Pamela MacArthur was a healthy artist whose body suddenly started to twitch. She had nightmares and her face erupted in boils so painful that it hurt to roll over in bed. Doctors suggested drugs for acne and psychological disorders, but MacArthur?s dentist had the solution. He removed nine metal fillings and replaced them with plastic substitutes, and soon she was fine.
MacArthur is one of a growing number of people who believe their medical problems are caused by the mercury in their dental fillings. Even though metal fillings are called ?silver,? they are actually an amalgam of half mercury and the other half a mixture of silver, copper, tin and zinc.
It?s known that that mercury fillings do release small amounts of colorless, odorless mercury vapor into the bodies of the 100 million Americans who have them, especially after chewing food or brushing teeth. Mercury is a known neurotoxin. The question is whether the emissions are high enough to cause health problems.
The dental community is sharply divided over whether mercury in fillings is harmful. The American Dental Association says they rarely cause problems, and only in people with mercury allergies, and are more durable than the alternatives. Meanwhile, ?mercury-free? dentists insist that their mercury fillings are slowly poisoning patients because the fillings release the mercury into the blood. Research findings are mixed.
A bill introduced in the Georgia Legislature in March would require dentists to tell patients about the risks of these fillings and about alternative fillings. The bill would also would ban mercury fillings in children and in women age 45 or younger. Last fall, a California congresswoman announced a bill to ban dental mercury nationwide.
Meanwhile, the U.S. Food and Drug Administration is proposing new guidelines for labeling and reporting of side effects, and the National Institutes of Health is spending $9 million for two large studies of mercury fillings in children.
Caught in the middle are dental patients, who don?t know whether to rush out and get rid of their silver fillings. Some dentists suggest that symptomatic people such as MacArthur, who may have a mercury allergy, should consider getting fillings removed. This is even more true if fillings are old and need to be replaced anyway. But because removing fillings can actually release more mercury into the body, the procedure is more risky for people who feel fine.
Dr. Michael Ziff, a retired dentist who fought a four-year legal battle over mercury with the dental board in Florida, is now executive director of the Orlando-based International Academy of Oral Medicine and Toxicology, a leading anti-mercury group with about 400 dentist members. The average American has seven mercury fillings, Ziff says. ?It?s kind of like holding seven leaking mercury thermometers in your mouth 365 days a year, 24 hours a day.?
Dr. Rod Mackert, a dentistry professor at the Medical College of Georgia, says the fillings emit from 1 to 3 micrograms of mercury a day, while people take in 5 to 6 micrograms a day through food, water and air. The American Dental Association prohibits its members from suggesting that patients have fillings removed, though members can comply if a patient requests it.
Mercury fillings have been used for at least 150 years, Mackert says. ?It is unethical to allow the removal of fillings for the curing of any disease, because there is no evidence linking it to systemic disease,? he says. ?It would be giving the patient a false hope.?
A January survey by the Chicago-based Dental Products Report found that 20 percent of dentists no longer use mercury fillings. Among those who do, two-thirds use them in fewer than half the fillings they place. Dentists who frequently remove mercury fillings, such as Dr. Ron Dressler of Norcross, usually do so for patients who are referred by doctors who treat chronic pain. The doctors run hair or urine tests to detect mercury levels, and high amounts suggest that the fillings should be removed.
Since removing the fillings can increase the amount of mercury in the body before decreasing it, patients are advised to use some form of chelating drug, which is a drug that binds to metals and eliminates them through the urine. Dr. Mark Merlin, a physician at the Atlanta Center for Alternative Medicine in Dunwoody, says chelation is crucial when fillings are removed. ?You have to get (the mercury) out of the body; it?s been leaking into the body for years.?
