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Mercury Amalgams: Now safe for kids! (Update 11)

Posted Sep 14 2008 5:31pm

(Posted by Patrick Sullivan Jr.)

In the past 24 hours, I've had 5 people email this AP story about 2 new studies that show no harm, no foul for kids that were given mercury fillings. Wade Rankin was the latest to send me an email linking to his post on the subject. Here's the comment I left on his blog:

Wade, good comments. While we delve into the thimerosal/autism debate, mercury amalgams are really the Sullivan's major bogey. I first heard about this study several months ago when Consumers for Dental Choice filed a formal ethical complaint (or whatever it's called) with the researchers of this experiment. Using a known toxin on indigent children is good how?

Then, last week, I was CC'ed on what seemed like 25 different emails going back and forth with members of the IAOMT and Consumers for Dental Choice. Since I've mostly been holed up working on another project for the last 9 days, I mostly just skimmed the emails going through. (I still need to go back and read through them more carefully as there are numerous rebuttals proposed.)

What is surprising to me is, all the sudden, mercury amalgam is in the "big" news. I've had 5 different people email this story to me in the last 24 hours. I had no idea how much press this was getting! My goodness, if it's "good" news about mercury amalgams, how is that able to spread so far and wide?

So in the AP article, I guess I'm glad that at the very least, dissenting comments from Charlie Brown of Consumers for Dental Choice and mention of IAOMT made it into the article. Though that is sort of like being thankful for the crumbs that fell from the master's table!

Quite frankly, it's still a positive thing for this to be in the news because we can (re)point people who's interest is peaked to one of the best compilations on the subject, The Scientific Case Against Amalgam from the IAOMT.

And speaking of the IAOMT, they really are in an uproar over the ethical lapse of experimenting with a known toxin on indigent kids without giving any sort of consent. So expect to hear more from them SOON if the press cares to pay any attention to a dissenting opinion from the status quo.

And oh yeah, if mercury amalgams are all fine and dandy, then why the heck did Pat drop $100K into the Jigsaw Health Foundation? Coulda bought a nice boat or something...

PS - My blog parody idea for "New scientific study shows that scientific studies are inconclusive, contradictory, biased, down-right confusing to Joe Public and should NOT be used under ANY circumstances to form an opinion. blah, blah, blah. More funding is needed complete this research." is long overdue.

I'll go through those emails from last week tomorrow if I get the chance and update this post. In the meantime, iIf there are any IAOMT members reading this blog, feel free to post your own comments on the studies.

UPDATE 1:Read Boyd Haley's criticism of these studies.

UPDATE 2: A letter to the editor:

Letters to the Editor:

Elements: Wrong to do, Outrageous misconduct, Designed to fail


Dr. Gupta:

Ever since you featured me as part of the Number One Medical story of the last 25 years I have been a big fan or yours and have enjoyed the many enlightened reports you do for CNN.

Sadly, your network and your viewers were done a major disservice yesterday by publication of a study that was designed to fail.

I urge you to read the attached observations from Dr. Boyd Haley, PhD who explains the flaws in the study far better than I can.

Let me just add this to make my interest in the matter clear. In addition to being a leukemia survivor whose life was saved by participation in a clinical trial for STI-571, now marketed as Gleevec, I had the privilege of working for the Committee on Government Reform and Oversight of the U.S. House of Representatives for three years. Since then I have become a Congressional Relations advisor to several respected organizations in the wellness industry, including the International Academy of Oral Medicine and Toxicology.

During my congressional employment I coordinated several Congressional Hearings on mercury-containing dental amalgam. My clear impressions were that the anti-mercury dentists and scientists who testified at those hearings based their opinions on solid science. The representatives of the pro-mercury groups, including the American Dental Association, the Food and Drug Administration, and the National Institute of Cranial facial and Dental Research of the National Institutes of Health gave notably unpersuasive, unscientific testimony. The pro-mercury groups seemed to work very hard to justify their past and continued use of a potent neurotoxin that has been banned from very other facet of medical treatment, including teething powder, mercurochrome, merthiolate, contact lens solutions, and even horse liniment.

