As Karen Campbell lowered herself into the dental chair on March 15, 1996, she couldn’t help feeling a little afraid. Not only was she afraid of the sound of the drill, of the hours she would be spending with her head back and her mouth open, but she also feared it might be pain and expense, all for nothing. Campbell, a 71-year-old Greenville, South Carolina native, was getting several fillings and a crown removed. She was having her silver fillings (also called amalgams, or mercury amalgams) removed, not because they were old and worn, but because she had reason to believe they were affecting her health, perhaps even causing the exhausting symptoms she had experienced for years.

During the past twenty years, Campbell had suffered through constant headaches, fatigue, pain, and depression. The pharmaceutical drugs she had taken religiously for so long were not helping. Out of desperation, she decided to try something new.

Her husband heard about Dr. Patrick Patton, a chiropractor in western North Carolina who helped people with unexplained illnesses, and they decided to give him a try. “Dr. Patton told me I was one of the worst patients he’d seen,” said Campbell. His tests showed that she had high levels of mercury and other heavy metals in her system, so he gave her natural supplements to help her body flush out the toxins and encouraged her to begin replacement of her dental materials.

“I started getting fillings when I was about eight years old. I had dental work in almost every tooth in my mouth! I also had a bridge that went across the roof of my mouth, and it had nickel in it. The dentist who put it in said I shouldn’t remove it, even when I slept! I was reacting to that, too,” Campbell remembers. She and her husband researched dental material toxicity, and after much consideration, decided to go ahead with the removals Dr. Patton suggested.

“I was terrified that I was going to be in total misery when they were being taken out, but it was so easy!” Campbell smiled, her eyes shining. The replacements took seventeen dental visits, but she will always remember the dental work she had done on March 15, 1996.

On that day, she had a large mercury amalgam removed from a molar in her right lower jaw followed by the removal of a gold crown on the opposite side. “After the removals, I noticed that the dull headache in the right and back part of my head that I had had constantly for so long was gone! I told the dentist, and he was amazed, too. We were rejoicing! I have had no recurrance of this headache since.” The pain that had been Campbell’s constant companion for over twenty years disappeared completely, right in the dental chair.

The loss of her headache was just the beginning. Campbell was amazed during the course of her many visits to the dentist to find other symptoms falling away. “There seemed to be a general feeling of well-being. Depression was less. Things like that are important to you! I wouldn’t take anything in the world for getting those amalgams out.”

She has heard that many dentists maintain that amalgam fillings are safe, but her disagreement is emphatic. “Those two things, that headache on the right side and that thing about my jaw cracking … and I used to have an aching that would go up on the right side, like a nerve, and that went away, too. Oh, I am in such marvelous shape for seventy-one years old, it’s just incredible!” Another issue that contributed to Campbell’s problem was the “galvanic effect” caused by the different metals in her mouth. Different dental metals, with saliva acting as a conductor, actually can create a battery effect in a person’s mouth, with a charge that can be measured by scientific instruments. This effect can cause its own set of neurological symptoms. [See “Ask the Expert” on the facing page for more information on the galvanic effect.]

Several metals used today in dental materials are suspected of causing toxicity problems, but by far the most infamous subject of the toxic dental material controversy is so-called silver amalgam, the most common filling material. Amalgam is composed of several metals, including silver, tin, copper, and zinc, but the largest ingredient in amalgam is mercury, accounting for 50% of its composition. Of all the elements in the Periodic Table, mercury is second only to plutonium in toxicity. Its poisoning effects are both cytotoxic (cell-killing) and neurotoxic (accumulates in the brain and damages brain cells). The EPA and FDA have stringent regulations on the level of mercury in fish and food, but the use of mercury amalgam fillings in the United States is curiously unregulated.

Some dentists and other health care practitioners in the United States believe, like many research scientists and even national governments, that many people’s health problems originate in their own mouths. Dr. James R. Biddle, M.D. has been detoxifying mercury from his patients for seven years in his Asheville, North Carolina practice. He comments, “There’s already plenty of data to show that mercury is toxic; it’s not that we need more data. The data is irrefutable! It’s just that the powers that be won’t look at it.”

