General Family Practice With a Holistic Approach To Dental Care...

Oral Mines Uncovered:

By Dr. Gary Fortinsky

 

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“Oral Mines Uncovered” 

- Adapted from an article regarding dental mercury in “Common Ground Magazine” – Winter 1995-96 

BY DR. GARY FORTINSKY, D.D.S. 

The use of amalgams in dental fillings is a controversy awaiting resolution. It is also a source of confusion to dental patients — even the dentist - primarily due to conflicting data, which makes a clear understanding of amalgam use difficult to interpret. When the dentist doesn't have a definitive answer to a patient's question, then the patient feels the dentist is being either evasive or uninformed or both. As a result, misconceptions are created regarding this issue. 

The result of scientific research into the use of dental amalgams involves the art of interpretation. Every piece of information is understood differently by people as a result of their knowledge, research, even personal experiences. Although a degree is not a pre-requisite for holding an opinion, it is necessary to be well-versed and well-informed to derive informative conclusions. Clinical experience is also an invaluable tool, because it allows the results of theory to be seen in practice. With this in mind, it is crucial to point out that every dentist has a personal opinion regarding any issue in dentistry. 

My intention is not to speak for all dentists, but to relay my opinion and, where possible, to provide understanding and the scientific rationale. 

The Controversy 

The amalgam controversy is comprised of two central aspects. The first issue concerns the basic constituents comprising silver/amalgam dental fillings, which are 50% mercury, 27% silver, 10% tin, 12% copper, and 1-2% zinc—-percentages may vary between manufacturers. The second issue is the corrosion of the amalgams and the sub- sequent generation of electricity in the mouth. 

The general public is most familiar with the first issue of the controversy: Is mercury toxic? The answer is a resounding and definite yes. It is even more toxic than lead, cadmium, or arsenic. There are no safe levels of mercury. In fact, no government agency has established a safe level of mercury to which people can be exposed. Even the pharmaceutical establishment has removed mercury from a number of preparations. 

The History 

Historically, the pro-amalgamists have said that once a silver/mercury amalgam was placed in the mouth, it took on an inert or stable state, thereby making it safe as a filling material. This state of stability eliminated any chance of the filling constituents being ingested by the patient. Recent scientific research has, however, proven beyond a doubt that mercury vapours are constantly being released from the fillings. This rate of mercury release increases up to fifteen fold every time food is eaten, teeth are brushed and hot liquids drunk.  

The amount of mercury vapours released however, is still a topic of debate between scientific researchers. When confronted with the scientific data showing mercury vapour release, pro-amalgamists maintain that only inconsequential amounts are released from mercury fillings and that more mercury is ingested from the food than from amalgam. 

Recent research has also shown that mercury affected the bacteria of the gut by causing it to produce antibiotic resistance, which disappeared when the amalgam fillings were removed.

Vapour Reactions 

The vapours which are released from silver/mercury fillings enter the body in a number of ways. Over the last five years it has been discovered that mercury is absorbed through the mouth's tissues. Or it can be breathed into the lungs where 80% is absorbed directly into the blood stream. Within a very short time, inhaled mercury vapours have access to every organ within the body. 

However, blood and urine levels may not show increased levels of mercury in people with numerous amalgam fillings. In fact, people with few or no amalgam fillings may have higher levels of mercury in their urine. However, if the mercury is absorbed directly into the blood stream and whisked away to all corners of the body, the chances are that these tissues have absorbed the mercury, therefore blood mercury levels drop. 

There are no research findings that can correlate blood levels to body burden, so therefore blood levels do not give any information regarding chronic exposure. To complicate things further, one of the main targets of mercury is the kidneys. Mercury will hamper renal function causing mercury excretion to be reduced. 

In summary: with chronic mercury exposure, kidney excretion of mercury drops, so the concentration of mercury in our urine will drop as well. This would explain why people with many amalgams excrete little mercury. But when the source of the mercury (amalgam fillings) is removed, the body is now more able to excrete mercury. As a result, the organs can begin to function to capacity and urine levels of mercury increase. 

The pro-amalgamists state that only minute quantities are released from fillings over time. The problem with this statement is that it disregards the rate of excretion of mercury. The excretion is based on the concept of half-life, which is defined as the time in which half the absorbed dose is excreted. The half-life of mercury varies between tissues from days to years. The significance of this is that the excretion is not on the total body content, but on the daily intake. So, therefore, what is absorbed and excreted yesterday has no effect on what is absorbed and excreted tomorrow. Each days absorption is independent. This means that the rate of accumulation of mercury far exceeds the rate of excretion. 