I first heard of the Children's studies during one of those hearings, and I wondered at the time whether they would be based on solid science, or on the need to justify past practices. Now the answer is clear. Science lost out.

Do these reports represent a deliberate cover-up or were they the result of ignorance? Before you brush aside the notion that highly trained professionals might be accused of ignorance, one must consider the specifics of their training. Dentists and dental materials specialists have little no training in toxicology, neurology, biochemistry, or any other discipline that would help them understand the connection between mercury poisoning and various neurological problems.

Consider this. Painters did not identify and solve the lead-based paint problem. Tobacco companies did not raise the red flag about diseases connected to smoking. Asbestos manufacturers did not alert their workers and the public to the health hazards of asbestos.

Similarly, the dental industry cannot be expected to solve the mercury toxicity problem. They just don't have the knowledge.

In my opinion, the startling increase in cases of ADD, ADHD, Fibromyalgia, lupus, Autism, and Alzheimer's disease constitute iatrogenic epidemics that can and should be stopped. That will happen only when the emphasis is placed on true science and not on protecting past practices.

I sincerely thank you for your interest, and I urge you to study Dr. Haley's document.

John Rowe
Baltimore,

UPDATE 3: Were these studies ethical? According legal precedent, no. Sandra Duffy from Consumers for Dental Choice wrote in an email:

The Grimes case focused in on the legal requirement that there must be the possibility of some benefit for the subject .... and in the Grimes case the kids got dosed with lead but no treatment protocol ... so it failed the test according to the court.

...Grimes IS analogous despite the dentists' claim that dental care is a treatment benefit of the trial. No it is not. The mercury fillings have been an informal experiment for 170 years. Making it a formal experiment for 7 years doesn't transform a negligent standard of care into a beneficial standard of care. As I noted in my Op Ed piece to the Oregonian, when the U of W investigators were applying for the grant they said THEY ACTUALLY WROTE THAT they used children because they were more sensitive to neurological damage and would show more harm. Good grief!

Consumer for Dental Choice's full critique of these two studies can be read here.

UPDATE 4: Criticism from Dr. David Kennedy, past-president of IAOMT.

  • Grossly inadequate informed consents both in the US and Portugal and in Portugal did not tell the guardian parent they were implanting mercury silver dental fillings.
  • The very questionable ethics of experimenting on indigent and orphaned children with a very
    toxic heavy metal looking for neurological impairment. Mercury poisoning in childhood is not necessarily reversible even with medical intervention.
  • The information is not new and these experiments make no meaningful contribution to the body of knowledge
  • Poorly designed and did not even try to identify vulnerable subsets
  • Used spot urine which has never been an adequate measure of chronic mercury toxicity (CMT)
  • Cost was enormous. So far the NIH has funded over 500 studies and only a handful have been published and they have all confirmed exposure to mercury
  • Lack of disclosure in the published article such as membership on the trade associations that advocate amalgam use
  • Did not disclose a 10 year child abuse scandal at the Casa Pia school for orphans in Portugal (would obviously skew the data on neurological impairment)
  • Did not disclose the ethical complaints being investigated by NIH
  • Used toxic composite that contained carcinogens instead of ones rated Zero by ANSI
  • High drop rate and meaningless tests for mercury

UPDATE 5: Read Dr. Needleman's editorial that appeared in the same issue of JAMA as these two studies.

"It is predictable that some outside interests will expand the modest conclusions of these studies to assert that use of mercury amalgam in dentistry is risk free. This conclusion would be unfortunate and unscientific."

More updates to follow? If this isn't enough, then heck yeah.

UPDATE 6: More from Dr. David Kennedy. Looking for a non-Klingon sounding critique? Then read this!

From all the knowledge that we have about mercury exposure and its consequences this study did not address even one of those known short term effects. Those investigators who have examined urine have unanimously concluded that there is little correlation between urine mercury and exposure, body burden and any physiological or psychological effects. This study inaccurately relied upon urine and blood mercury as its only measurement of exposure. Statistical significance is irrelevant if the investigators are comparing the wrong things.

