Mercury Safe Dentistry: Protect Your Patients – and Yourself

August 25, 2009 By Guest Author 15 Comments

Dr. Tom McGuire, DDS, a leading authority on the occupational safety of mercury in the dental office, addresses the sometimes confusing difference between "mercury free dentists" and "mercury safe dentists," and makes the argument that all dentists should be practicing mercury safe dentistry – and why.

Mercury Free and Mercury Safe: What's in a Name?

Strictly speaking, the term "mercury free" refers to dentists who do not put amalgam fillings in their patients' teeth. But over time, the term "mercury free" came to indicate those dentists who not only didn't put amalgam fillings into their patients teeth, but those who also safely removed them.

However, mercury free isn't really an accurate description because as long as dentists still remove amalgam fillings, their offices can't officially be called "mercury free." Therefore, mercury safe is a more accurate description of those who not only don't put amalgam fillings in teeth, but also remove them as safely as possible. Another way to put it is that safely removing amalgam fillings means you are dramatically reducing the occupational exposure to mercury at the dental office.

Thus, I encourage true mercury free dentists to use the term "mercury safe" to describe themselves if they not only do not place amalgam fillings but also use a safe protocol to remove them. There can also be distinct promotional advantages to being mercury safe. (You can click to access a list of amalgam removal protocols and read why they are so important.)

While I absolutely respect the right of pro-amalgam dentists to expose themselves to mercury, I don't believe they have the right to expose their patients, their staff and the environment to mercury – just because they've chosen to believe what the ADA tells them; that mercury amalgam fillings are safe.

It's one thing to believe that the mercury released from a patient's amalgam fillings on a daily basis isn't a health hazard. But it's another thing entirely not to offer the dental patient protection against mercury vapor exposure during the removal process. These are really two separate issues because there's a huge difference between the amount of mercury emitted from the fillings on a daily basis and the amount released during their removal at the dental office, up to 1000 times more during unsafe removal.

The only effective way to protect the patient, the dentist and staff, and the environment from unnecessary and excessive exposure to elemental mercury vapor is to make your office mercury safe. I simply can't imagine the ADA not supporting the practice of mercury safe dentistry.

Amazingly, the dental profession uses more mercury per year than any other business. In fact, it's the only industry using elemental mercury that isn't regulated by the government.

Written by Tom McGuire, DDS

Tom McGuire, DDS

Dr. McGuire and Dr. Paul Rubin will be presenting a one-day seminar on "How to Make Your Practice Mercury Safe" in San Francisco on September 26 and in Portland, OR on October 10. Learn more at www.NewDirectionsDentistry.com.This unique seminar is the only one of its kind available to dentists and nothing you could do for your practice will be as important to you, your staff and your patients' as making your office Mercury Safe.

Filed Under: Dental Editorials, Dental Safety Tagged With: amalgam, mercury

Jim Economos DDS

This continued rubbish about Mercury shows a complete lack in the knowledge of chemstiry. Iv’e been in the profession including school days for almost 35 years, including using the cloth technique of squeezing Hg out of a fresh amalgam mix. All of the blood testing I’ve had done, has showm mu Hg levels to be well below any noticible amounts including years of removing old Ag fillings.

It’s not a good thing to scare the public with false ideas where everything is bad for you. This is why we are seeing a paranoic reaction to just about everything mentioned by he lame media.

We as dental professionals should not contribute to this as it tends to get the government involved and then you have a bunch of lawyers telling us how to run our professional, if not personal lives.
Howard

First off, we haven’t placed amalgams in decades, so we have no personal stake in this.

I’m surprised to hear a healthcare professional say “just because they’ve chosen to believe what the ADA tells them; that mercury amalgam fillings are safe.”