Amalgam mercury exposure, along with exposure to nickel, copper, and various other dental metals found in crowns, bridges, and some composites, increasingly are suspect in many illnesses like Chronic Fatigue Syndrome, Multiple Sclerosis, Multiple Chemical Sensitivity, Parkinson’s and Alzheimer’s Diseases. A growing number of practitioners, like Dr. Biddle, have devoted their practices to working with patients on these issues. These doctors and their patients tell stories of profound results from methods including dental material removal and replacement and various detoxification regimes, often including nutritional supplements, intravenous Vitamin C drips, or elimination dieting.

Critics of mercury amalgams cite the blatant contradictions in the statements and policies of both the U.S. government and the American Dental Association regarding mercury amalgams. Although the Environmental Protection Agency insists that removed amalgam fillings must be disposed of as hazardous waste, their literature states flatly, “Dental amalgams do not pose a health risk.” Scrap dental amalgam must be stored in unbreakable, sealed containers in mineral oil and handled without touching. The ADA strongly advises dentists to remove all carpet from their operatories because mercury from amalgams might contaminate it, but at the same time, they condemn dentists who suggest to their patients that amalgams could be toxic.

Scores of scientists have taken on the issue of mercury toxicity from amalgams.

The World Health Organization (WHO) stated in 1991 that “recent experimental studies have shown that mercury is released from amalgam restorations in the mouth as vapor. The release rate of this mercury vapor is increased, for example, by chewing. Several studies have correlated the number of dental amalgam fillings or amalgam surfaces with the mercury content in tissues from human autopsy, as well as in samples of blood, urine, and plasma.” It goes on to state, however, that the information provided by those studies on the health impacts of such mercury exposure is “inconclusive.”

Even in 1991, the data should have alarmed the WTO, but since that time the debate has only increased, and many more studies have been done. The huge volume of research on the subject offers sobering results: mercury from amalgams has been related to a broad range of physical, mental, and behavioral symptoms, including the potential for weakening the immune systems of people with amalgams so much that they can be more susceptible to cancer and a multitude of serious diseases. How dental materials affect a person depends on their biological individuality.

Every person has a particular biological makeup which gives each individual certain physical ‘weak links’. Those areas of weakness are where problems will arise when a person is exposed to a toxin like mercury. In other words, one person may develop chemical sensitivities, while another may develop clinical depression or heart problems. (Huggins, It’s All in Your Head, 1993)

A German study, published in 1996, found that 39% of those having amalgam fillings had ingested mercury in levels exceeding the WHO mercury standard. Another study published in a German medical journal in 1984 determined that the blood and kidney mercury load of a person with amalgam fillings is often five times that of a similar person without. Along the same lines, studies published in the Journal of the American Dental Association (JADA) and elsewhere found levels of mercury in the urine of people with amalgams to be approximately twice that of the FDA and EPA Action Level for bans on eating fish and food due to high mercury level, and some were as much as 50 times the EPA Critical Level.

Several studies, published in JADA (1987) and other prestigious journals, show that mercury from amalgam fillings is transferred to the fetuses of pregnant women and to children who breastfeed, and those levels often exceed the levels found in the mother. In fact, a 1984 study found that female dental personnel, with their occupational exposure to mercury vapor, have a higher spontaneous abortion rate, elevated prenatal mortality, and higher incidence of premature labor. These problems are all shown by the EPA to be characteristic of women chronically exposed to mercury vapor.

Mercury can have impacts on the male reproductive system, as well. The metal has documented estrogen-increasing and other hormonal effects, and it can cause lowered sperm counts, defective sperm cells, and lowered testosterone levels in males. Mercury from amalgams, along with toxicity from other dental metals, continues to be researched as a cause of infertility and other reproductive problems in both men and women.

Fingers also point to mercury amalgams as the cause of the current and very serious problem of antibiotic-resistant bacteria. In a study published in The Physiologist in 1990, Anne O. Summer, M.D. at the University of Georgia put mercury fillings into the molars of monkeys. Less than five weeks later, the monkeys’ intestinal bacteria became resistant to mercury, as well as to common antibiotics like penicillin, streptomycin, and tetracycline. These results were confirmed in a similar study by Dr. Stuart B. Levy at Tufts University. The American Dental Association responded that animal studies “cannot be viewed as affecting humans.”

