- Pamela MacArthur was a healthy artist who loved to ballroom
dance when a trio of bizarre symptoms stopped the music.
- Her body suddenly started to twitch, she had nightmares
and her face erupted in boils so painful that it hurt to roll over in bed
and touch the pillow.
- Doctors suggested drugs for acne and psychological disorders,
but MacArthur turned instead to her dentist. He removed nine metal fillings
and replaced them with plastic substitutes, and soon she was doing the
- MacArthur, 40, of metro Atlanta, is one of a growing
number of people who believe their medical problems are caused by mercury
in dental fillings. Even though dentists often refer to metal fillings
as ``silver,'' they are an amalgam of half mercury and the other half a
mixture of silver, copper, tin and zinc.
- The dental community is sharply divided over whether
mercury in fillings is harmful. The American Dental Association stands
firmly behind such fillings, saying they only rarely cause problems, in
people with mercury allergies, and are more durable than the alternatives.
Meanwhile, a legion of ``mercury-free'' dentists insists that their mercury-using
colleagues are slowly poisoning patients because the fillings release the
element into the blood. Research findings are mixed.
- Lawmakers are starting to say that patients have a right
to hear about the pros and cons of mercury fillings. A bill introduced
in the Georgia Legislature in March would require dentists to tell patients
about the risks of, and alternatives to, the fillings. The bill, by Rep.
Bob Holmes (D-Atlanta), 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
to strengthen its dental mercury regulations with new guidelines for labeling
and reporting of side effects, and the National Institutesof Health is
spending $9 million for two large studies of mercury fillings in chidlren.
- Last week, lawsuits were filed against dental groups
on behalf of nine Georgia children with autism, claiming that mercury from
their mothers' fillings caused the disease and arguing that dentists deceive
patients by calling the fillings ``silver.'' Suits in California and Maryland
have accused the American Dental Association of imposing a ``gag rule''
forbidding anti-mercury dentists from having open discussions with patients.
- Caught in the middle are the patients, who don't know
whether to rush out and get rid of those shiny spots in their teeth. 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 temporarily, the procedure is more risky for people
who feel fine.
- What is clear is 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. And mercury is a known neurotoxin. The question is whether the emissions
are high enough to cause health problems.
- GIVING `FALSE HOPE'
- 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 that has about 400 dentist members.
The average American has seven mercury fillings, Ziff said. ``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 and one of the ADA's main spokesmen on the issue, said
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 ADA 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,
- ``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 said. ``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
- 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 lead to a suggestion to remove
- Dressler performs another test to determine how much
mercury vapor is in the mouth. Holding a boxy instrument, he scrapes a
straw-like device around the gums, and the detector registers the gas.
- Mercury fillings are generally removed in groups, one-fourth
of the mouth at a time. They're usually replaced with composite fillings
of reinforced plastic resin or, sometimes, with other materials such as
gold or porcelain. During metal filling extraction, dentists use vaccuums,
air filters, eye covers, oxygen masks and rubber dams over teeth to protect
the patient from exposure to excess mercury.
- But the process can increase the body's mercury load
before decreasing it. To reduce systemic mercury, patients are advised
to use some form of chelation, in which drugs that bind to metals are taken
orally or intravenously, eliminating the metals through the urine.
- Dr. Mark Merlin, a physician at the Atlanta Center for
Alternative Medicine in Dunwoody, who tests many patients for mercury,
said 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.''
- Merlin prescribes amino acids, herbs, vitamin C and intravenous
drips of DMPS, a chelating agent. The treatments cost at least $1,000 over
several months and often aren't covered by insurance. Health plans generally
cover the cost of about $100 per mercury filling, but they often don't
pay the additional cost of plastic fillings. Those fillings may run $150
- `TIME BOMB' IN MOUTH?
- Many patients who have had their mercury fillings removed
and undergone chelation say the process is worth the price. MacArthur,
the ballroom dancer, had her fillings out nearly three years ago. Her nightmares
and body twitches disappeared immediately, and her facial boils gradually
- ``I had a time bomb ticking in my mouth,'' she said.
``You could never convince me that it wasn't mercury.''
- 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
- 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.
- CONFLICTING RESEARCH
- 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
- 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.