This, to me, is not unlike saying “just because they’ve chosen to believe the empirical evidence that shows mercury amalgam fillings are safe.”
Dr. Gary Hochstetler

Or… how about the FDA saying that a drug is completely safe, only to come back a year or two later after people are sick and dying and then they remove it from the market. All of the studies, however, always show the drug with minimal side effects and completely effective. The empirical evidence demonstrated the drug safe. What happened? Odd how the studies seem to prove whatever it is you want them to show. I was a chemistry major too. True, the Hg reaction was complete and completely bound. But then as dentists, in order to make it usable, we add extra mercury which gets trapped in the crystal lattice structures. Free elemental mercury to leach out. What a deal! No problems? Why not try reading all of the studies (foreign as well), not just what is put out by the ADA. Does it really make sense that free mercury (remember vapor pressures) doesn’t leach out and cause problems?
Bill C., DDS

Since when is anyone who wants to promote his moneymaking “seminar” considered to be “a leading authority?”
On what grounds?
Is he an established professor at an accredited dental school? In which department?

Sheesh, if I call myself an “expert toxicologist” six times before lunch, does that make me one?
I guess that I can now call myself “a leading authority!” Why not?

There is a good reason why dentists are notorious for falling for various investment schemes in the world of finance. We make a good living, and we don’t bother to check the credentials or the credibility of those who try to sell us something.
If we fall for bad investments, we can also fall for bad substitutes for science.

In order to make a decision based upon scientific criteria, who are you going to believe — the PhD’s who do the actual research at the dental universities, the scientists at the FDA and the ADA, or some guy trying to sell you his seminar?
Bob Bowman

I’m happy that Jim doesn’t have any symptoms or health issues related to chronic mercury exposure but he is wrong about the blood testing. I’ve had numerous symptoms that could be associated with mercury exposure over a long period of time. I was shocked when I learned how many seemingly common symptoms could be related to mercury exposure, chronically. I ended up doing a lot of research in this area and discovered that the blood test for mercury isn’t nearly as accurate as testing for fecal metals. Unless he is free of any mercury related symptom he could still be mercury toxic. I’d recommend he have a fecal test for mercury. I appreciated the article and have been trying to make my office as mercury safe as possible and why not is my question? Bob
Tom McGuire, DDS

First I want to thank The Wealthy Dentist for the great information they provide. I’ve always believed them to be fair in their presentations, even when I’m not always in agreement. Plus they provide the opportunity to respond to articles and comments.

That said I want to address my comment/response to Jim Economos and anyone else who shares his point of view. I’ve been involved in the amalgam issue for over 30 years and there is one thing I learned, you really can’t have a logical, rational and scientific debate about amalgams being a health hazard or not, so I simply don’t engage anymore. I’ve found this subject to be more like religion and politics, where the focus is on faith and opinion.

But I’d like to forget about amalgam fillings for a moment and clear the air about mercury. It is the most poisonous, naturally occurring, non-radioactive substance found on our planet. Far more poisonous than arsenic or lead. There is no such thing a safe level of mercury and every atom of it in our bodies is doing some harm, regardless if a related symptom has expressed itself or not. And elemental mercury is elemental mercury regardless of the source. Indirectly its long-term effects can be even more harmful in that it seriously depletes essential antioxidants, making us more susceptible to other health problems. There are 100 symptoms, diseases and disorders associated with chronic mercury poisoning. This has been scientifically proven, is found in standard medical literature and is not debatable, nor controversial.

Governmental agencies regulate every facility using elemental mercury and have instruments that monitor the air in those facilities for mercury exposure that exceeds accepted amounts. Why, because they know that mercury is a powerful poison and that if levels exceed safety levels employees will start expressing symptoms of chronic mercury poisoning. Dentistry is the only industry using elemental mercury that isn’t regulated, even though the mercury vapor that is released during unsafe amalgam removal dramatically exceeds regulatory guidelines.