Dentists are taught in dental school that, although mercury is highly toxic alone, it becomes biologically inactive when combined with copper, tin, and silver. The ADA’s literature reflects this teaching, but countless studies, including a landmark 1985 study by Drs. Vimy and Lorscheider, refute it, proving that mercury vapor is, indeed, released from amalgam fillings, and vapor levels increase after chewing or drinking hot liquids.

The ADA reinforces its stance by stating in its Code of Professional Conduct that removal of silver amalgams for the purpose of reversing a health condition is both “improper and unethical.” They claim that amalgams have been proven safe in studies, but when scientists have challenged them to produce such studies, they have not. A Health Canada biologist compares the ADA’s response to the amalgam issue to the tobacco industry’s stubborn insistence that research linking smoking to lung cancer was unscientific. Dr. Biddle agrees: “The class action lawsuit that’s waiting to happen with mercury amalgams is going to make the silicon breast implant and the tobacco lawsuits look like tiddlywinks.”

Opponents of amalgam use suggest several reasons for the ADA’s stance. Mercury amalgam is easier to use, it is cheaper than less toxic alternatives, and additional training and equipment are required for use of the alternative materials. An additional motivation could be the potential liability dentists might incur by admitting that the materials they put in their patients mouths are toxic. “The ADA wouldn’t be at such risk if, when the data was first recognized as strong, they had said, yes, you’re right, we just didn’t know,” says Biddle. “But the problem is, the data has been here and it has been presented to them, proof has been presented to them, and they’ve maintained their position. That’s negligence, and that’s causing disease in many people, disease, suffering and death. That’s what’s not forgiveable.”

Indeed, other countries seem to view research condemning amalgams as quite conclusive. In January 1999, the use of mercury amalgams was banned in Denmark, following Sweden’s ban on the fillings two years before. Austria’s Health Ministery created restrictions on amalgam use in 1995, and its director promised a mercury-free Austria by the year 2000. They maintained that amalgam is an additional source of mercury exposure to patients, dental personnel, and to the environment.

Germany’s Health Ministry recommended to the German Dental Association in 1991 that no further amalgam fillings be placed in children, pregnant women, and people with kidney disease, and, in 1993, they extended the recommendation to include all women of child-bearing age. If their government recommends further limitations on amalgam use, the German Dental Association plans to advise its members to end all use of amalgams because of legal risks. The French government also began regulation of amalgams in May 1998 following public complaint and an anti-amalgam petition signed by over 150 dentists.

In the U.S., two states, California and Colorado, have instituted related laws. California now requires signs in large dental offices announcing the potential health risks of amalgams, and Colorado actually grants its dental patients the right to choose what filling material to be used. That state also prevents prosecution of dentists on the sole ground of removing one filling material for replacement of another.

Everywhere else in the U.S., dentists who believe amalgam is toxic keep a low profile, and physicians who help patients with toxicity from dental materials are careful about what they say and do. Diane Benbow, a high school teacher and mother, went to see one such groundbreaking doctor about her unexplainable symptoms. She began her quest into alternative therapies when her dermatologist could find no cure for the unexplainable excema and hives she was experiencing. She saw a chiropractor who used a muscle testing technique and treated her with natural supplements and diet, and began feeling somewhat better. Her hives, which had been constant for about a year, began to come and go.

In addition to her rashes, Benbow was experiencing irritability, chemical sensitivities and other allergies, and she had an annoying hearing problem in her left ear. “It was like having fluid in your ear that just doesn’t go away. It wasn’t painful, really, just kind of irritating not to be able to hear well and feeling like there was something in there.” This problem began, she realized later, within a day or so of having a nickel-beryllium crown put in by a local dentist. Nickel-beryllium, the most common metal combination in crowns, has also been shown to have adverse health effects.

