurotransmitters, is significantly decreased in patients with heimer's, Parkinson's, and MS. Such patients have abnormal inhibition of neurotransmitter production. (supplements which inhibit breach of the blood brain barrier such as bioflavonoids have been found to slow such neurological damage). Mercury at extremely low levels also interferes with formation of tubulin producing neurofibrillary tangles in the brain similar to those observed in Alzheimers patients with high levels of mercury in the brain (207). Mercury and the induced neurofibrillary tangles also appear to produce a functional zinc deficiency in the of AD sufferers(242),as well as causing reduced lithium levels which is another factor in such diseases. Lithium protects brain cells against excess glutamate induced excitability and calcium influx(280). Also mercury binds with cell membranes interfering with sodium and potassium enzyme functions, causing excess membrane permeability, 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 interfere with their vital functions, and to inhibit cytochrome C enzymes 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(57,97,100,102,148,170,207,213,222,234,237,282). 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(35,38,180).

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 like mercury vapor crosses the blood-brain barrier and also damages and weakens the immune system(225,226,234,235, 237, 293,38,etc.). Methyl mercury has also been shown in animal studies to induce autoimmune reactions and disease through its affects on immune system T cells(226,268,269,270,etc.)

7. Body mercury burden was found to playa role in resistant infections such as Chlamydia trachomatis and herpes family viral infections; it was found many cases can only be effectively treated by antibiotics after removal of body mercury burden(cilantro tablets were used with followup antibiotics) (251,131). Similar results have been found for treatment of cancer.

VI. Scientists and Government Panels or Bodies That Have Found Amalgam Fillings to be Unsafe.

1. A World Health Organization Scientific Panel concluded that there is no safe level of mercury exposure(183,189,208). 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 against use of dental amalgam in pregnant women(61). Most major countries other than the U.S. have similar or more extensive bans or health warnings regarding the use of amalgam, including Canada, Great Britain, Austria, Norway, Sweden, Japan, Australia, etc. A Swedish National Mercury malgam Review Panel found that "from a toxicological point of view, mercury is too toxic to use as a filling material"(164). A Swedish medical panel nanimously recommended to the government "discontinuing the use of amalgam as la dental material"(282). The U.S. EPA found that removed amalgam fillings are Ihazardous and must be sealed airtight and exposed of as hazardous waste(214). ost 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 exposure beyond that recommended by the USPHS Standard(209). Many of those researching amalgam related health effects including several very prominent 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, 26,36,38,57, 61,88,94,99, 100 113,115,125,126,148,153, 164,170,183, 208,209,210,222, 227,236,237, 238,239,282).

3. The use of mercury amalgams has been banned for children and women of Ichild-bearing age or put on a schedule for phase out by several European Icountries. The use of amalgam is declining in Europe and Germany's largest roducer of amalgam has ceased production, The director of the U.S. Federal rogram overseeing dental safety advises against using mercury amalgam for new fillings.

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