Dental AMALGAM and Mercury

According to Miriam Webster's OnLine Dictionary Amalgam: is an alloy of mercury with another metal that is solid or liquid at room temperature according to the proportion of mercury present and is used especially in making tooth cements. Mercury, according to Webster's, is "a heavy silver-white poisonous metallic element that is liquid at ordinary temperatures and is used especially in scientific instruments -- also called quicksilver". The word Amalgam comes from the Arabic al-malgam, meaning softening ointment (presumably because, when it is first mixed, it is soft and putty-like). Amalgam is the word for the liquid or solid alloys of mercury with other metallic elements or alloys.

In some countries dental amalgam is classified as a medicine. If that were the case in the United States it would be subject to many more regulations than it is now. As far as the U.S. Code of Federal Regulations is concerned amalgam is a prosthetic device and not a drug:

Amalgam Alloy, (a) Identification. An amalgam alloy is a device that consists of a metallic substance intended to be mixed with mercury to form filling material for treatment of dental caries. (b) Classification. Class II (21 CFR 872.3050 (2001)).

What is an alloy? According to Webster's an alloy is a "substance composed of two or more metals or of a metal and a nonmetal intimately united usually by being fused together and dissolving in each other when molten." Therefore, strictly speaking, given this definition, "amalgam is not a true alloy. It is made up of 50% mercury, which is not locked into a set filling but escapes continuously during the entire life of the filling in the form of vapor, ions and abraded particles" according to the Australasian Society Of Medicine And Toxicology (ASOMAT) fact sheet, which contains an extensive bibliography.

To this day there are still dentists who believe mercury amalgam is stable despite hundreds of observations and studies proving the opposite. As early as 1883 amalgam was proven to give off mercury vapor sufficient to shorten the life of the hardy cockroach (Talbot E. S., "Injurious Effects of Mercury as Used in Dentistry", MISSOURI DENT J, 15:124-30, March, 1883).

There is a lot of disagreement about the dangers of mercury in the medical and dental professions. This is because many of their members were taught by professors who are old enough to have been introduced to mercury before the advent of antibiotics, at a time when mercury and its compounds were thought to be useful medicines. Science has made giant strides toward recognizing what causes disease, what makes cells grow and how chemicals interact. There was no knowledge of DNA, and there were no electron microscopes. Testing medicines for approval by the FDA with its many stages and double blind studies is a relatively recent safety net for the consumer and the pharmaceutical companies alike.

In the beginning of the 20th century much of how pharmaceuticals worked was left to educated guessing. For instance, the Encyclopedia Britannica of 1911 gives, at least the way we see it now, a somewhat illogical description of what mercury does to the human body. The following paragraphs are excerpts of the then accepted understanding of mercury:

...In discussing the pharmacology of mercury and its compounds it is of the first importance to observe that metallic mercury is inert, as such, and that the same may practically be said of mercurous salts generally. Both mercury itself and mercurous salts tend to be converted in the body into mercuric salts, to which the action is due. When metallic mercury is triturated or exposed to air, it is partly oxidized, the first stage of its transformation to an active condition being reached.... (Encyclopedia Britannica, Vol. 18, p.158)

Saying that an active condition is being reached, in this single paragraph, already contradicts the statement that mercury is inert. The next paragraph continues

...Metallic mercury can be absorbed through the skin, passing in minute globules through the ducts of the sweat glands. ...

[and]...One part of the perchloride in 500,000 will prevent the growth of anthrax bacilli and one part in 2,000--the strength commonly employed in surgery--kills all known bacteria....(Ibid. p.158)

...Single doses of mercury or its compounds have no action upon the mouth, the characteristic salivation being produced only after many doses. Their typical action on the bowel is purgative the effect varying with the state of the mercury. So relatively inert is metallic mercury that a pound of it has been given without ill effects in cases of intestinal obstruction which it was hoped to relieve by the mere weight of the metal. (Ibid, p.158)

The general tenet seems to be that mercury has no action. Yet why would mercury use result in salivation if there is no action. Why indeed would it be used for any medical purposes if there were no action?

...Mercury is largely used in affections of the alimentary canal, and has an obscure but unquestionable value in many cases of heart-disease and arterial degeneration. But its value in syphilis (see VENEREAL DISEASES) far outweighs all its other uses. ... (Ibid, p.159)

An example of how sexually transmitted diseases were treated with mercury before the discovery of antibiotics in the middle of the 20th century can be found in Sex Trans Inf (STI); 1998; 74;20-26: Sexually Transmitted Diseases and the Raj

Finally the entry of the Encyclopedia Britannica discusses the poisonous aspects of mercury in some detail. It is stated that mercury can kill and that it can produce some rather severe allergic reactions especially on the skin and mucous membranes of the mouth.

Those were the ideas then. There are very few doctors who would still go along with that type of thinking. And yet there are still many anachronisms to be removed to get to the truth of what mercury really does.

For current general information about mercury and a link to the Periodic Table of Chemical Elements consult the Mercury website and for an explanation of why mercury is poisonous see: Mercury, HG

Mercury is poisonous. But how poisonous is it really? In its metallic form it is relatively harmless. Many people talk about how they played with mercury as children after the fever thermometer broke. My neighbor told me that when she was a child her teacher let her play with the mercury. There used to be toys that included mercury. People all remember playing with the shiny, silvery substance because it is so fascinating to watch. However, they usually can't remember that it made them sick, and they don't often wonder, as my elderly neighbor did recently, whether the mercury might have caused her to be edentulous by the time she was 30 years old or whether it caused the scleroderma she has been suffering from for years.

So, is mercury really that poisonous? The question can only be answered when it is specified in what form the mercury presents itself. Also, the degree of toxicity is a matter which seems to not have been fully explored, especially when it comes as a function of time. What time frame is necessary for this substance to be causing or exacerbating autism or amyotrophic lateral sclerosis--if indeed it is? Does it take a day, a week, months or years to cause symptoms? Both diseases have been mentioned in connection with mercury. There seems to be a paucity of data on the longterm effects of lowgrade exposure. What is known is that there are varying degrees of toxicity.

The relatively less poisonous metal and vapor forms of elemental mercury are not the only forms in which mercury occurs. There are many chemical combinations, inorganic and organic ones. All of them are poisonous. The most poisonous ones are organic. To illustrate how poisonous mercury can be, one only has to mention dimethyl mercury. Dimethyl mercury is an odorless, colorless liquid with the appearance of and weighing about three times as much as water. The extreme toxicity of dimethyl mercury is brought home in the WETTERHAHN LABORATORY POISONING CASE: FINAL MEDICAL REPORT, "Dimethyl Mercury Poisoning" (New England J. Med. 4 Jun 98 338:1672)(Science-Week 26 Jun 98), which describes the death of a scientist from mercury poisoning. Karen Wetterhahn spilled only a few drops of the liquid on her latex-gloved hands. Methylated mercury is relevant in the discussion of amalgam because under certain circumstances the mercury from amalgam may be methylated (Heintze, U., Edwardsson, S., Derand, T. and Birkhed, D.: "Methylation of Mercury From Dental Amalgam and Mercuric Chloride by Oral Streptococci in Vitro." Scand. J. Dental Research 91(2) 150-152, 1983; Yamada, Tonomura: "Formation of Methyl Mercury Compounds from Inorganic Mercury by Chlostridium cochlearium," J Ferment Technol 1972 50:159-166, and Field study on the mercury content of saliva, by P.Krauß and M. Deyhle*, K.H. Maier, E. Roller, H.D. Weiß, Ph. Clédon). See also Journal of Nutritional & Environmental Medicine (1996)6,33-36; Methyl Mercury in Dental Amalgams in the Human Mouth, by WILLIAM A. SELLARS MD, RODNEY SELLARS JR DDS, LIAN LIANG PHD AND JACK D. HEFLEY PHD

The Canadian Edmonton Journal, March 27, 2001, states in its headline: "Mercury Fillings Toxic -- Report U of C Researchers Say 'Visual Evidence' Brain Cells Affected," by Robert Walker. The article further states:

New research vividly demonstrating the damage mercury has on brain cells -- in concentrations seen in people with amalgam fillings -- was published by University of Calgary medical school researchers Monday...Drs. Fritz Lorscheider and Naweed Syed's research, published in the British journal, NeuroReport, is supported by a time-lapse video showing how brain cells die within 10 minutes when they are exposed to mercury in minute concentrations...

Owen Hamill summarizes Lorscheider/Syed in an article "Mercury induced growth cone collapse: another reason for flossing" (NeuroReport 2001;12:A23) saying

...evidence indicates that mercury vapor is continuously released from tooth fillings where it is breathed in by the lungs and converted into mercuric ions. Although there is no debate on the toxic effects of high concentrations of mercury (i.e. associated with urinary concentrations > 50 µg/l), a challenge exists to demonstrate more subtle, preclinical effects associated with chronic low level mercury exposure in the general population with fillings. At least consistent with this notion is the study published in this issue [5] showing that exposure to mercury concentrations of < 0.1 M results in rapid (i.e. within 10 min) retraction of growth cones in snail neurons and is correlated with disruption of microtubules. Interestingly, the authors point out that similar disruption of microtubules is associated with Alzheimer's disease. These recent findings give added impetus for the development and implementation of alternative materials for fillings and may provide parents with added ammunition in teaching their children to floss.