Therefore, over years, your body's store of mercury can enlarge to the point that disease may occur. 

There is information that says the levels of mercury released do not come close to the levels required to produce toxic symptoms. 

The response to this can be answered on a couple of levels. Firstly, remember that it takes time for toxicity to occur. In the majority of individuals, illness does not influence a person's life immediately. Most chronic illnesses are insidious (creeping up on us), and by the time we realize something is seriously wrong, the disease is well entrenched, or we have tried to adapt to the changes it has thrown at us. It could take years for these changes to occur, and the relationship to the teeth is never as direct as we would like. Further, in some people the time lapse between amalgam placement and illness is not as great. 

Secondly, the individual constitution dictates how much their body can handle and, when it reaches this point, overt disease manifests. Just because someone is not obviously sick does not mean that there aren't any subtler effects. It is easier and faster to treat an individual in an earlier state of illness. Once obvious signs of disease occur, it takes longer and is harder on the client to recover completely, especially if illness has developed. 

Electrical Discharge 

Electrical interference as a result of amalgam fillings has not received the attention accorded to mercury. Personally I feel it's just as important if not more so. Frequently, I ask clients if they have ever bitten down on a piece of foil and felt a shock. The usual response is yes — with a cringe! That shock is due to the discharge of electricity from within the filling. This is an indicator of corrosion or rusting. 

There is no dispute whatsoever within dentistry about the corrosion or rusting of amalgam. In fact, it is encouraged, as the by-products of this breakdown are suppose to fill in any gaps that exist between the filling and between the filling and the tooth. Whenever there is corrosion, there is always electricity. Why be concerned? 

Our body, more specifically its nervous system, function via electricity. The nervous system also functions at a specific current. Amalgams can generate currents stronger than the natural ones, and in my opinion this can over-ride the natural current and interfere with proper function. This leads to systemic or body effects. 

Symptoms of Toxicity 

So, how can people find out whether or not their amalgams (or the mercury from them) is affecting their health? Symptoms for mercury toxicity can be vague and diverse. Mercury can interact with almost every protein in the body and alter its function. The initial signs of poisoning may include: 1) neurological (relates to the nervous system and brain) e.g. inability to concentrate, loss of memory, drowsiness, 2) immunological effects (relates to the body's protection system) e.g. infections, chronic fatigue, auto-immune diseases, and 3) systemic effects e.g. headaches, kidney disease, cardiovascular disease. 

The other difficulty is the insidious nature of toxicity. The body adapts to its slow progression. The definition of health should be the absence of disease, but should disease be identified only when the body is compromised and no longer adapting? Should disease be recognized in its earlier stages? If so, how? 

Vegatesting & Remedies 

In my practice I refer patients to one of a number of practitioners who is trained in using a machine based on electro-acupuncture. The test basically "asks" the body if various substances are detrimental to its health - i.e. amalgam, mercury, etc. It can also ask if this is the key issue. If the answer is "Yes", then we recommend removal, but not every amalgam necessarily requires removal. If the answer is "No", the amalgams and/or mercury are not affecting health, then removal is not recommended. However, there are some clients who feel uncomfortable having these materials in their body and elect to have them removed anyway. It should be borne in mind that if a health problem exists and is unrelated to mercury and amalgam, and amalgams are removed, the health problem will not change. 

We have patients who, on discovering that amalgam is not a health risk for them, are devastated. They have health problems that have not been effectively treated and the test was their last resort. In these situations, and actually, I feel in all cases of patients who want to improve their overall health, consultation with an alternative health care practitioner is the best route to unravel and treat systemic problems. 

Amalgam removal does not always mean that health will improve completely. I have had clients whose amalgams were removed but are still having health difficulties. On testing, it shows that mercury is still a problem. The reason is that the body still retains mercury, or the effects of the mercury, in which case other treatments may be is necessary. 

Certain foods aid in the detoxification of mercury from tissues: garlic, lentils and pectins (found in fruits, especially bruised apples) help the body clear the digestive tract which is retaining toxins. 

The Vegatest will also determine whether the body is exhausted and can tolerate change. If so, the amalgam fillings are removed at a slower rate. For some clients, changing a filling can exacerbate existing health problems, or cause a relapse, which is generally temporary until the body readapts. 

Nor does it follow that the larger the filling the greater the current. The problem could be the smallest filling. There is a complex interaction between all the fillings, the saliva and factors we may not even know about which determines the corrosion and current. The higher the current, the greater the breakdown of the filling and release of its components and also the greater the electrical interferences. 