Moreover, a more careful examination of the minimal data displayed in this report does however raise serious concerns about the impact of mercury on these children.

UPDATE 7: Need a refresher?

Mercury Amalgam Label

UPDATE 8: Via email from Amy Carson of Moms Against Mercury:

For Immediate Release
April 25, 2006

Contact: Bert Hammond (202) 225-7084, Lois Hill Hale (323) 965-1422

Press Advisory -- Reps. Watson and Burton Criticize NIH Studies on Mercury Dental Fillings Schedule Press Conference for Thursday, April 27, at HHS

Washington, DC — Representatives Diane E. Watson (CA) and Dan Burton (IN) will hold a press conference on Thursday, April 27, 2006, in front of the Department of Health and Human Services, 200 Independence Ave., SW., at 11:00 AM.

Reps. Watson and Burton will discuss their serious concerns about two studies commissioned by the National Institute of Health (NIH) and published last week in JAMA on the safety of mercury dental amalgams. The government-funded studies found no evidence that dental fillings containing mercury are a health risk for children. The studies, however, did not look at the health effects of mercury amalgam on two groups that may be more susceptible to unhealthy concentrations of mercury in the body: older adults and pregnant women and their infants.

The studies also did not assert that use of mercury amalgam in dentistry is risk-free. In fact, an editorial printed in the same edition of JAMA by Herbert L. Needleman, MD, a recognized authority on lead toxicity, cautioned against using the two NIH funded studies to conclude that the use of dental amalgams in children poses no significant health risks.

One study commissioned by NIH tracked minority children in inner-city Boston and low-income children in Maine. The other traced children at an orphanage in Portugal. Both studies failed to disclose the risks of mercury exposure to the children, parents, or guardians – a fact that has led the HHS’s Office of Human Research Protections to open a comprehensive investigation about the medical ethics of the studies.

Immediately following the press conference, Reps. Watson and Burton will deliver a letter outlining their concerns about the studies to HHS Secretary Leavitt.

Reps. Watson and Burton are cosponsors of H.R. 4011, The Mercury in Dental Fillings Disclosure and Prevention Act, which prohibits after 2008 the use of mercury in dental fillings.

Additional speakers at the press conference are
- Charlie Brown, Consumers for Dental Choice;
- Amy Carson, Moms Against Mercury;
- Dr. Richard Fisher, International Academy of Oral Medicine and Toxicology (IAOMT).

Five nonprofit groups, led by the group Moms Against Mercury, will be filing a lawsuit against the FDA that addresses the agency’s failure to classify mercury dental amalgam or to ever approve its safety. The suit petitions the court to halt the use and sale of mercury dental amalgam immediately.

Find out more at the Congresswoman's official website: http://www.house.gov/watson/

I guess nothing rallies the troops like bad news.

UPDATE 9: Bernie Windham weighs in, heavily.

Preliminary Comments on Neurobehavioral Effects of Dental Amalgam in Children, T. A. De Rouen, et al, JAMA, April 19, 2006

In justifying the study design the authors state on page 1 that there is little or no evidence concerning health effects of low level mercury exposure from amalgam, especially in children. In fact, there are over 3,000 peer-reviewed studies in the medical literature(3) that were submitted by parties in the FDA amalgam docket to the FDA (4), that document the mechanisms by which mercury(from amalgam) commonly causes over 30 chronic health conditions. And there are hundreds are peer-reviewed studies and clinical studies that document that many thousands of patients with these conditions have improved after amalgam replacement(2). While it is clear that hundreds of thousands (or millions) of children have had their health adversely affected by mercury, since there are multiple exposure mechanisms its not clear the extent to which dental amalgam is responsible(7).