Significantly

...the other metals [also present in amalgam] – aluminum, lead, cadmium and manganese – did not produce this type of degeneration.

A news item in the Calgary Gazette provides further information about the study in which the researchers added mercury ions to snail neuron cell cultures, which were subsequently observed to degenerate rapidly. Fritz Lorscheider (physiology and biophysics) elaborates: "Our study illustrates how mercury ions alter the cell membrane structure of developing neurons. This discovery provides visual evidence of our previous findings that mercury produces a molecular lesion in the brain." (University of Calgary Gazette on the Web, April 2, 2001, "Researchers present evidence of mercury’s effect on brain neurons," April 2, 2001, Lorscheider, Syed, Leong).

The first reported cases of methyl mercury poisoning occurred in 1863:

A 30 year-old male who had been exposed to dimethyl mercury for three months "complained of numbness of the hands, deafness, poor vision and sore gums...[He was] unable to stand without support," although no motor palsy was detected. His condition rapidly worsened; he became restless and comatose within a week and died 2 weeks after the onset of symptoms. Another victim was a 23-year-old laboratory technician who had been working in the laboratory for 12 months, although he had handled dimethyl mercury for only 2 weeks.

He complained of sore gums, salivation, numbness of the feet, hands and tongue, deafness and dimness of vision. He answered questions only very slowly and with indistinct speech... Three weeks later he had difficulty in swallowing and was unable to speak... [He] was often restless and violent. He remained in a confused state and died of pneumonia 12 month after the onset of symptoms (from Environmental Health Perspectives, Vol. 104, Supplement 2, April 1996).

These two men had obviously been affected very severely. Milder cases outside of a mercury-laden environment would not have gotten much attention at a time when death from an infectious disease was so common and would probably be the suspected reason for a person's demise. The toxicity of mercury could be seen much more easily in context with a known mercury environment. In addition metallic toxins were ubiquitous. People still ate from pewter plates. Houses were painted with lead paint. People boiled tea water in copper kettles. All those metals are now known to be poisonous. The comparative symptoms of poisoning from the various heavy metals are remarkably similar and mercury was just one of them. There were no blood or urine tests, yet, sensitive enough to positively mark one or the other metal as the greater culprit for the symptoms at hand.

It is not known at which point mercury is not toxic any more. Mercury works at the molecuar level. At which point can it be said that no damage occurs? 150 years ago it was common for people to complain about symptoms of all sorts and it was even more common to label someone a hypochondriac.

All that said, already over a hundred years ago there existed reports and studies concerning the dangers of mercury from amalgam. The ADA cannot claim that amalgam has always, and by everyone, been considered to be harmless. The dentist E. S. Talbot writes in 1883:

The subject of mercurial poisoning from the use of amalgam fillings in decayed teeth, has given rise to numberless articles, and has been a source of discussion in dental societies since its introduction into this country. Symptoms of mercurial poisoning have manifested themselves in cases where these amalgams have been employed, causing the scientific members of the profession to investigate these fillings, to determine if these symptoms are due to the mercury contained in its composition. Nor is this investigation confined to men of science; the ordinary practitioner is constantly meeting these symptoms, and by careful observation will be able to diagnose these cases when met with. I will mention two cases which have come under my notice. ("Injurious Effects of Mercury as Used in Dentistry", MISSOURI DENT J, 15:124-30, March, 1883)

The article describes cases of amalgam poisoning. It also describes tests Dr. Talbot--the same dentist who witnessed the demise of the cockroaches--performed to prove that mercury constantly leaks from amalgams.

Let me enumerate some of the poisonous effects of mercury on the human family. A metallic taste in the mouth, headache, soreness and sponginess of the gums, pain in the sockets of the teeth when pressed together, fetid breath, ptyalism, ulceration of the mucous membranes of the mouth, fauces, larynx, and bronchia, loss of voice, hectic fever, profuse perspiration, emaciation, and death....

Those persons who have ... amalgam fillings in their teeth, frequently suffer from mercurial rheumatism and other symptoms of that poison; in fact, some are walking barometers, and by their pain can foretell the weather.

But even in those days recognizing amalgam toxicity would have had to depend on an observant dentist who was aware of the dangers of mercury or on the rare truly fulminant case that forced the dying patient to see a doctor. Doctors were even less aware that their patients' symptoms were the symptoms of mercury poisoning since the medicines doctors commonly prescribed for baby's teething pains, kidney problems, syphilis, constipation etc. contained mercury (Calomel, mercurous chloride, Hg2Cl2, teething powder, mercuro-chrome, Blue Mass). Moreover, what was prescribed as a cure always resulted in side effects, which, I venture to say, were not advertised by the doctor as being mercury poisoning. The side effects, which were sometimes worse than the cure and probably killed many a patient, usually happened with a time delay so that the patient was unaware that his new ailment was really an after-effect of the mercury-containing "remedy." It should not surprise, then, that the symptoms of, e.g., syphilis became nearly identical to those of mercury poisoning.

All in all it was very unlikely that those people who had had only a whiff of mercury would have known that those vapors had affected them enough to make them sick. By the time the mercury started to show symptoms, they would have forgotten about the exposure to it and assumed that they had fallen ill because of some infectious agent. Mercury is insidious because one of the symptoms of mercury poisoning is short term memory loss. If they couldn't remember what they had touched or inhaled or ingested, how were they going to tell the doctor--in the rare event that he might have asked--about what they had taken when they couldn't recall the offending agent? Karen Wetterhahn, who had known what she was working with and did remember, did not feel that she was poisoned until months after her deadly exposure--her long term memory was apparently not affected. She knew that she was working with a very dangerous substance. The New England Journal of Medicine reported that it took at least 90 days before any symptoms arose. It took nearly five months (154 days) for the 48 year-old scientist to complain about neurological symptoms which brought her to the hospital.

The following events might be typical for mercury exposure. More than forty years ago, let's say starting in the late 40s, a child, I'll call her Lisa, broke a fever thermometer. She picked up a bubble of mercury from the floor and ate it. The girl's younger brother, Werner, watched the remaining mercury roll on the floor until it magically disappeared. The older brother, Juergen, also watched. Doing that they unknowingly inhaled some of the vapor. Here is another scenario: Supposing a dentist's two-year old grandson, I'll name him Karsten, sneaked into the office where amalgam had just been mixed and inserted into a patient's mouth. The child inhaled the still lingering vapor, which by now, being heavier than air, had sunk to the level of the child's mouth. Here is another scenario: Supposing a young woman, Gigi, somewhat compromised in her calcium intake because she didn't drink milk and ate candy all through her childhood, had received a multitude of fillings in her teeth. Also, her two upper front teeth were not straight. She wanted them to look nice. To straighten out the crooked teeth she had gone to a dentist for porcelain crowns. In the process of grinding down the teeth the dentist had killed the nerves of those teeth. To aleviate the pain she went to yet another dentist who suggested removing the damaged nerves. The resulting root canals were filled with amalgam.

Here is what happened to the just mentioned people: The little girl, Lisa, who ate the mercury had no obvious ill effects from ingesting the beads of mercury. She was not as smart as one would have hoped. But she was going to be a wife and mother and nobody cared whether she was likely to go to the university or not. As for her brother, Werner, who had watched? He was sickly much of the time. I remember him bundled up in the backyard. He literally couldn't move because the blankets were tied around him with a rope to keep him on the stretcher that had been placed near where we played. He was not allowed to play. He watched us. He was thought to be too ill. It may seem far fetched to blame such a small amount of mercury vapor for the Attention Deficit and Hyperactivity Disorder--in those days that term was not used, yet--he experienced once he was better. Werner's mother was mainly resigned to the fact that her second child was not going to be as smart as his parents or his older brother, Juergen. Werner became a massage therapist, instead of the doctor she had wanted him to be.

Curiously the metallic mercury Lisa ingested affects the organism less severely than the vapor. It goes through the system and is absorbed only minimally. Whether the little girl had no ill effects at all is to be questioned. Was there really no ill effect or do we simply not know what ill effects she may have suffered? After all, our knowledge of what a small amount of tobacco smoke is capable of doing should alert us not to be casual about what a small amount of mercury vapor might do. A puff of smoke here and there (passive smoke) from another person's cigarette is also only a very small amount of smoke. And yet, the cumulative puffs have been known to cause lung cancer. Note! There is one important difference between tobacco smoke and mercury. Smoke is visible and easily detectable by its smell; mercury vapor is not.

Nothing happened to Werner's brother, Juergen, nothing to the dentist's grandson, Karsten, at the time when they inhaled the vapors. The nasty effects came years later when they were young adults, both Juergen and Karsten, came down with Multiple Sclerosis.

About Gigi, the young woman who had a root canal done, she did not know that she had been given mercury. The dentist who had performed the then (1965) new procedure did not know that a root canal should never be filled with mercury amalgam and thus set into action a process that would cause Gigi to suffer pain and several surgeries nearly thirty years later.