Just because the government has not yet seen fit to regulate the dental office for occupational exposure to mercury doesn’t mean the mercury that is released in placing amalgams and removing them is safe. It also doesn’t mean that somehow the elemental mercury used in amalgams is somehow different and the mercury vapor is somehow magically less harmful. It is the same mercury and it is just as toxic as the elemental mercury used in thermometers and other products (mercury based paint) and instruments that have since been banned because of the toxicity of mercury.

So I say, believe what you will but it is at your own peril that you take a position that mercury used in dentistry is harmless and cannot have an adverse affect on your health, or the health of your staff, or patients. I wonder what Jim’s argument to OSHA will be when they regulate the dental office for occupational exposure to mercury. I also wonder if his view of mercury, “This continued rubbish about mercury ….” would be a defense he could use if he were sued for not protecting his employees from occupational exposure to mercury. Simply hoping and believing that something is true doesn’t make it so.

I don’t believe that Jim is aware of the distinction I’ve clearly made between the health implications of mercury released from amalgams when in a person’s teeth and the mercury released from an amalgam when it is being unsafely drilled out. I made it clear that the seminar is about “Minimizing Occupational Exposure to Mercury at the Dental Office” and has nothing to do with what goes on in someone’s teeth.

Bottom line, the seminar is solely about how to make the dental office mercury safe, protecting the dentist, the staff, the patient and the environment. In doing so it will protect dentists from possible lawsuits and be a practice builder. Becoming mercury safe is simply is the right thing to do and in this situation, doing the right thing benefits everyone.
Karlj J. Muzikar, DDS

Clearly there are those dentists who prey on patients’ fears of “mercury fillings” and find ways to fatten their wallets by doing so. Now we have “experts” on the removal fattening their wallets by preying on dentists’ fears that they don’t know how to remove them safely. I wonder when the lawyers will begin to fatten their wallets by advertising for patients who have been wronged by a (what was the word that Dr. McGuire used?) “pro-amalgam dentist”. And what will follow that?
Karlj J. Muzikar, DDS

Oh, now I see what will follow this: you get on the Internet list of Dr. McGuire’s so that you can get referrals for more patients (to prey on). Click on the amalgam removal link above and see what a “pro-amalgam
dentist” is NOT doing to earn “mercury safe” status. (You might save the money you were going to fork out for the seminar, too.) It is noteworthy that “mercury safe dentists” have more powerful high volume suction than “pro-amalgam dentists”. I also find it noteworthy that if Dr. McGuire states repeatedly that if you are NOT an amalgam safe dentist then you are a pro-amalgam dentist. I don’t place amalgams, but I don’t try to pigeon-hole other practicioners to fatten my wallet on the internet either. Shame on you Dr. McGuire, shame on you for tainting your words to disparage the rest of us. You should take a very good look at what you are actually saying to the rest of us. You may not like the way we practice, but stating that anyone not in your corner is pro-amalgam is clearly horsepucky and you know it, too. Read what you write or have someone actually read it out loud to you.
Bob B., DDS

I love these blog comments. It looks like the amalgam folks have found a new whipping boy in Dr. McGuire. I find it ironic that I read the same material and didn’t have a negative response so I decided to expand my earlier comments. I started my practice using amalgams and thought they were a pretty good filling material and believed they were safe because no one told me otherwise. Then I started having some scary symptoms that weren’t getting any better no matter what I did. A patient finally brought up the mercury/amalgam connection and I finally started looking into it. Overtime, and it wasn’t easy, I gathered enough information to at least doubt the safety of amalgams and more than enough to make a link between my exposure to mercury at the office and my health problems. Once I told my physician and we started testing i was convinced there was a connection.