But the main problem with the study design appears to be the choice of what conditions were tested for and the kinds of tests that were used. In describing why the chosen conditions were tested for and in what manner, the authors stated on page 2 of the study that the target organs for elemental mercury exposure from amalgam were identified to be the renal system and neurological functions(memory, attention/concentration, and motor/visuomotor). Actually, while there is documentation in the medical literature of many other types of health effects, there is little evidence in the literature on common renal effects.(1,2,3). And there are other types of health effects that have been well documented in the literature to be more commonly caused by mercury than attention or memory(though these also have been documented to be commonly caused by mercury exposure).

The following analysis shows that the basic assumptions that the authors say they based their study design on were not valid, and the study does not demonstrate what it has been suggested to demonstrate. In fact, due to the poor study design the study is not very useful. It had been documented by millions of medical lab tests that those with amalgam fillings commonly have mercury exposures between 5 and 10 times that of the average person with no amalgams (5), and that mercury accumulates in the brain and major organs in direct proportion to the number of amalgam surfaces. It has likewise been documented in the medical literature by thousands of studies that mercury and other toxic metals exposures are synergistic and cumulative, and commonly cause chronic autoimmune, neurological, hormonal, and reproductive problems later in life(3), depending on individual susceptibility(6).

Thus it was clear that the study design exposing children to a known highly neurotoxic and immunotoxic substance that commonly causes adverse effects was highly unethical. And also, the effects that might happen in the early years of exposure has little relevance to whether amalgam is safe as a filling material.

The study was not designed to determine anything about the long term health or safety effects on this population of children. Or even on the most common types of conditions known to be commonly caused by dental amalgam or the types of cardiovascular effects found in a similar test of children from the Faeroe
Islands.

Questionnaire results of 1569 patients (1) regarding health problems that have been documented to be commonly caused by mercury toxicity found the following
distribution:

Condition % with Condition % improved after Amalgam Replacement

Fatigue/lack of energy (12) 51% 86%
Headaches/migraines (8) 37% 87%
Allergy/skin conditions (10) 34% 84%
Vision Problems 29% 63%
Cardiovascular problems(9) 27% 70%
(tachycardia/irregular heartbeat/high blood pressure/chest pain)
Depression/anxiety (11) 27% 90%
Dizzyness(could be cardio) 22% 88%
Oral conditions (13) 20% 85%
ADD/lack of concentration 17% 80%
Memory Loss (8) 17% 73%
MS/Parkinson’s/tremor(10) 15% 78%

Similar patterns and recovery results after amalgam filling replacement have also been documented in a larger group of over 60,000 patients(2). Thousands of peer-reviewed studies documenting the mechanism by which mercury commonly causes these conditions are in the literature(3). It is seen that there are 8 major types of health conditions known to be caused by mercury that are more commonly seen in the population than the types of conditions that these studies chose to attempt to test for.

And in all of those types of conditions, peer-reviewed studies and clinical studies have found that the majority of those who had amalgam fillings replaced properly had health improvement after replacement. There are few studies documenting significant renal effects from dental amalgam exposure, so it's not clear why the authors chose to test for renal effects. There is some question as to what the study being reviewed actually measured regarding neurological effects, since other studies have documented that mercury from amalgam and other toxic metals commonly cause ADD/attention deficit(7), as well as memory problems(perhaps more later in life)(8) and that the majority with such conditions usually improve after amalgam replacement.

It should also be noted that since the effects of toxic exposures are known to be synergistic and cumulative, the results of a study in one country or population do not necessarily apply to another country or population- that has significantly different patterns of toxic exposures, such as the extremely high mercury thimerosal exposures to children in the U.S. in the 1990s which are documented to have significantly impacted that population(7).