According to Dr. Meinig, who wrote a book about research done in the early 1900s, all root-filled teeth harbor harmful bacteria. Dr. Price, a dentist who later became head of the ADA, did the early research. He advanced a theory that bacteria coming from root filled teeth can cause infections. They quasi metastacize to remote locations such as heart, bones, brain etc. These infections can become life-threatening even without mercury. [Ref.: http://www.curezone.com/dental/root_canal.html: Dr. Joseph Mercola: ROOT CANALS POSE HEALTH THREAT - AN INTERVIEW WITH GEORGE MEINIG, D.D.S. Dr. George Meinig, one of the founders of the American Association of Endodontists (Root Canal Specialists), has written the book: "Root Canal Cover-Up Exposed - Many Illnesses Result."]

If bacteria and mercury are mixed methyl mercury results. Therefore root canals should not be filled with amalgam. It is likely that a root canal eventually turns into a bone cyst, also called cavitation. This is how a cavitation develops. Bacteria trapped at the tip of the root remain--despite all precautions-- in the recesses of the tooth after the root canal is filled. The anaerobic bacteria multiply. The only place they can go is into the jaw bone. There they may cause the bone to erode. What is worse, the mercury causes the surrounding tissue to become infarcted because the mercury causes the blood vessels to die. That means there is no blood supply to the bone. Thus the bone cannot heal. It becomes necrotic. The bacteria cannot be eradicated with antibiotics because the blood carrying the medicine does not reach the affected bone. Furthermore, the bacteria could convert the accessible mercury from amalgam into methylated mercury, which may--possibly through osmosis--continually reach the blood stream and be dispersed all over the body and into the brain. It seems methyl mercury seeps through tissues fairly easily. (It entered Karen Wetterhahn's system through Latex gloves and the skin). Furthermore mercury helps the bacteria to survive better because it compromises the immune system. Thus the mercury indirectly causes the cavitation to get bigger and bigger. What makes the situation worse is that cavitations are not visible in x-rays. They do not show any inflammation nor do they cause a fever, and they may remain painless for many years because the nerves do not reach into the bone and tell the person that something is wrong. (Scand. J. Dental Research 91(2) 150-152, 1983). The patient only notices the problem when the cyst finally gets large enough and breaks through to the outside or comes in contact with functioning blood vessels and/or nerves. That would be the point at which the bone is nearly completely destroyed. See also: Cavitations, by Karen Shrimplin

Another explanation for the erosion of bone is given in a web site about osteonecrosis/osteomyelitis, which, when it happens to the mandible and maxilla, is also called Phossy (or more recently Fossy) Jaw or Maxillofacial Osteonecrosis. This condition used to be very common in the 19th century. It is a condition where the bone dies due to "intramedullary ischemia and infarction." The ischemia is thought to have resulted from "environmental pollutants, such as lead and the phosphorus used in safety matches, as well as from popular medications containing mercury, arsenic or bismuth."

Maxillofacial Osteonecrosis of the maxillofacial region is not new to dentistry. During the pre-antibiotic era "phossy jaw" and other forms of "chemical osteomyelitis" resulted from environmental pollutants, such as lead and the phosphorus used in safety matches, as well as from popular medications containing mercury, arsenic or bismuth.[23-29] This disease was well established by 1867, did not often occur in individuals with good gingival health, and appeared to "attack" the mandible first.[25] It was associated with localized or generalized deep ache or pain, often of multiple jawbone sites. The teeth often appeared sound and suppuration was not present. Even so, the dentist often began extracting one tooth after another in the region of pain, often with temporary relief but usually to no real effect.[24] Occasionally, large fragments of necrotic bone would come out with the tooth, sometimes involving much of an entire quadrant, as depicted in the figure at the top of this page. Apparently, Lorinser of Vienna in 1845 was the first to call attention to the problem.[25]

( http://www.maxillofacialcenter.com/NICOhistory.html#History, and http://www.maxillofacialcenter.com/NICO1v55.html#Why)

According to the above web sites the chemical osteomyelitis described in Phossy Jaw can be seen in other parts of the body, i.e. for necrosis in the head of the femur it is called Legg-Calvé-Perthes disease. "G. V. Black,[29] the father of modern dentistry, described in 1915 an osteomyelitis look-alike disease which he called 'chronic osteitis.'" Other conditions are Osgood-Schlatter Disease, Panner's Disease and many others. (Appendix B)

In a new development, osteonecrosis is appearing in patients being treated with bisphosphonates such as Fosamax, Boniva, Actonel etc. (The New York Times, June 2, 2006, p.1; Drug for Bones is Newly Linked to Jaw Disease). According to http://orlando.craigslist.org/lgs/160483544.html "bisphosphonates are drugs that suppress or reduce bone resorption by osteoclasts. They do this both directly, by hindering the recruitment and function of osteoclasts (the bone-resorbing cells) and perhaps indirectly, by stimulating osteoblasts (the bone-forming cells) to produce an inhibitor of osteoclast formation."

Getting back to the young mother, she became pregnant a few days after the root canal procedure. She and her fetus were exposed to a good dose of mercury already then because of the root canal. The mother also took fluoride pills and vitamins. Fluoride might matter if the mother brushed with a fluoride toothpaste or had a fluoride treatment while pregnant. Fluoride should not be used as long as there are amalgam fillings in the mouth. It is likely to free mercury from the amalgam. The loss of mercury causes the filling to deteriorate and add to the mercury body burden. talkinternational.com: Egypt Dent J 1994 Oct;40(4):909-18 (ISSN: 0070-9484) Role of Fluoride on Corrodability of Dental Amalgams. See also Deutsche Amalgam Page: Fluoride, noch ein Betrug im Gesundheitssystem? July 19, 2002

The baby boy born nine months later would seem to be normal and happy. Of course, he received his DPT shots on time and was, to be more efficient, inoculated on the same day, against whatever else there might be to guard against illnesses. By age three this same child also had received thirty amalgam fillings. The baby's teeth looked perfect. Still, the pediatric dentist discovered many tiny pin-hole cavities, which needed to be taken care of. (This dentist is still working as a pediatric dentist and professor). He said not filling those teeth would cause them to fall out prematurely, and that would later affect the bite in the growing child. I wonder if he knew that he was putting poison into the boys mouth that was being mobilized later on, every time the school insisted on giving him fluoride treatments

This is what happened to the baby when he grew up. As already said, he seemed to be normal. Still, it was disconcerting that he did not learn to talk until age three and a half, much later than his peers. At least he did not wait to talk until age five as Einstein did. Talking late would be of no concern if the boy turned out to be another Einstein. But this boy also had a difficult time falling asleep and his mother would wear herself out trying to wake him up in the morning to get him ready for school. Was that like Einstein? Later when he was tested at school, the boy had an Intelligence Quotient of 137--quite a bit above average. So nobody worried. Maybe he would be like Einstein after all. But then, as a teenager, he withdrew from social interaction. He was very shy and after a while he suffered from depression. His mood swings caused disruptions for his family. Indeed his mother and father were afraid to criticize him for fear that he would react with outbursts of anger at any given moment. He is now thirty-five years old, and he is still depressed.

The next child born two years later was a healthy boy. He has had only one cavity. No problems with him. But then there was the third child. Four years after her first son was born, and after more dental work--done during pregnancy--the same mother gave birth to a third son. This boy had a number of birth defects, which the doctors lumped together as midline defects. The boy's profound psycho/motor retardation became obvious after the craniosynostosis, the partially missing corpus callosum, hypospadias, the inguinal hernia and problems having to do with his teeth and ears were diagnosed. These defects may be explained by what Dr. Hal Huggins, DDS, refers to in his essay about mercury and Birth Defects:

How can dental mercury produce birth defects? What are the mechanisms? During normal cell division, our cells undergo a process called mitosis in which all the internal substance of a cell duplicates itself, then the contents divide evenly, and migrate to opposite ends of the cell until the cell looks something like an exercise dumbbell. Finally it squeezes itself in the middle until it separates into two identical cells. Mercury can stop this duplication process at any of its multiphasic steps resulting in an abnormal cell. If this new cell is capable of reproduction, then the abnormality may show up as a birth defect. If it is deep within a tissue, it may alter the function of a tissue or organ without being readily observed.

HgCl2 was found to have a very potent toxic effect on MO3.13 (10-50 µM), as did Cd. Caspase activation was observed and morphological analysis showed that cells exposed to low concentrations of HgCl 2 exhibited features of apoptotic cell death including shrinkage and condensation of chromatin. High doses of HgCl2 (250 µM) revealed necrotic characteristics (cell swelling and lysis). Conclusion: mercury is extremely toxic to differentiated oligodendrocytes at relatively low concentrations and thus is potentially damaging in vivo.

All this said the retarded boy never talked. He is the size of a small nine-year old and looks like a child. He learned to walk at age 4. He was toilet trained already before that. At age 32 he is confined to a wheelchair due to the unfortunate after-effects of Legg-Calvé-Perthes disease. Doctors examined him long ago, thinking that he might be autistic. This child certainly would not have been able to diagnose himself.