This is the reason I feel the electrical component of amalgam is important. When a number of amalgam fillings are present, the order of their removal is based on the detected current within the fillings. The fillings with the highest current in a quadrant - the mouth is divided into four quadrants - are removed first. By removing the highest current the client can get the greatest change with the least amount of treatment. 

I feel it is important for the client to understand what is actually happening in their mouth. The easiest way to do this is to save a piece of the amalgam during removal. What they see is a chunk of metal with a shiny surface on one side. This is where the drill did the cutting. On the other surfaces are various shades of grey to black, indicating corrosion or tarnishing. What this means is that the ingredients of the filling have broken down, which also leads to electricity production. 

There is a difference between the surface representing the biting surface and all other surfaces. The surface which is used for chewing is rarely as dark as the other surfaces. This is due to the grinding of the teeth during chewing and swallowing. When we go through these motions we are essentially polishing the surface of the fillings. When this occurs a very thin layer of the filling is removed and consequentially swallowed (we should also remember that this increases vapour production for about an hour and a half). This is a major problem for people who grind and clench because both usually occur over long periods of time. With the increase in vapour, the ingestion of mercury is increased many times (some people grind or clench all night, it's mind bog-gling to think how much more vapour would be produced and inhaled). 

Once the filling is removed, the body must adapt to a new electrical current, or lack of it, and this stresses the body and can alter health. If the body is exhausted, it may not have the strength to adapt, and gets sicker before it over-comes the stress. If the body is not exhausted it usually can adapt, but if the person is getting his fillings changed too rapidly he/she can still get sick. If this occurs, I stop removal until the individual feels better. In the exhausted group we recommend removal at a rate of one filling per month. For many people it may take one to two years to have all their fillings changed. But you must remember that the purpose of changing them is to improve health. If treatment is under- taken too rapidly, the patient may become even more ill, and in some cases even incapacitated. 

After one quadrant of amalgam is removed, the electrical readings are redone to determine how to proceed. The readings on every filling could change. There are patients who get discouraged when readings show an increase. This does not mean that treatment is not progressing. We do not understand the inter-relationship between the fillings and the current, the readings are just guiding us to the best route to take. 

Time to Heal 

Many patients ask how long it will take to see an improvement. That is difficult to say because everyone is different. Think of our bodies as a pail with a hole in it. The mercury or toxins are being poured into the pail and a hole in the bottom is allowing the mercury to flow out (be excreted). If more toxin is being poured in than excreted we start accumulating a surplus. When we change an amalgam, we are altering the flow into the pail. At some point it will be reduced to a level less than that being excreted. At that point we have the potential to start healing. It may take a while for enough to exit the hole so that we feel better. For people with 15-20 amalgams they may not start feeling results until more than 1/2 or 3/4 of the fillings are removed, which can take over a year. Patience is vital to success. Most people do feel some changes before that though. 

Alternative Dental Materials 

With all this in mind how should we proceed? Do I get all my teeth extract- ed to remove the amalgam and improve my health? There are a variety of materials and techniques that have been developed: l)gold alloy 2) composite (white fillings)-light cured 3) composite-heat and/or pressure cure 4) porcelain 5) glass ionomer). I won't go into the details of each material because the choice of material may depend on your particular situation. No one material is perfect, each has its strengths and weaknesses. The important thing to remember is that it should not be deleterious to your health. 

Also different dentists are more comfortable with one technique or material over another. This does not necessarily mean that one is better over the other. What must be emphasized is that many of the new materials are "technique sensitive", i.e. they are more difficult to use. That was one reason why dentists loved amalgam. If the tooth preparation (cavity) was wet with a little saliva, the amalgam stayed and the filling succeeded. With the above materials the tooth cannot get contaminated or else the filling will fall out or decay underneath. The reason is that the new materials are glued to the tooth and if saliva gets on the tooth it creates a barrier between the filling and the tooth. The way around this problem is to devote enough time to properly isolate the tooth so the filling can be placed. 

This is the reason many people come in saying, for instance: "I was told if I get white fillings placed I will need root canals on all these teeth." That is 100% wrong if the filling is placed properly. That does not mean that the teeth will not develop a new cavity or the filling will last forever! The filling only fills a hole, the process that causes cavities are independent and a new cavity may develop with time, but it should not happen because of the filling. 

It's also good to remember that just because an alternative material is not silver/mercury amalgam an individual can tolerate it. You must decide for yourself how this issue fits into your other priorities and affects your life. If it's important to you, ask some questions at your next dental visit. The important thing is that you are aware of these potential concerns.