So in summary, I stopped placing them and slowly figured out how to make my practice mercury safe, thanks mostly to the IAOMT information. Many of my earlier symptoms improved and that was proof enough for me. Since all of the uproar about Dr. Mcguire’s article I decided to visit the seminar website. I didn’t see anything about arguing that amalgams are a health hazard. All I got was that dentistry is a high risk occupation because of mercury and that it would be prudent, for many reasons, to deal with the occupational exposure to it. I really don’t see this about being pro or anti-amalgam and I still think everyone is entitled to his/her opinion about that topic. What I read was that it is about being anti-mercury and finding out what you can do to protect yourself. After looking at the website I’m going to attend his seminar and it is a 2 hour flight for me.
http://www.holisticdentist.com David Lerner, DDS

I stopped using Amalgam the first time I was diagnosed with mercury toxicity in the early 80′s. After much suffering I learned how to detox and restore my health. I didn’t become a mercury safe dentist until I was ill with mercury toxicity the second time in the mid 90′s. I say Right on Tom !!
http://www.fitzroydental.com.au Cosmetic Dentistry Melbourne

There is no real protection from mercury exposure here for children and unborn fetuses.
Don K, DDS

For Cosmetic Dentistry Melbourne
I’ve been mercury free for 9 years and pretty much as mercury safe as I know how for the past two. I’m not sure what your comment means but as for children I don’t see why the same safe removal process can’t be done for children as well as adults. We protect them in our office. As for the fetus, what Ive read is that the mother should be protected during removal of amalgams but I also believe that the best protection for the fetus is that the mother not get amalgam fillings or have them safely removed before conceiving. But it is hard to get information about this subject, one way or another. I do know that when amalgams were being phased out before they were banned in Denmark, Norway and Sweden, dentists weren’t allowed to put them into teeth of pregnant and nursing mothers and children under 18.
Sandra Duffy

This comment is specifically directed to Economos (#1), Says (#2), Bill C. ((#4) and Muzikar (## 7 and 8):

The scientific evidence is overwhelming that mercury vapor is emitted from amalgams. The conclusion from the World Health Organization is that amalgam is the primary source of mercury for most people and it exposes them with 3-17 mcg/hg per day averaging 10 mcg/hg per day. The USDHHS maximum allowable dose is 3.2 micrograms and Health Canada levels are .98 micrograms per day. Mercury vapor is absorbed into the lungs at 80% efficiency (Reinhardt JW) and causes a wide range of adverse systemic effects. See “The Scientific Case Against Amalgam.” http://www.iaomt.org/articles/files/files193/The%20Case%20Against%20Amalgam.pdf

I am a lawyer who has been trying cases for 31 years (don’t worry, I’m a government lawyer, so I won’t be suing any of you). I can tell you the causes-of-actions that might be brought against you:
(1) Lack of informed consent. Are you telling your patients that “silver fillings” are 50% mercury, that they emit mercury vapor in excess of government denoted “safe” levels and that there are alternatives? The amalgam manufacturers warn dentists of the risks of amalgam. If you do not pass that warning on to your patients, you could be held liable for harm. You are considered a “learned intermediary,” which means when the patient sues, the manufacturer will be off the hook because it gave its warning (see the Barnes v. Kerr case), and the dentists will be left holding the (liability) bag. Based on a Zogby poll, 92% of dental patients believe that their dentist should be required to inform them of the mercury content of amalgams, and 77% would pay more for a mercury-free alternative fillings. http://www.thewealthydentist.com/surveyresults/16_MercuryAmalgam_Results.htm

(2) Consumer fraud. The magazine, The Wealthy Dentist, did a survey and found that more than 80% of dentists use the term “silver fillings” when describing amalgam. http://www.thewealthydentist.com/blog/1005/dental-amalgam-opinions/
In most states it is consumer fraud to call a product by a minor component of the product (ex. you can’t call it apple juice if it is 70% pear juice). Since amalgam is approximately 50% elemental mercury and 30-35% silver, it is consumer fraud to call them silver fillings.

(3) Common law fraud/Assault and Battery. I have been made aware of several situations where dentists are specifically told by parents not to place mercury amalgam dental fillings in their children, only to find out when they get home that amalgams have been placed. One dentist, when confronted, even claimed that the filling was ALL silver and contained no mercury. (Assault and battery is an unconsented touching that does harm.)