As for the other above-mentioned three boys, they would never be able to connect the earlier events with their later illnesses, either, and, even though all the examples are not hypothetical, they are not meant to be proof that amalgam actually caused the neurological, psychological and behavioral difficulties just mentioned. There are too many confounding factors. They do, however, point out that the connections between cause and effect are not always visible within a short time span. Here it is worth mentioning that it takes years for the nicotine in tobacco to cause cancer, for the AIDS virus to do its damage, and the prion to cause Bovine Spongiform Encephalopathy (BSE). The children who were exposed to mercury would not remember that they had inhaled the vapors while watching brother or grandfather. The parents of the third boy could not relate the delay in speech acquisition, his shyness and, later, his depression to the fact he had been exposed to mercury via his dental fillings or his mother's amalgam-filled root canal while he was still in the womb. They did not know that "silver fillings", that's what amalgams are called, contained mercury.

On the subject of delay in toxicity of methyl mercury D. C. Rice writes in Neurotoxicology, 1996 Fall/Winter, 17 3-4, p.583-96:

Delayed toxicity as a result of developmental methyl mercury exposure was identified in mice two decades ago by Spyker, who observed kyphosis, neuromuscular deficits, and other severe abnormalities as the mice aged. Delayed neurotoxicity was also observed in monkeys...
http://www.web-light.nl/AMALGAM/EN/SCIENCE/medl_neuro.html

There are so many reasons why things can go wrong in a person's life. A mother looks for all the known factors of what might have influenced her child. Was he traumatized somehow? Maybe his mother got impatient and yelled at him because he was so difficult to handle. What other psychological scars might there be? Depression and anger are supposed to originate from early childhood experiences. What about childhood illnesses that might have left neurological scars? The guessing game does not stop when a child has difficulties. Were those many vaccines to blame? They sometimes cause a fever and mimic the illness the vaccine is meant to inoculate against. The doctor tells the frightened mother that those symptoms are a natural reaction. You are supposed to have a reaction to the vaccine. The reaction means that the vaccine is making antibodies. The mother is somewhat reassured and stops worrying about the inevitable suffering. Meanwhile, one thing that is never mentioned--just as it is never mentioned that amalgam contains mercury--is that the vaccines contained a preservative called Thimerosal (it, too, contains mercury). Neither the parents nor, of course, the children had knowledge or control over receiving mercury (Children must be vaccinated. It's the law).

No doctor made the parents aware of the mercury. Even though Thimerosal, which contains ethyl mercury (chemical cousin to methyl mercury) and salicylic acid, has been used in vaccines since the 1930s, most doctors are unaware that those vaccines contain preservatives, let alone mercury. What might come as a surprise in this context--in addition to the fact that vaccines contain mercury--is that Eli-Lilly, the company that invented the preservative Thimerosal, first tested the vaccine on 22 patients dying of meningitis. I guess Eli-Lilly did not want to test mercury injections on healthy subjects. There is no indication that Thimerosal had no ill effect on those patients. ( WFAA.com, June 21, 2002, Dallas Fort Worth: Mercury in Childhood Vaccines: What did the Government Know? (Part II)). According to the original study at least 60% of the patients died while they were still in the hospital. The substance--called merthiolate at the time--was not injected, but rather applied in some form to the nose. It was not injected as would be imperative if today's stringent rules were applied. The preservative Thimerosal, it could be said, was snuck into the list of FDA acceptable substances by fraudulent means.

Disclosing that mercury might be an ingredient in a vaccine is the law in California just as it is the law for a dentist to diclose that there is mercury in amalgam. That law (resulting from Prop. 65) is constantly being sidestepped today. Nobody suspects mercury in a vaccine. What's more vaccines don't need Thimerosal to work. As a matter of fact, there are several studies where it is shown that Thimerosal does not kill bacteria at all and causes a diminished immune response. Refuting pharmaceutical manufacturers' claims that Thimerosal kills bacteria, Leonard J. Goldwater states in his book "Mercury: A History of Quicksilver," (York Press, Baltimore, 1972) that merthiolate is thought to not be a particularly good preservative. Rather than being a real antiseptic it should be considered a bacteriostatin (it does not reliably kill bacteria). Thimerosal is not mentioned in the book. That leads me to conclude that the name Thimerosal for merthiolate is of a more recent date. One wonders if the name change was instituted in order to make it more difficult to find research done previously on the substance.

On immune response Dr. John Whitman writes in his website:

The presence of mercury in dental amalgam fillings has been shown conclusively to adversely affect the body's immune response. It has been shown that after amalgam removal the red and white blood cell levels tend to seek normal range with a corresponding increase in the body's immune response as evidenced by T-lymphocyte count increase (Bio-Probe References: Immunologic Adverse Effects)

That gets me to wondering whether an AIDS patient getting an amalgam filling or a flu-shot might inadvertently be risking his life by receiving Thimerosal with the vaccine.

Thimerosal is useful only to the manufacturer. Thimerosal allows the manufacturer to be a little sloppier in his laboratory. What Thimerosal does is mask the expression of contamination during the manufacturing process, and diverts attention from a potential defect in the vaccine. It serves the manufacturer well, but not the patient. The patient is not likely to connect the dots because they are hidden from view. Ask your doctor next time if the flu shot he is giving you contains mercury. His answer will most likely be: "Of course not." Then ask for the insert that comes with the shot. The insert will, most likely, tell you that it contains mercury. The next thing you'll hear is: "You got me there. But its only a trace amount." Most doctors don't know that those trace amounts can make your baby sick. For more information on the subject of organic mercury poisonings read Chiho Watanabe and Hiroshi Satoh who wrote about the "Evolution of Our Understanding of Methylmercury as a Health Threat."

Returning to amalgam I am assuming that mercury from tooth fillings does similar damage as mercury from Thimerosal depending on the oral environment. Thus it is entirely conceivable that mercury from amalgam that interacts with aspirin, taken for a headache, becomes something very similar to Thimerosal.

The main ingredient in dental amalgam is mercury. Amalgam has been used for centuries. The Chinese used it 1400 years ago to fill cavities. In the western world it became popular less than 200 years ago. It is a malleable material, similar to putty, and much easier to work with than gold when the dentist lays it into the cavity. That and the fact that it was much cheaper than gold, eventually made it the material of choice in all dentists' offices despite the fact that American dentists in the first half of the 19th century were amalgam-free.

Before the 1850s, there were strong efforts to ban the substance because it was thought to be poisonous. For economic reasons and convenience the proponents of amalgam prevailed. At that time the evidence that mercury compounds are poisonous was not found sufficiently compelling to discontinue it considering all its "beneficial" properties. By and large amalgam was thought to be stable. It was thought to be a special material that absolutely did not dissolve, at all. Since then chemists have learned that there is no substance, including amalgam, that does not dissolve in water over time.

Mercury's poisonous effects were well known in the days when mercury was used indiscriminately in certain industries. For instance, madness was an occupational hazard for workers in the felt industry. That was an accepted fact. That is why the saying "Mad as a Hatter" was coined. The "Mad Hatter" syndrome was a symptom complex thought to be due to mercuric nitrate used in the processing of animal fur for felt hats. The mercury made you "mad" but it was thought that it didn't kill you (In Danbury, Connecticut, where the expression "Danbury Shakes"--shaking is a symptom of mercury poisoning--was coined, mercury was used by felt makers until 1941). For more on the interesting history of felt making please see: Was the Mad Hatter Really Mad? by Sharon West, March 20, 2001. Still, it was known that mercury could kill; that is why prisoners were, and maybe still are in some places, used for mercury mining. It was not widely known, though, that you could die from mercury poisoning the way Karen Wetterhahn did.

It should be added that the expression "mad scientist" was worn almost as a badge of honor. Chemical labs had always been thought to be places where an abundance of poisons made their way into the world. Among all those poisons amalgam was indeed a very safe substance. Yes, you could get poisoned. Laboratories were not the safest places to be. But the alchemist's goal was to make gold, and create wealth. The prospect of winning praise from the king for making porcelain and gun powder or ultimately gold was worth the risk. A good description of the Norwegian scientist Kristian Birkeland who, it appears, was affected by mercury and other noxious vapors in his laboratory can be found in Lucy Jago's "Bright Lights, Big Trouble - How The Aurora Drove A Genius Mad - The Bright Stuff" (The Independent On Sunday: The Sunday Review, 29 April, 2001, p.11). Arnold Orville Beckmann, founder of Beckmann Instruments, a medical insturmentation company, was so severely affected by mercury that he had to

...switch over from organic chemistry to physical chemistry, away from mercury and toward a whole new realm of fascinating chemical questions and puzzles.

Besides being the discoverer of gravity and his writings about mathematics Isaac Newton dabbled in alchemy--in Newton's days that meant he worked with mercury. The signs of mercury poisoning were already noticeable long before his death. His shyness, on the one hand, his inability to make friends, his nasty disposition even towards those he adored and his unkempt appearance all fit into a picture of chronic mercury poisoning:

His character, at least as painted here, was almost pathologically solitary. At Cambridge, he rarely left his room. He had no friends, and was roused from his lonely musings and scribblings only to write vicious letters to those who seemed to have stolen his ideas. To other scientists, even the adoring Halley, he was curt and ungenerous. He seems to have acquired social graces, such as combing his hair, only after becoming Warden of the Mint in 1696.