SOURCES:
(1) Patterns of chronic conditions in 1569 patients and percent recovery after amalgam filling replacement,
http://www.home.earthlink.net/~berniew1/hgrecovp.html
(2) Results of amalgam filling replacement in over 60,000 patients monitored by
peer-reviewed or clinical studies,
http://www.home.earthlink.net/~berniew1/hgremove.html
(3) Mechanisms by which mercury(from dental amalgam) commonly causes over 30
chronic health conditions (over 4,000 peer-reviewed & Gov’t studies cited),
http://www.home.earthlink.net/~berniew1/indexa.html
(4) Listing and abstracts and compilation of medical studies submitted to the
FDA dental amalgam safety docket,
http://www.flcv.com/fdatally.html
http://www.flcv.com/fdarev.html
http://www.flcv.com/fdarevl.html
(5) Dental amalgam is the largest source of both inorganic and methyl mercury in
most people with dental amalgams,
http://www.home.earthlink.net/~berniew1/damspr1.html
(6) http://www.home.earthlink.net/~berniew1/suscept.html
(7) http://www.flcv.com/tmlbn.html
http://www.flcv.com/kidshg.html
http://www.flcv.com/autismc.html
(8) Mechanisms by which mercury is documented to cause neurological conditions,
B Windham(Ed) –over 150 cites,
http://www.home.earthlink.net/~berniew1/neurohg.html
(9) Mechanisms by which mercury is documented to cause cardiovascular
conditions, - over 150 cites,
http://www.home.earthlink.net/~berniew1/cardio.html
(10) Mechanisms by which mercury is documented to cause
autoimmune/immune conditions, over 150 cites,
http://www.home.earthlink.net/~berniew1/ms.html
http://www.home.earthlink.net/~berniew1/immunere.html
(11) Mechanisms by which mercury is documented to cause depression/mood
disorders, over 100 cites,
http://www.home.earthlink.net/~berniew1/depress.html
(12) Mechanisms by which mercury is documented to cause
fatigue/CFS/FMS, over 150 cites,
http://www.home.earthlink.net/~berniew1/cfsfm.html
(13) Mechanisms by which mercury is documented to cause oral conditions, over
100 cites,
http://www.home.earthlink.net/~berniew1/periodon.html

B. Windham, Research Director and President, DAMS, Intl.

Yeah, not much science there.

UPDATE 10: I got this via email from Amy Carson, (lead?) plantiff in Moms Against Mercury vs. Leavitt.

For Immediate Release
April 27, 2006

Contact: Bert Hammond (202) 225-7084, Lois Hill Hale (323) 965-1422

Representative Diane E. Watson Questions Recent National Institute of Health Studies on Mercury Dental Fillings

Washington, DC — Congresswoman Diane E. Watson (CA), along with Rep. Dan Burton (IN), today held a press conference in front of the Department of Health and Human Services (HHS) to discuss their serious concerns about two studies on mercury fillings (amalgam) commissioned by the National Institutes of Health (NIH).

The government-funded studies found no evidence that dental fillings containing mercury are a health risk for children. The studies, however, did not look at the health effects of mercury fillings on two groups that may be more susceptible to unhealthy concentrations of mercury in the body: older adults and pregnant women and their infants.

The studies also did not assert that use of mercury fillings in dentistry is risk-free. In fact, an editorial by Dr. Herbert L. Needleman, printed in the same April edition of the Journal of the American Medical Association in which the two NIH-funded studies appear, cautions against using the studies to conclude that the use of mercury fillings in children poses no significant health risks.

One study commissioned by NIH tracked minority children in inner-city Boston and low-income children in Maine. The other traced children at an orphanage in Portugal. Both studies failed to disclose the risks of mercury exposure to children, parents, or guardians – a fact that has led the Department of Health and Human Services’ (HHS) Office of Human Research Protections to open a comprehensive investigation about the medical ethics of the studies.

Immediately following the press conference, Reps. Watson and Burton delivered a letter to HHS Secretary Leavitt. HHS’s Assistant Secretary for Legislative Affairs (see attached photo) accepted the letter on Leavitt’s behalf. The letter criticizes the Food and Drug Administration (FDA) for permitting the sale of mercury fillings without having classified the substance and certified that the product is safe. The letter also addresses the NIH-funded studies on mercury fillings.

Reps. Watson and Burton are cosponsors of H.R. 4011, The Mercury in Dental Fillings Disclosure and Prevention Act, which prohibits after 2008 the use of mercury in dental fillings.

