I'm watching a video called "Smoking Teeth" on the International Academy of Oral Medicine & Toxicology's website. In it, a man takes an extracted tooth and rubs its 25-year-old amalgam filling with a pencil eraser. A phosphorescent screen in the background illuminates mercury off-gassing — more than 1,000 times higher than what the Environmental Protection Agency allows for our air.
"No amount of exposure to mercury vapor can be considered harmless," the narrator says. "Especially considering its cumulative effect."
IAOMT, a 30-year-old nonprofit that counts more than 700 members, argues that vapor is continuously emitted from fillings, with damaging effects sometimes not manifesting for decades. It draws correlations between mercury in fetuses and mothers' amalgam fillings, and warns of potential learning disabilities for the child.
Scared yet, you nighttime teeth grinders? Some local dentists think you should be.
"If you're concerned about mercury in your fish and your light bulbs, why are you not concerned about quantities thousands of times greater in your teeth?" asks Dr. Craig Sommer, who's practiced locally since 1992 after getting a chemical engineering undergraduate degree from Colorado School of Mines and graduating from the UCLA School of Dentistry.
No one disputes that mercury is a toxic substance by nature. The tension lies between some medical associations and government regulatory agencies who argue its presence in dentistry remains safe, and concerned dentists like Sommer, who fear mercury's long-term impact on the body and wider world.
Keep it separated
Before folks realized it was toxic, mercury nitrate was used in the 18th and 19th centuries to felt beaver fur for hats, poisoning hat-makers and inspiring the phrase "mad as a hatter." But even since then, the world has seen many instances of environmental mercury poisonings.
Perhaps most notably, over a three-decade-long period beginning in the late 1950s, methylmercury in wastewater from a chemical factory in Minamata, Japan bioaccumulated in shellfish eaten by locals. First, a 5-year-old girl began having trouble speaking and walking; convulsions followed as her central nervous system, kidneys and liver came under attack by mercury. Next, house pets and wildlife exhibited similar spasms prior to death; even seaweed receded near shore. Thousands of people fell into comas before dying.
This is where the United Nations' Minamata Convention on Mercury gets its name. Signed in 2013 by representatives of more than 100 nations, including the U.S., it is aimed at protecting human health and the environment from all anthropogenic (human-caused) releases of mercury, though focusing primarily on coal-fired power plants.
But with tens of thousands of U.S. waterways already carrying warnings against fish consumption because of mercury — including the Great Lakes — the IAOMT insists that dental mercury needs increased attention, as does the Campaign for Mercury-Free Dentistry (toxicteeth.org). The latter group is petitioning Secretary of State John Kerry to ensure the U.S. upholds Minamata by getting away from dental mercury.
The IAOMT says dental mercury amounts to 340 tons released globally each year — 28.5 of that from the U.S. alone. Dentists are the second-largest mercury users, placing some 30 million new fillings annually. Excess product or that removed from teeth either goes down a drain or into the trash, joining sewage sludge destined for fertilizer or a landfill — either way seeping into the ground or off-gassing into the atmosphere.
What can be done
A decade ago, Dr. Sommer voluntarily — at a cost of roughly $500 plus an annual mercury-recycling fee of another $500 — installed an amalgam separator in his downtown office to keep the heavy metal from escaping into wastewater during dental procedures. That's something the city of Boulder made mandatory in 2007, and that the Denver Metro Wastewater Reclamation District will begin requiring by August 2015.
Colorado Springs has no such compulsory program. Springs Utilities environmental specialist Lauren Swenson says that local dentists were surveyed and involved in developing a voluntary program that's been in place since 2006, though she doesn't know how many local offices currently use separators. What she does know is that state limits for mercury in water released back to waterways aren't being exceeded: "We keep a very close eye on it."
Still, the separators, along with "best management practices" can capture 99.9 percent of amalgam waste. And as a Boulder spokesperson notes, "The Colorado Department of Public Health and Environment explained that the point is not how much dental offices contribute to the source of mercury in lakes and streams, but that dental offices have the means to dramatically minimize the amount of mercury discharged."
As for personal health, Sommer (who, for transparency, is my dentist) also protects both his patients and staff from mercury dust via a special HEPA vacuum, "the dental equivalent of a Shop Vac." It catches particulate matter via an elephant trunk-like hose brought to the patient's chin. He also sprays ample water in patients' mouths, supplies nasal oxygen, and uses rubber dams.
The American Dental Association, citing supporting evidence from the FDI World Dental Federation, the World Health Organization and the ADA's Council on Scientific Affairs, among other major orgs, says measures like those taken by Sommer are unnecessary.
"Dental amalgam is considered a safe, affordable and durable material that has been used to restore the teeth of more than 100 million Americans. ... [it] has been studied and reviewed extensively, and has established a record of safety and effectiveness."
The U.S. Food and Drug Administration notes more than 150 years of safe dental amalgam fillings usage, but does acknowledge that mercury "releases low levels of mercury vapor that can be inhaled." It couches this by saying the amount of mercury measured in people with up to 15 or more amalgam fillings still falls "far below the lowest levels associated with harm."
These agencies also get a boost from quackwatch.com, moderated by a retired psychiatrist turned health-fraud watchdog. The IAOMT years ago sponsored sheep and monkey studies with radioactive amalgam fillings that "demonstrated that the mercury quickly disseminated around their bodies," particularly into the jaw, stomach, kidneys and liver, within 30 days. Quackwatch's "Mercury Toxicity Scam" debunks those experiments, co-blaming 60 Minutes for a scare segment back in 1990. It also identifies the leading advocate of "dubious" holistic claims as Dr. Hal Huggins of Colorado Springs (who failed to return our calls).
On Huggins' website, he with no shyness calls himself "the world's most controversial dentist," which likely has something to do with having his license revoked by the Colorado State Dental Board for gross negligence in 1996. In practice since 1962, he cites a post-doctorate master's in immunology and toxicology, and has authored many books available for sale. He suggests blood screenings, hair analysis and other methods to determine your toxicity, and the planning of treatment "jointly with the dentist, physician, IV personnel, acupressurist, nutritionist, detoxification doctor and other health professionals so that the timing of events complement each other."
Much like mercury itself, this topic is nothing if not volatile. But it's worth thinking about the next time you're in the dentist's chair. A recent Zogby poll, after all, claims that 57 percent of Americans don't know that amalgam is mainly mercury (50 percent mercury by weight), and that only 11 percent are told amalgam contains it.
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