Because it is commonly thought to be a stable substance, in other words non-toxic, amalgam has not been subjected to the strict regimen the Food and Drug Administration prescribes for all new medicines, applied internally as well as externally. Amalgam was approved (grandfathered in) without actually ever having been tested for toxicity. Environmentalists, on the other hand, have made sure that mercury amalgam outside the human body was included in the list of hazardous substances. It is poisonous before the dentist puts it into the mouth and after he takes it out. The only place dental amalgam is still considered to be safe is in the mouth. It is considered hazardous in any other place.

The recent lawsuits (See also below under Additional Websites: Stanford Law School - Dental Amalgam Litigation) filed in the United States dealing with the environmental hazard of dental amalgam (Tibau v. American Dental Association, BC252124, and Kids Against Pollution v. American Dental Association, BC 252125; San Francisco Daily Journal, Wed. June 13, 2001, p.2) have brought renewed interest in whether dental amalgam is really as safe as dentists have us believe. In spite of all the recent studies, ADA President Dr. Robert M. Anderton (ADA.org: Today's News - Association Responds to Amalgam Litigation, June 15, 2001) responds to these suits stating:

There is no sound scientific evidence supporting a link between amalgam fillings and systemic diseases or chronic illness. This is a position shared by the ADA and all major U.S. public health agencies and is a matter of public record.

Dr. Murray J. Vimy, DMD, Clinical Associate Professor, Faculty of Medicine, University of Calgary, Canada, counters Dr. Anderton's letter by pointing to 9 critical facts why amalgams are harmful. After referencing carefully those facts he concludes that

... statements by ADA spokespersons suggest that the ADA and its advisors may be knowingly disinforming the public through the media or they lack an understanding of the scientific research about mercury release from amalgam published in their own journals

control (by dental regulators) of dental licenses to punish, or threaten punishment of dentists who criticize mercury amalgam.

...legislative demands for creation and distribution of a warning sheet on the potential side effects of mercury cavity fillings.

...Lawyers for Attorney General Bill Lockyer, who weighed in on the case on the side of the plaintiffs, called the decision an important reaffirmation of one of the basic foundations of the 1986 voter-approved law...

The Chicago Tribune entered the discussion with the headline: "Health Risks of Mercury Debated" (Chicago Tribune, August 22, Wednesday, 2001, p.N1). The article states among other things that:

The fillings slowly release tiny amounts of odorless, colorless mercury vapor. Their effect on health has been the subject of scores of conflicting studies, and no federal agency has moved to prohibit the fillings.

"You can't say mercury fillings are bad for you," said Dr. Myron Bromberg, a dentist in Reseda, Calif., and spokesman for the Academy of General Dentistry, an industry group. "You can't say it because it's inaccurate. ...I have silver fillings in my mouth. I have silver fillings in my kid's mouth. If there were any problem with them, I wouldn't use them."

"It should be reassuring to parents that we found no convincing evidence linking Thimerosal to any neurological disorder," said Dr. Marie McCormick of the Harvard School of Public Health...

This statement is being made even though ethyl mercury (mercurochrome, merthiolate), a chemical cousin to methyl mercury, has been banned for external use. Apparently, as long as mercury is applied internally it magically loses its toxicity. Furthermore, as long as there is any evidence at all, convincing or not, the medical community ought to be erring on the side of caution when it comes to toxic substances like mercury.

In spite of the above assurance, law suits keep coming. law.com published an article "Drug Companies Sued Over Vaccines Containing Traces of Mercury" by William McCall (October 3, 2001) where it states:

A coalition of law firms went to court across the nation Tuesday, trying to force the pharmaceutical industry to study whether vaccines containing a trace of mercury cause autism and other brain damage in young children.

Getting back to mercury in teeth, the California Lawyer joins into the debate by featuring Shawn Khorrami in an article about his multiple amalgam lawsuits filed in Los Angeles as well as San Francisco (Getting Drilled - The Controversy Over Mercury Fillings Turns Litigious, October 2001, p.18):

Shawn Khorrami calls it "the m-word," and the Van Nuys attorney wants dentists to open wide and say it. The m-word is mercury, a component in countless dental fillings that speckle the mouths of millions of Americans.

Further down on the same page it becomes evident that law makers keep busy, too. The same article comments about the California Dental Board saying

Senator Liz Figueroa (D-Fremont) has a bill pending (SB 26) that would shut the current board down altogether, with the intention of forming a new board. "I've never seen any government agency that is more alligned with a trade association than this board," says Julianne D'Angelo Fellmeth of the Center for Public Interest Law at the University of San Diego.

On October 11, 2001 the Feat Daily Newsletter (www.feat.org) reported that Governor Gray Davis had "signed SB 134 (Figueroa), the Dental Board sunset reform bill. One of the reforms in the bill requires a dentist to provide a fact sheet on possible health risks related to mercury to a patient prior to performing a dental restoration that could involve the use of dental amalgam. The bill also requires new patients to receive and acknowledge receipt of the mercury risk fact sheet."

In February 2002 under the Section: FDA Forum, Pharmaceutical & Medical Devices the Web Postings report among other news that

the FDA's Center for Devices and Radiological Health has created a web page, http://www.fda.gov/cdrh/consumer/amalgams.html (updated Feb. 11) with the latest safety information on the amalgam materials used in dental fillings. The FDA and other organizations of the U.S. Public Health Service continue to investigate the safety of amalgams used in dental restorations (fillings). However, no valid scientific evidence has ever shown that amalgams cause harm to patients with dental restorations. The FDA is aware that some manufacturers have advised in their labeling against using amalgam in very young children and pregnant and nursing women.

The FDA Plans to uniformly regulate dental mercury, amalgam alloy, and pre-encapsulated dental amalgam. To reduce allergic reactions from restorative materials, FDA will propose in labeling guidance that the products's labeling list the ingredients in descending order of weight by percentage and include lot numbers, appropriate warnings and precautions, handling instructions and expiration dating.

The Daily Journal (March, 21, 2002, Mercury In Dental Fillings Caused Autism, Family Claims, by Erin Carroll) covers what it claims is the "first case to link [autism] to mercury in dental fillings:"

LOS ANGELES - A Burbank family has sued the American Dental Association and 29 other dental corporations, claiming that they concealed the dangers of mercury in dental fillings, a toxin the family believes contributed to their child's autism.

In the suit, lawyers for Kathy Galeano allege that her nine amalgam fillings released enough mercury into her system during her pregnancy to help cause her son Daniel, now 5, to develop severe autism. While lawsuits have been filed alleging a link between mercury in pediatric vaccines and autism, plaintiffs' lawyer Shawn Khorrami of Van Nuys believes this is the first case to link the disease to mercury in dental fillings. Galeano v. American Dental Association, BC270306 (L.A. Super. Ct., filed March 20, 2002).

The FDA defends itself in the Daily article by making the same statement it had already made in its Web Postings (Vide supra): "...no valid scientific evidence has ever shown that amalgams cause harm to patients with dental restorations. The FDA is aware that some manufacturers have advised in their labeling against using amalgam in very young children and pregnant and nursing women."

Shawn Khorrami, however, states that the "metal's link to autism has been documented and that, despite mercury's known dangers, the dental profession continues to use it in fillings."

The Seattle Post-Intelligencer (Wednesday, March 20, 2002, Suit: Fillings Caused Child's Autism by Erica Werner, also Charleston Gazette, March 21, 2002, also San Jose Mercury News, Mar. 21, 2002, p.11A, DENTAL GROUPS SUED OVER CHILD'S AUTISM) reports about the same suit, and quotes ADA chief counsel Peter Sfikas as saying that

mercury in fillings is chemically bound with metals including silver, copper and tin into a "hard, stable and safe substance"

whereas Boyd Haley, chairman of the chemistry department at the University of Kentucky, states in the Seattle Post-Intelligencer: "I don't know that it's [the connection between amalgams and autism] proven, but it's very credible. Mercury is one of the most neurotoxic compounds known to man."

Haley said some studies show people with amalgam fillings have four to five times as much mercury in their blood and urine as people without such fillings.

Not surprisingly the ADA counters with a newsletter (ADA.org, Todays News, April 5, 2002) saying that

Eleven lawsuits claiming that mercury in dental amalgam caused autism in the plaintiffs' children were filed this week in Fulton County (Georgia) State Court.

Named as defendants were the American Dental Association and Georgia Dental Association; pharmaceutical firms American Home Products (now Wyeth), Glaxo Smith Kline, Armour Pharmaceutical and Johnson & Johnson; and Utility Georgia Power Co.

...these complaints are an "egregious abuse of the legal system," the ADA immediately responded. "Actions like these mislead vulnerable people, using information with no scientific basis to give false hope to those with chronic, often incurable illnesses."

Dr. Dean Edell, whose syndicated "Health Talk" radio program is broadcast nationwide, characterized the autism suits as prime examples of "junk science" in the courtroom.

"Autism is not caused by vaccines or [amalgam fillings] in your mouth," Dr. Edell told his audience April 4. "A jury doesn't understand the science in this.... We all pay for this."

Natural Health (March 1, 2002, p.26) asks its readership to comment on the controversy by asking: "Should Amalgam Fillings Be Banned? Evidence On The Risks Of Mercury Fillings Is Mixed. Should They Be Outlawed Anyway? Backtalk." The article refers to a bill recently introduced to Congress by Diane Watson, D-Calif., that would prevent dentists from using amalgam fillings nationwide by 2006. It also mentions that results from two trials currently underway at the National Institute of Health are expected in 2005.