During this time, she gave birth to a little boy, Andrew. “It really clicked with me when I took my son to my chiropractor and he said Drew had mercury toxicity. I said, well, where’s it coming from?” She didn’t have to look far for the answer. “It was coming from me.” Not only had mercury from Benbow’s amalgam fillings transferred to Drew in utero, she reasoned, but he was getting it from her breast milk. She stopped breastfeeding Drew, but she knew she wanted to have more children, so she decided to get her dental materials removed and replaced with non-toxic ones.

Benbow’s chiropractor suggested a dentist who specialized in dental metal removal and replacement with non-toxic materials. She proceeded with removals of her fillings and crowns, in the order of reactivity her chiropractor found through his muscle testing. Benbow decided to have her dental metals removed as quickly as her chiropractor and dentist felt was safe.

Many people are surprised to find out that dental metals have a measurable electrical charge. Like some other practitioners who recommend toxic dental material removal, Benbow’s chiropractor believed that removals should be done in a certain order, with the most negatively charged coming out first. At one point, he suggested that Benbow have a highly-charged root canal removed. His testing found mercury, along with nickel and beryllium, in the tooth. “The dentist was reluctant to do (the root canal) because that particular one was very hard to file out. But I felt that I needed to have it done.”

When the dentist lifted the nickel-beryllium crown from the tooth, he found a large amount of mercury amalgam under the nickel-beryllium crown, which he removed. He then removed the root canal material and replaced all of the materials with safer ones. “That’s when I distinctly remember my ear clearing up,” she said. “It opened up. It was like the root canal was plugging it. It was immediate. They sat me back up [in the dental chair], and I said, ‘Wow! My ear is clear!’ I was really excited. And it stayed clear!”
Benbow completed removals and replacements on all of her reactive dental materials in one summer. Since that time, she has had no more hives or skin problems, her allergies to mold and chemicals have almost disappeared, and her emotional state has completely regulated. Like Campbell, Benbow began getting fillings when she was a young child. Being free of toxic dental materials for the first time in over twenty years has given her renewed health and a positive outlook.

“For the first time in my life, I feel really, really good! I’ve had chronic illness throughout my life. And honestly…I think it had to do with all the fillings in my mouth. I had chronic problems – immune system problems…just on and on.” She shook her head, amazed. “When I had the last bit done, for the first time in my life, I felt really aware, clearheaded. I really feel like I came out of a very deep fog, like being on drugs. I didn’t even know… I thought things were going on just fine before, having a family, having a job. I think it had been going on for years.”

As publicity about this issue increases, more and more people are convinced of the toxicity of mercury amalgams. Unfortunately, many mistakes can be made in the process of removing toxic dental materials and replacing them with safer ones. Horror stories of people’s health problems getting worse after mercury removal has scared many people away from replacing their amalgams. Dental material removal is very tricky, and the dentist must take important precautions because of the potential for mercury exposure. There are many possible replacement materials, and it may be counterproductive to have mercury amalgams replaced with other potentially toxic combinations like nickel and beryllium, or aluminum and barium.

Dr. Darryl Nabors, a Clyde, North Carolina dentist whose practice has been amalgam-free since 1982, places ultimate importance on precautions during amalgam removal to reduce mercury exposure for his patients, his staff, and himself. The first and most important step is to use a rubber dam, which is a thin piece of latex that the dentist installs in the back of the patient’s mouth to keep material from going down their throat. “A study that I saw said that if a dentist takes out an amalgam filling without a rubber dam, the patient can swallow anywhere from 40–60% of the old filling,” Nabors stated. “It’s taken out in the form of a powder, pulverized, and then it hits the inner lining of the tongue, the cheeks and everything, and when the patient swallows, they ingest that. A rubber dam is absolutely essential.”

He and his staff members also use masks when they remove amalgam fillings, and the dental assistant uses a high-speed suction device. They use large amounts of water to cool the amalgam so less vapor will be released, and they cut the amalgam out in large chunks, to reduce the powdery cloud of minute mercury particles that is generated when amalgam is drilled out. Nabors also uses a new high-velocity suction device that he places in front of the patient to pull mercury vapor and powder away during the procedure.