Hyacinth Meeks, a patient of Merlin's, had a similar experience. Plagued by migraines that made her head throb when she walked even a block, Meeks became frustrated with doctors who put her on mind-numbing sedatives and painkillers. Her dentist was at first reluctant to take out her seven fillings but eventually agreed. ``Within six months, there were no headaches,'' said Meeks, 48, of Austell, an office manager for an Atlanta wood products firm. ``It has totally changed my life.'' Felicia Gaston of McDonough believes that her 3-year-old daughter Tylicia's autism was caused by mercury in fillings that seeped into breast milk. She is one of the plaintiffs in the Georgia lawsuits. ``I should have been aware'' that metal fillings contain mercury, Gaston said. ``I feel like her life has been taken away from her.'' Some mercury-free dentists say they're treated like pariahs by their peers, and many are unwilling to speak publicly for fear of reprisal. Dr. Wayne King, a metro Atlanta dentist who opposes mercury, said that, several years ago, the Georgia Board of Dentistry threatened to punish him after he ran a newspaper ad depicting a skull and crossbones with the questions, ``Is there poison in your mouth? Do you have symptoms of mercury poisoning?'' King was merely given a letter of reprimand, he said, and records show no official sanctions against him by the dental board. But to King, the don't-rock-the-boat message was clear. ``They're afraid to let patients know what we're doing to them,'' he declared. The research is inconclusive, with studies both suggesting and seemingly refuting links to various ailments. The debate even divides institutions: One chemistry study at the University of Kentucky found a relationship between dental mercury and the conditions leading to Alzheimer's disease, while another report at the same school, relying on brain autopsies, found no connection. Research by University of Georgia microbiologist Anne Summers suggests that mercury from dental fillings makes the body more resistant to some antibiotics. Yet some studies indicate that plastic fillings also may leak hazardous substances into the body, such as xenoestrogens that can disrupt cell activity, said Mackert, the professor and mercury supporter. ``Everything has a theoretical risk,'' he said. The U.S. Public Health Service says there is no evidence to support claims of adverse effects from mercury fillings except in cases of allergy. A few countries, such as Sweden and Denmark, recommend that dentists try to use alternative fillings, especially for children and pregnant women. Arizona, California, Colorado and Maine have laws requiring dentists to explain potential mercury risks to patients, said Charles Brown, a lawyer with Consumers for Dental Choice. Brown, a former attorney general of West Virginia, has represented the group in lawsuits in California and Maryland contending that the dental profession threatens dentists who oppose mercury and deceives patients by referring to fillings as ``silver.'' Last year, the California State Assembly disbanded the state's dental board over the mercury issue. A state senator who took part in that action, Democrat Diane Watson, is now a U.S. representative and, in November, announced a bill calling for stricter warnings, an inmediate ban on mercury fillings in children and pregnant women, and an eventual ban for everyone. In February, the FDA announced a proposal to upgrade dental mercury from a Class 1 to a Class 2 medical device, which would require the makers of metal fillings to list all product ingredients on labels and encourage dentists and patients to report side effects. Mackert said patients should ask their dentists about mercury fillings if they're concerned. Most dentists will say the fillings are safe and more durable than plastics, especially for large fillings, but they may grant a patient's request for an alternative. And a sea change may be beginning. When Mackert needed repair of a tiny mercury filling a few weeks ago, he went with plastic
?I had a time bomb ticking in my mouth,? MacArthur says. ?You could never convince me that it wasn?t mercury.?
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The parents of a group of children with autism have sued several drug companies and dental associations in the United States for allegedly exposing their children to the neurological disorder in vaccines and dental fillings containing mercury. Some scientists have linked mercury to autism, a neurological disease that can cause severe learning disabilities, impaired motor skills and repetitive behavior.
The American Dental Association, as well as several drug companies, are accused of negligence in 11 lawsuits filed in an Atlanta court. Georgia Power is also listed as a defendant for allegedly releasing harmful mercury-containing emissions into the environment.
Shawn Khorrami, an attorney for the families, says the dental groups misled consumers by not telling them that amalgam fillings contained mercury and could, when implanted in women?s mouths, expose fetuses and nursing infants to toxic levels of mercury. The drug companies are being sued because they failed to warn parents that children receiving vaccines containing the mercury-based preservative thimerosal were at higher risk for mercury poisoning. Khorrami says, ?These companies have been hiding the ball from the American public.?
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Coffee may protect teeth from decay, according to Carla Pruzzo of the University of Ancona, Italy, and colleagues. In lab tests, some of its compounds stopped bacteria from becoming active, which the first step towards dental cavities.
The coffee components chlorogenic acid, nicotinic acid and trigonelline prevent decay-causing microbes from sticking to a synthetic tooth surface. Trigonelline, the main contributor to coffee?s bitter taste, is the most potent anti-adhesive. Caffeine does little to fend off tooth decay, so decaf coffee will still help prevent tooth decay.Animal and human experiments will be needed to determine whether or not they work the same way on real teeth.
Coffee beans ? both green and roasted -- have long been known to contain antibacterial and antioxidant chemicals. ?For eons, people have focused on caffeine as the bioactive compound in coffee, but there are many others to look at,? says Peter Martin, a researcher at Vanderbilt University?s Institute for Coffee Studies in Nashville, Tennessee.
Coffee is one of several foods being screened for substances that prevent the early stages of tooth decay. Tea and cranberry juice may alos contain ingredients that help prevent decay. ?These studies may help us understand the relationship between diet and cavities,? says Pruzzo.
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