The ADA, instead of expressing interest in the bill and merely being cautiously skeptical rather than concerned about all dental patient's wellbeing, finds Diane Watson's proposed bill threatening enough to respond with an ADA.org Newsletter (April 16, 2002):

"In plain terms, Rep. Watson is attempting to legislate based on junk science," ADA Executive Director James B. Bramson said in an April 12 statement posted online. "We have requested meetings with her numerous times and thus far have been shut out. But we will continue to attempt a dialogue with her."

"Concern about amalgam, because of its mercury content, is intuitive but unfounded," the ADA executive director said. "The process by which amalgam is made renders the bound mercury component stable and therefore safe for use in accepted dental applications."

Rep. Watson's proposed Mercury in Dental Filling Disclosure and Prohibition Act would prohibit after 2006 introduction into interstate commerce of mercury intended for use in a dental filling. The bill would require new labeling, with consumer warnings about mercury content, for dental amalgam materials regulated by the U.S. Food and Drug Administration.

Studies show that no filling material has been proven superior to amalgam in safety, durability, and cost effectiveness. Amalgam has been researched worldwide and no study has ever caused a professional dental organization or agency to recommend a ban of amalgam (Fact Sheets: Dental Health by the California Dental Association)

If it were so easily proven that amalgams are not dangerous why does it take no time at all to find the following study that confirms the dangers of mercury. B. Fredin comes to the following conclusion in Studies on the Mercury Release from Dental Amalgam Fillings:

...It is concluded that dental amalgam should be considered an unstable alloy constituting a long term Hg exposure and toxicologically unsuitable as a dental filling material. (Swed J Biol Med no 3, 1988 pp 8-15)

This study may be from a foreign country and it may be small. But it gives a clue about the validity of the tenet that amalgam causes symptoms. Amalgam has been researched worldwide; but the ADA has never acknowledged the importance of studies in other countries. Dental associations have not recommended a ban on amalgam because this very recommendation would mean--in the absence of long-overdue ADA initiated studies--admitting that amalgam has always been a toxic substance.

Apparently there is no need to acknowledge the facts of basic science that there is no such thing as absolut stability in science, and that chemists have known for a long time that mercury is not stable even in amalgam form (See Alfred Stock).

It is much easier to stick with conventional wisdom. That attitude does not convert conventional wisdom into modern science. It merely leaves us in the dark. The media have forgotten how to expose powerful forces such as the ADA and various amalgam manufacturers. Thus, unfortunately, even the usually outspoken Washington Post is not convinced of the dangers of amalgam. Jennifer Huget discusses amalgam in two articles (March 26, 2002, Tuesday, p.F01 and p.F04). The headline for the first one reads: "Filling In For Mercury; There's No Proof Dental Amalgam Is Unsafe" (p.F01). The second one gives a synopsis of the two opposing views titled "Mercury Fillings: The Cases For And Against; Mercury Amalgam's 150-Year History As A Dental Restorative Has Been Marked By Occasional Eruptions Of Controversy Over Its Safety. Following Is A Synopsis Of The Opposing Arguments" (p.F04). While her discussion gives voice to both sides of the argument, the main points of the anti-amalgam argument--that it is poisonous to many systems in the human organism--are only discussed in the most general terms.

The mercury amalgam issue may be somewhat trickier than the mercury vaccine issue. But behind both amalgam and thimerosal hides mercury. They have a lot more in common than might be suspected at first glance. Dentist and doctors both have something at stake keeping the truth from coming out.

The ones who are not fooled so easily are the lawyers. A law.com headline on April 29, 2002, reads "National Lawyer Network Gears up for Mercury Litigation; Two Miami Lawyers Launch Attacks on Vaccine Makers, Saying Mercury Component Leads to Autism," by Julie Kay. She points out, among other things that

Robles is one of hundreds of plaintiffs' lawyers around the country who are filing or about to file negligence lawsuits against companies that manufactured or distributed vaccines containing thimerosal, a mercury-containing preservative that until the past few years was used in many pediatric vaccines. It is still used in some adult vaccines

While Robles has advertised on daytime television, in the National Enquirer and on his Internet site for clients in other types of cases, he says he isn't scouting for mercury clients. "I don't have to," says the attorney, who heads the Robles Law Center. "There are thousands of them. This is definitely the next big thing."

Relevant Laws for California:

• Health & Safety Code: Section 25249.6 et seq., Business & Prof. Code 17200 et seq.
• Labor Code 6382(b)(1) and 6382(d) discussing the list of chemicals known to cause cancer and reproductive toxicity
• Chapter 3.2. California Occupational Safety and Health Regulations (CAL/OSHA) Subchapter 1. Regulations of the Director of Industrial Relations, §339. The Hazardous Substances List

The U.S. requirement for preservatives in multi-dose vaccines was incorporated into the CFR in January 1968, although many biological products had contained preservatives, including thimerosal, prior to this date. Specifically, the CFR states:

Products in multi-dose containers shall contain a preservative, except that a preservative need not be added to Yellow Fever Vaccine; Polio-virus Vaccine, Live Oral; viral vaccine labeled for use with the jet injector; dried vaccines when the accompanying diluent contains a preservative; or to an Allergenic Product in 50 percent or more volume (v/v) glycerin. [21 CFR 610.15(a)]

The CFR also requires that the preservative used

…[s]hall be sufficiently non-toxic so that the amount present in the recommended dose of the product will not be toxic to the recipient, and in combination used it shall not denature the specific substance in the product to result in a decrease below the minimal acceptable potency within the dating period when stored at the recommended temperature. [21 CFR 610.15(a)] (from an FDA website dealing with Thimerosal toxicity: Thimerosal in Vaccines)

Even thought the law clearly states that there is a need for preservatives in vaccines, it does not specify that this preservative has to contain mercury. The reason why Thimerosal is preferred by all the pharmaceutical companies is that it doesn't have to hold up to any standards. Thimerosal has never been adequately tested. Any new preservative would have to hold up under the current standards, and that costs lots of money and time. Since testing is not required for this "time-tested" material, no one sees it necessary to bother with a new risky product that has no chance of making extra money for the company even if the mercury contained in Thimerosal is poisonous. Let whomever it may concern prove that Thimerosal is not safe.

While dentists are shying away from the "m-word," dental amalgam manufacturers are worried about future litigation. According to ASOMAT, a letter was sent out March 13, 1998 by the Australian Dental Association to 10,500 dentists stating, among other things, that

Contrary to the claims made by the Australian Dental Association that amalgam is safe, the manufacturers are now acknowledging the intrinsic dangers of this material. The legal implications of this latest development are far reaching. If you continue to use dental amalgam you may be playing legal roulette with your assets.

• In Proximal Or Occlusal Contact To Dissimilar Metal Restorations.
• In Patients With Severe Renal Deficiency.
• In Patients With Known Allergies to Mercury.
• For Retrograde or Endodontic Filling.
• As A Filling Material For Cast Crown.
• In Children 6 and Under.
• In Expectant Mothers.

Most mercury is mined in Spain and in the Near East in countries such as Uzbekistan and Tajikistan. Amalgam manufacturers are found all over the globe. Amalgam has been used in more or less identical formulation for more than 160 years. Nowadays it is supplied in two parts. Part 1. is mercury and Part 2. is a mixture of ground mercury and other metals. After the two parts are mixed, the resulting amalgam often contains more than 50% mercury. The other ingredients, by the way, are also poisonous. The percentages of the other ingredients vary from manufacturer to manufacturer depending on how strict the manufacturer country's environmental regulations are. This matters because the global marketplace does not respond to the rules of the country to which the amalgam is shipped unless the country's regulators are watchful. Individual countries' governments have to see that their own environmental laws are obeyed.

The mercury contents, depending on who supplies the amalgam, vary from as low as 50% to as high as 70% depending on the source.

According to http://www.ericdavisdental.com/facts_and_figures_mercury.htm the amount of mercury in amalgam is sometimes as high as 65%. This means that the amounts of copper, zinc, and other heavy metals vary, as well.

Usual percentages mentioned are approximately:

• Mercury: 50%
• Silver: 34-38%
• Tin: 12-14%
• Copper: 1-2%
• Zinc: 1-2%

• > 65% silver (Ag) (poisonous)
• < 29% tin (Sn) (Highly poisonous)
• < 6% copper (Cu) (poisonous)
• < 2% zinc (Zn)
• < 3% mercury (Hg) (poisonous)

• > 40% silver (Ag) (poisonous)
• < 32% tin (Sn) (Highly poisonous)
• < 30% copper (Cu) (poisonous)
• < 2% zinc (Zn)
• < 3% mercury (Hg) (poisonous)

Note: It is rather disturbing that, according to Ulf Bengtsson and others, studies have found that the desired stability of gamma-2 free amalgam was not achieved. Not only are the modern non-gamma-2 amalgams shown to release even more mercury vapors than the gamma-2 containing ones, but they have a strange propensity to form mercury droplets on the amalgam surfaces after polishing (On the Instability of Amalgams, by Ulf Bengtsson, January 1, 1997).