According to Dr. Nabors, if you decide to have your amalgams removed, the first thing you should ask a dentist is whether or not they use amalgam at all in their practice. “There are a number of dentists out there who say, I’ll take your amalgams out for you and I’ll put something other than amalgam in, but they still do amalgams. The best idea is to choose a dentist who is committed to mercury-free dentistry.”

Nabors has shown a great deal of commitment to healthful dentistry. In cooperation with the doctors he works with – M.D.s, chiropractors, and other practitioners – he has researched and found metal-free replacements for dental materials containing heavy metals.

When removing toxic or potentially toxic dental materials, ideally patients should approach a qualified health practitioner and request biocompatibility testing for replacement materials, but even testing for materials can have its pitfalls. [See Ask the Expert for more information.]

Fortunately, Nabors and the physicians he works with have found replacement materials that tend to be safe for the majority of patients. For patients who request safer materials, or who have been sent to him by a doctor for removal of toxic materials, generally he uses a white composite called Diamond Crown for replacement of smaller amalgams, and for larger amalgams or nickel crown replacements, he uses a ceramic crown material called Empress. Although Diamond Crown is somewhat more brittle than composites containing aluminum and barium, it is often chosen by patients and their doctors because it contains no metal.

Empress crowns, although more difficult to work with than standard nickel-beryllium crowns, are very strong and can be made to look identical to teeth. Empress is also metal-free.

Removing mercury amalgams from your mouth and replacing them with safer materials is a good start, but does that end your problems? Many experienced doctors and dentists say no. After Nabors stopped using amalgam, a number of people with Multiple Sclerosis and other chronic diseases sought him out and asked him to remove their amalgams and replace them with safer materials. “I was curious to see if people would throw their crutches down and be miraculously healed. But nobody was. …I was a little bit disappointed.” Convinced that mercury’s toxic effects could be contributing to their problems, Dr. Nabors wondered what he was doing wrong.

Later, as he began working with doctors who specialized in heavy metal detoxification, he found out. “I was taking the amalgam out of their teeth, but I wasn’t doing anything for what had built up systemically that created the problem in the first place.” A characteristic of mercury is that it has an affinity to bond to sulphydral compounds [check to see if this is correct], like the ones found in human tissue. If left alone, the mercury that has been absorbed into a person’s body will remain there, bound up in their tissues, and can continue to affect their health.

“It isn’t until you actually chelate some of [the mercury] out of there that you start getting the benefits. …It’s kind of a two-way street. It comes out of the mouth, and then you have to take out what is still left in the body.” Practitioners like Dr. Biddle use combinations of amino acids and natural supplements to bind the mercury and pull it out of their patients’ tissues. Chelation can be done with oral supplementation or with i.v. solutions, depending on the practitioner.

After Dr. Nabors began working with patients who were doing chelation along with the removals, he began seeing the dramatic results he had been hoping for. Bruce Pike, a patient with “terminal” leukemia whose white blood cell count dropped dramatically after having several large fillings removed, and another man whose failing sight began coming back immediately after the removal of two nickel crowns.

It is illegal for dentists to tell their patients that removal of mercury amalgams can cure diseases or alleviate symptoms, and Dr. Nabors is careful always to let the doctors he works with do the diagnosing. “I prefer to work with another health practitioner, a physician …If I’m taking out these amalgams and replacing them with biocompatible materials, they also need to chelate it out of their system. In order to get the full benefit, that’s what they need to do. The only way that I do take them all, totally out for people, is if they’re working with somebody on a program, and it’s the doctor’s recommendation that they come out, rather than mine.”

As more and more people demand safer dental materials, many scientists, doctors, and dentists are speculating about when and how the U.S. will follow in the footsteps of the European countries that have changed their laws and regulations regarding mercury amalgams and other toxic dental metals. Until it does, patients who are concerned about toxic metals and their potential to cause immune system dysfunction, neurological symptoms, and a variety of illnesses will continue to seek out physicians and dentists who can help them with dental material removal and detoxification. And some will end up like Bruce Pike, Dr. Nabors’ leukemia patient, a police detective who was given six months to live three years ago. “I am back at work and feeling great! Having those fillings removed was the best thing I’ve ever done.”

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