The complete text of Congresswoman Watson’s remarks follows:

“Who can conclusively say dental mercury is safe when in our bodies? Mercury amalgam is considered dangerous before it is put in the mouth, and according to the government, must be labeled a hazardous waste coming out of the mouth. How is it safe while in the mouth? I have been advocating for dental safety and informed consent for over 14 years.

“When the California Senate Health and Human Services Committee, which I chaired, brought up the fact that tobacco should be banned from public places in the 1980s, everyone thought that we were crazy. The widespread use of lead paint was also overlooked as a health hazard. Both of these substances are highly dangerous to human health, but the fact that mercury is only one periodic element removed from radioactivity is even more alarming.

“I fail to understand why the FDA would ban mercury in disinfectants such as Mercurochrome, warn against mercury in fish, and even ban mercury in all veterinary products, yet continue to allow its unregulated use inches from a child’s brain. Fully ten years ago, Health Canada ordered an end to amalgam for pregnant women and children under six. Since then, the United Kingdom stopped its use for pregnant women, and Scandinavian countries are phasing it out altogether.

“I want you to consider the fact that there has not been one argument or study provided to justify the FDA permitting the sale of a product that is 50% mercury, a product that was never proven safe in the first place. The FDA is allowing the sale of mercury amalgam, so-called “silver fillings,” without classification as the law requires, without demanding that manufacturers prove they are safe, and without disclosing to the American people that they are constantly exposed to toxic mercury. It is an undisputed fact that mercury vapor is released during the entire life of a mercury filling.

“Equally alarming, FDA has never written an Environmental Impact Statement on a product that is the major source of toxic mercury in our wastewater. Dentists’ offices are one of the major sources of mercury pollution in our environment. Continuing to allow mercury amalgam to be sold makes no environmental sense. Alternative materials are available for every kind of cavity.

“A study released last week, involving administering mercury fillings to Portuguese orphans and low-income New England children, raises more questions than answers. In an editorial in the Journal of the American Medical Association, Dr. Herbert Needleman, an early whistleblower on the impact of incremental lead exposure on children, cautions that the study in no way exonerates mercury fillings; he calls for immediate attention on the impact of mercury amalgam on vulnerable populations. The fact is these researchers are implanting into children a material that is 50% mercury and known to emit mercury vapors. It is a dereliction of duty to place a toxic material into any patient, above all a child, and especially if the level of toxic exposure is not defined.

According to Professor Boyd Haley, Chemistry Department Chair at the University of Kentucky, these studies were poorly designed and tell us just one thing of value: children with amalgams most likely slowly lose their ability to excrete mercury after about two years of amalgam exposure. He further questions the medical ethics of the study and states that it should have been done on primates, not humans. The Office of Human Research Protections, the federal agency which guards against wrongful experimenting on children, has similar concerns. The agency is examining the principal investigators of these experiments for withholding information about risks and other alleged improprieties.

“In conclusion, I commend the FDA for announcing hearings in September regarding the neurotoxicity of mercury amalgam. I plan to testify. Moreover, I hope my colleague, Congressman Burton, plans to do the same. But let’s be clear, hearings alone are not the answer. FDA must do its duty – address the environmental impact of mercury fillings, require proof of safety, and level with the American people about the fact that “silver” fillings aren’t really silver.

“I am also pleased to announce that a lawsuit has been filed by Moms Against Mercury, four other nonprofit organizations, a state lawmaker, and a state dental board member. The suit raises substantial questions about FDA’s failure to regulate mercury amalgam. Toxic Mercury has been unclassified for too long. At best, FDA is trying to keep the product on the market via a loophole; at worst, it is shirking its duty to evaluate mercury fillings on the merits.”

Find out more at the Congresswoman's official website: http://www.house.gov/watson/

Is this really happening? Pinch me.

UPDATE 11: Yes, this post is getting long. But isn't that sort of the point? Here's a letter to the editor printed yesterday in the Washington Post. Boyds_letter_where_did_the_mercury_go

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