Another problem is posed by the interaction of dissimilar metals, which are, if not part of the amalgam, often found in gold crowns or other protheses next to the fillings. According to the Kieler Amalgam Gutachten-- reviewed by Birgit Calhoun (excerpts in English: http://www.zan.cc/AG5.htm)-- Loebich, the leader of the metallographic laboratory of Degussa AG, a former German amalgam manufacturer, published a report already in the 1950s warning that "...amalgam has 'caused complaints and Illnesses.'" Also according to Loebich (1955), it is not necessary that the metals in question need touch each other. Merely the presence in the mouth is enough to cause generalized malaise. Loebich says: "This can happen via two fundamentally differing pathways:

Either the ions (metal salts) work as poisons, which may form from the metal (chemical Influences).
Or the potential difference (voltage) effects some sort of functional disturbance in the organism (physical influence)." (Translated from the German by B. Calhoun). The author of the just mentioned web site has the following comments about the subject of differing metals:

It is part of the basics of the knowledge of physics that a voltage difference, the so-called "potential difference," exists between two different metals or metal alloys. Now, if these two metals make contact, or if there is a conductor or a conducting medium, then this voltage difference is being evened out by an electrical current. In an oral cavity, which has been treated with differing alloys, appears - explained in this way - the phenomenon of the co-called "mouth battery." In order to get an idea about the "quantities" and "strengths" of this equalization of potential only this needs to be mentioned: In order to effect a stimulus transfer on a healthy neuron, the cells have to produce 95 millivolts (the so-called "action potential"). The measurements between two alloys in the oral cavity amount to up to 300 millivolts.

The daily intake of mercury per person (measured in Micrograms) in the population (World Health Organization Bulletin, 1991) is:

• Amalgam Filling: 3.0 - 17.0
• Seafood: 2.34
• Other Foods: 0.0035
• Air: 0.001

The information on gamma-2 amalgam and the daily amounts each person is exposed to, reported by WHO, was translated by B. Calhoun after obtaining it from a German Amalgam website.

In view of the great differences in amounts of mercury between one type of amalgam and another there is really no way of telling what the dentist puts into our mouths. Any person allergic to mercury or pregnant or just interested in the poisons in our environment has a right to know. Proposition 65 (The Safe Drinking Water and Toxic Enforcement Act of 1986) became effective January 1, 1987. Since then people in California presume that they can rest assured they know what toxins they are exposed to. It is important to make an informed choice about the material the dentist uses, whether it is amalgam, porcelain, gold or plastic. Environmental poisons abound. Women are told they cannot eat certain types of fish when they are pregnant because the waters are polluted with mercury. They are warned not to take any medicines, or most recently common medicinal plants such as Echinacea or Valerian unless they consult with their doctors. The most recently broadcast environmental scare comes to us in the form of chocolate, which apparently contains lead and cadmium (American Health Line, 10, 2002, Fri., California, "Group Files Suit Over Toxic metals In Chocolate"). But so far there is no public warning about mercury coming from amalgam or the vaccine preservative Thimerosal. Babies are exposed to mercury by way of vaccines sometimes as early as the day they are born, if not before because the mother needed dental work or took Rhogam because her blood was Rh-negative.

Because mercurial medicines such as mercurochrome and merthiolate as well as the former diuretic and antisyphilis drug mercuric chloride are inherently dangerous, they are no longer on the market. You can no longer buy fever thermometers containing mercury. House paint containing mercury was banned in the early nineties. Thimerosal, now under investigation with respect to DPT (Diptheria, Pertussis, Tetanus), was often given to infants together with flu, Hepatitis B, and other shots containing Thimerosal. In the past, they were given without any hesitation. Now they are quietly being eliminated. But there is no law, yet, forbidding mercury preservatives, just as there are no laws forbidding the use of amalgam in the dentist's office or tobacco in cigarettes etc. (See also: Hearings Before The Committee On Government Reform, House Of Representatives, One Hundred Sixth Congress: "Vaccines--Finding The Balance Between Public Safety And Personal Choice," Aug. 3, 1999, and "Mercury in Medicines--Are We Taking Unnecessary Risks?" July 18, 2000, http://www.access.gpo.gov/congress/cong017.html). In order to calm its readership about the fear of exposing themselves and their children to vaccines the Wall Street Journal (Review & Outlook, Editorial: Immune To Reason, Tuesday, October 23, 2001) downplays Thimerosal's risk and calls "modern" America "risk-phobic." The writer prefaces that statement by saying:

The hysteria this time is over Thimerosal, an organic mercury compound that since the 1930s has been used in very small quantities as a preservative in vaccines. The Food and Drug Administration requires such preservatives to keep vaccines from being contaminated by bacteria and fungus. But back in 1999, the FDA released a report fretting that some children receiving the entire schedule of vaccines might ingest slightly more mercury than considered safe by (controversial) Environmental Protection Agency standards.

That report rallied a number of advocacy groups that claim Thimerosal is behind childhood neurodevelopmental disorders such as autism and attention- deficit disorder. Parents groups like Safe Minds have for years demanded that thimerosal be outlawed, even though there is no credible evidence whatsoever -- none -- linking the low levels of mercury in vaccines to any disorders.

As a presenter during the Institute of Medicine's workshop on Thimerosal-Containing Vaccines and Neurodevelopmental Disorders, I must respond to your Oct. 30 [SIC] editorial "Immune to Reason." The IOM report did not find "no evidence that mercury-containing vaccines cause harm," but rather that there was not yet enough direct evidence to either accept or reject the hypothesis. This is quite different from concluding that there was no credible evidence and rejecting the hypothesis, as your editorial suggests.

More importantly, it was the IOM, whose responsibility it is to make such difficult recommendations, that concluded it is in the best interest of the public health to use thimerosal-free vaccines exclusively for children at this time and to move toward removing mercury form all vaccines.

The goals of protecting the public from vaccine-preventable diseases while providing the safest possible vaccines are equally important to the health of America's children and are not mutually exclusive. Jane Maroney El-Dahr, MD, Tulane University Medical Center, New Orleans - The author is associate professor, clinical pediatrics and Head, Section of Pediatric Allergy/Immunology/Rheumatology

To confound the situation, MMR (Measle, Mumps, Rubella) vaccine seems to many parents to be the cause for their children's autism. As it turns out this vaccine contains no preservatives and thus no Thimerosal (Physician Desk Reference). So, not surprisingly a study in Denmark (The Wall Street Journal, Danish Study Finds No Links Between Vaccine And Autism, by Rachel Zimmerman, Thur., November 7, 2002, p.D4, reporting on an article in The New England Journal of Medicine, Nov. 7, 2002, p.1477, A Population-Based Study of Measles, Mumps and Rubella Vaccination and Autism) discounts the theory that the MMR vaccine might be the cause for autism.

... More than 400,000 of the Danish children received the MMR vaccine for measles mumps and rubella--the same shot given to children in the U.S. About 100,000 of the children weren't vaccinated with MMR...

The study found that in both the vaccinated and the unvaccinated groups...about three in every 1,000 children were diagnosed with autism or related disorders...

Going by the Danish study the MMR vaccine thus could easily be a "red herring," possibly designed to "exhonorate" all vaccines. The late conscience of Dr. Neal Halsey does not alter the fact that there is only luke-warm questioning of Thimerosal's safety. In the '90s, Dr. Halsey used to advocate the vaccination of all infants, and the sooner the better.

Of course children need to be vaccinated. That does not mean all children need mercury. I wonder if Dr. Halsey even knew, then, that Thimerosal was an ingredient. Not many physicians knew. But in the face of all the evidence, showing toxicity coming from Thimerosal, it is amazing that the only response the doctor can muster is ambivalence.

On June 18, 2003 an articles in The New Scientist reviews a report to be published in the September Issue of the International Journal of Toxicology, Toxic Metal Clue To Autism, that there is indeed a connection between mercury in autism:

A study of mercury levels in the baby hair of children who were later diagnosed with autism has produced startling results. The babies had far lower levels of mercury in their hair than other infants, leading to speculation that autistic children either do not absorb mercury or, more likely, cannot excrete it.

The possibility that the Danish study was a "Red Herring" is even more plausible knowing that only two months later another Danish study was published in Pediatrics Magazine (Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data, by Kreesten M. Madsen, MD*, Marlene B. Lauritsen, MD, Carsten B. Pedersen, Msc, Poul Thorsen, MD, PhD*, Anne-Marie Plesner, MD, PhD, Peter H. Andersen, MD and Preben B. Mortensen, MD, DMSc; Vol. 112, September 3, 2003, pp.604-606) that is trying, once and for all, to eliminate the idea that Thimerosal is the culprit causing autism. All major newspapers and magazines carried the story claiming that Thimerosal was not to blame any longer for the rising incidence of autism. Yet reading the article it becomes soon obvious that the data must have been massaged and manipulated to make them fit the wanted conclusion. Two of the scientists had a conflict of interest working for the Danish manufacturer of Thimerosal. The scientists, if indeed any were involved, employed the scientific method only minimally. In addition the pool from which the subjects were drawn was enlarged some time after Thimerosal was removed from Danish vaccines so that the numbers became meaningless. ( PR Newswire, Tuesday September 2, 8:06 am ET; Vaccine Health Officials Manipulate Autism Records To Quell Rising Fears over Mercury in Vaccines; Safe Minds Cites Unscientific Trending Techniques and Conflicts of Interest, Call Study's Conclusions Doubtful)

Mercury from Thimerosal is not the same as mercury from amalgam. Still the following question presents itself: Can we really presume all is being done to keep us secure in our belief that public entities such as the ADA, the CDA, CDC, and our dentists tell us the truth about what they are putting into our bodies? The psychological harm by not telling us what we are exposed to might be even greater than the actual harm that amalgam causes. Rumors run rampant on the internet about Chronic Fatigue Syndrome, Alzheimer's, and MS being caused by amalgam.