(4) Malpractice/personal injury/negligence. Hundreds of thousands of dental patients know that they have been injured by the mercury in their dental fillings. Their treating doctors and dentists have seen the “before” and “after” condition of their patients. Dentists have a duty of care to their patients. A survey by the Wealthy Dentist indicates that 52% of dentists are now mercury-free. http://www.thewealthydentist.com/surveyresults/16_MercuryAmalgam_Results.htm
It can be argued that the standard of care no longer includes the use of amalgam fillings (in fact, I would assert that even when 95% of dentists were using amalgam, that the profession, as a whole, had adopted a negligent standard of care). The ADA sits smug thinking that lawyers will be unable to prove direct harm from amalgams. But the ADA will continue to seek dismissal of cases against it, claiming it owes no duty of care. It has worked in the past. Tolhurst v. Johnson & Johnson. ADA stated to the California court:
“The ADA owes no legal duty of care to protect the public from allegedly dangerous products used by dentists. The ADA did not manufacture, design, supply, or install the mercury-containing amalgams. The ADA does not control those who do. The ADA’s only alleged involvement was to provide information regarding its use. Dissemination of information relating to the practice of dentistry does not create a duty of care to protect the public from potential injury.”

The easiest cases to prove will be those showing amalgam causes periodontal disease.
http://www.iaomt.org/testfoundation/vimyresponds.htm

Dr. Panini from Ohio State has found nanogram amounts effecting the plasma membranes on coronary arteries and their ability to function normally when poisoned by mercury.

JA Rothwell has found a significant linear correlation between amalgam and hearing loss. He concludes: “This provides further argument for the use of amalgams to be phased out where suitable alternatives exist.”

This is the veritable scientific “tip of the iceberg.”

One of the dentist comments to the survey asserts that it is malpractice to overstate the dangers of amalgam. Has this dentist done his research on the safety of amalgams? It is malpractice to understate the dangers of amalgam, especially when you haven’t done your homework, but rely blindly on the ADA, FDA, CDC. Those organizations will be scurrying from the lawsuits while you are left to defend.
http://www.dentalwellness4u.com Tom McGuire, DDS

I think Sandy Duffy is right on regarding the legal risks of not making the dental office mercury safe. But I’m sure that there will be those who disagree with her.

It is obvious that it is impossible to find common ground with those who believe that amalgam fillings are safe and harmless and/or those who feel it is unnecessary to protect the patient, staff and environment from occupational exposure to mercury at the dental office. While I believe not placing amalgams is a good first step (for whatever reason the dentist chooses not to put them in), and will help reduce mercury exposure, it is only a first step. But it isn’t enough to just be mercury free when it comes to minimizing occupational exposure to mercury released during unsafe removal and only being mercury free offers no protection in a court of law.

For those of you who are uncertain, curious, or are simply looking for more information about the need for, benefits and value of making your practice mercury safe and minimizing occupational exposure to mercury at the dental office I encourage you to go to http://www.newdirectionsdentistry.com. It presents our point of view in a more organized and in-depth way than has been presented here. It will then be a simple matter to compare our position on mercury safe dentistry with what those opposed to it have said in these blogs.

And for those who still don’t think dentists and staff are at greater risk for health problems related to chronic mercury exposure I suggest reviewing the studies on the links section on the newdirectionsdentistry.com website. It should also be noted that because mercury depletes the body of essential antioxidants and dramatically increases free radical production, that it will indirectly increase the risk of many other health problems.

Tom McGuire, DDS
http://www.irishtimes.com/legal/medical-malpractice/ medical malpractice claim

If any person is suffering from the medical malpractice then he should have the right to get medical malpractice compensation claim so that he can get the full amount of the negligence of the physician..It the responsibility of the doctor to avoid such mistakes to be happen if he does not give u compensation then you can move to the court in order to get better settlement .The court will provide the full support in order to get the medical negligence claim