The institutionalized complacency of the above-mentioned organizations reminds of the complacency with which NASA ignored warnings in both the Challenger and the Comlubia space shuttle disasters as well as some aspects of 9-11. In the first two disasters administrative personell only saw what they wanted to see and not what sciencists had warned of all along.

But ignoring the influence of mercury on our bodies, even if it is only a small amount, allows us to ignore not only the fact that it could poison individual cells, but also that it could wreak havoc with our enzyme, vitamin, mineral and protein metabolism. It could interfere with our state of nutrition and whether we are making good use of the things we eat on a day to day basis.

For example, it is not often mentioned that mercury displaces zinc when it courses through the body. The zinc deficiency thus caused could leave a child stunted and immature. It is also not mentioned that the presence of mercury deprives the body of an optimal level of thiamin (Vitamin B1). Thiamin deficiency causes beriberi (in Sighalese this word means "I can't, I can't"). The presence of mercury in our bodies also could cause the signs of methionine deficiency, a form of protein malnutrition. Methionine is an essential amino acid, i. e. it cannot be synthesized by the human body. In African countries this type of malnutrition is called kwashiorkor. The reason why both thiamin and methionine deficiency can arise in the presence of mercury is because thiamin and methionine have a sulfur component and are very unstable. Mercury thus has no trouble destroying the two essential nutrients. We humans compensate for the lack of that deficiency by eating more. It is no wonder that there is so much discussion about obesity, particularly in teenagers.

The symptoms of both thiamin and methionine deficiency show some similarities to mercury poisoning, such as depression, fatigue, mental deterioration, numbness in the distal extremities etc. To find out how severe this problem is deserves further investigation.

Since there are no results of official studies in the USA, as yet, of how great the danger from amalgam actually is, it could be implied that there are also no studies on the effects of mercury from amalgam on human physiology, not to speak of human psyche and behavior. Anyone will tell you that the difficulty lies in the fact that double blind studies cannot be considered relevant unless they are done on human subjects. Testing animals would not allow for the testing of characteristics specifically human in nature. To add to the problem, the following two qualifications have to be met. First the test subjects have to be willing to submit to tests involving one of the most toxic metals known to man, and second the subjects would have to be free of mercury. Even if there were willing subjects, it would be unethical and highly irresponsible to use human subjects to test the effects of a substance that is known to cause illness.

The Nuremberg Code became the standard for testing after World War II and the Nuremberg Trials: "Permissible Medical Experiments." Trials of War Criminals before the Nuremberg Military Tribunals Under Control Council Law No. 10. Nuremberg October 1946 - April 1949, Washington. U.S. Government Printing Office (n.d.), vol. 2., pp. 181-182. "Recommendations guiding physicians in biomedical research" involving human subjects followed in 1964 in the Declaration of Helsinki; adopted by the 18th World Medical Assembly, Helsinki, Finland, June 1964, amended by the 29th World Medical Assembly, Tokyo, Japan, October 1975, and the 35th World Medical Assembly, Venice, Italy, October 1983

The first qualification, studying mercury double blind on humans, would be akin to studying the toxicity of poisonous mushrooms on people. The second, finding subjects unexposed to mercury, is almost impossible to meet. Mercury is ubiquitous. Almost everyone is exposed these days. The consumption of fish containing ever-increasing amounts of methyl mercury, due to environmental overload from coal-fired power plants etc., is rising exponentially. Adding to that, most people have mercury fillings by the time they are ten years old, and the first exposure of mercury arrived in our bodies when we were still infants in the form of thimerosal (a mercury antifungal preservative) in vaccines or even in the womb if our mothers had amalgam fillings or ate a lot of fish.

Most of us have been exposed to mercury from car exhaust and air pollution. Fish contains mercury because that is where all mercury winds up eventually. It winds up in the water either naturally through soil erosion or after it has been used in various manufacturing processes. It is being released into lakes, rivers and eventually the oceans. There the algae metabolize the metallic mercury. These algae are eaten by smaller sea creatures, which in turn are eaten by the bigger fish etc. The oldest, largest fish eventually wind up with the highest mercury content. Whales, dolphins, sharks, tuna, swordfish, king makarel are the most likely to contain a lot of mercury. Tin cans, in which tuna is stored, have also been known to contain mercury. Paint and toilet paper from recycled paper products contain residues of mercurial antifungicides. The New England Journal of Medicine (Mercury Poisoning in Paper Pica, April 29, 1982, p. 1056) reported that an Inuit woman showed the typical signs of mercury poisoning (headaches, dizzy spells, tunnel vision) after having habitually eaten paper over a stretch of ten years. She had eaten a box of Kleenex (83ppb) and cigarette packages (108ppb) daily and sometimes consumed whole paperback books (341ppb). She did not eat fish. Her hair was tested and found to contain hair mercury levels that corresponded to 251 ppb in blood. Given all these sources of mercury, it is easy to see that there are no straight-forward solutions to the study of mercury in the human body. The only way to find out about most chronic, non-lethal, mercury poisonings is, therefore, through epidemiologic processes.

Most of the symptoms of mercury poisoning have been gathered empirically in the same way people found out about poisons since prehistoric times. Eat a toadstool or deadly nightshade berry and you die. Touch poison oak and you get a rash. Cyanide or strychnine are bad for you because you die from those poisons. The toxicity of chemicals ranges from mildly allergenic to mind-altering to medicinal to lethal. The outward signs of toxicity can vary from very mild to severe.

Meanwhile it is often forgotten that acrodynia still exists. It just does not show up as a result of calomel. Nowadays acrodynia results from other sources of mercury. The source of mercury could be a pesticide, fungicide, paint, floor cleaner/preservative etc.

Another example for empirically determining mercury poisoning is the story of a "cure" for syphilis by using mercuric chloride. This mercury salt had been the drug of choice and the only "cure" for that venereal disease for centuries. The "madness" syphilitics experienced was thought to be a symptom of syphilis. Mercury made it worse. But that was but a small price to pay for regaining your "health." If there were side-effects, they would not have been immediately recognized as being connected to the mercury. At any rate, with the arrival of antibiotics, the, by now, apparent harm mercury caused was eliminated. Epidemiologically speaking, this proved that mercury had caused the "madness."

Calomel had been used as a teething powder on babies for over a hundred years. That is how long they had been suffering from "Pink Disease." Not until the middle of the 20th century did it dawn on a few Australian doctors that mercurous chloride, Hg2Cl2, was causing it. The proof that Calomel was the culprit, though, was not brought until ten years later when it became evident that babies did not suffer from acrodynia any longer. See Mats Hansen: ACRODYNIA OR HOW TO FAIL TO RECOGNIZE MERCURY POISONING FOR MORE THAN 100 YEARS. The reason why mercury was implicated so late was partly due to the fact that it was known to cause "allergies" and partly due to the typical delay of neurological symptoms in chronic mercury poisoning.

Epidemiological studies are not ideal because of the many confounding factors. Marcia Angell, MD, writes in "Science On Trial", pp. 166-167:

Probably the chief difficulty in epidemiologic studies is chosing groups of people who are alike in every way except for the exposure in question (in cohort studies) or the disease in question (case control studies). Yet this is essential. Otherwise, some other differences between the groups might account for the results and badly mislead everyone. Other differences between groups that may confuse the results are "confounding variables." For example, cigarette smokers are more likely to drink alcohol than nonsmokers. So when an epidemiologic study shows a link between cigarette smoking and a disease, it is necessary to determine whether the real association is with smoking or whether it might possibly with drinking (the condounding variable in this case). It could be the combination--or even some other factor that might be different between smokers and nonsmokers.

Although there are statistical methods for neutralizing confounding variables, they are not perfect, and they are of no use whatsoever unless the confounding variables are known and measured. For example, epidemiologic studies have shown an association between premature births and lack of prenatal care, but maybe there are confounding variables that explain the association. Maybe it has nothing to do with the prenatal care itself. For example, it could be that women who can afford prenatal care are more likely to carry babies to term because such women are better nourished.

But back to the subject of amalgams. While all this was going on, mercury was considered "safe" in the form of amalgam. There were "no" acute symptoms (or were there?) right after the filling was put in, and there were no "apparent" symptoms later on that could be clearly labeled as having resulted from amalgam. The symptoms "mild" mercury poisoning is known for are usually not recognized as medical problems, but fall into into the realm of psychiatry. If there were symptoms after a visit to the dentist they might have been a migrain headache or some ringing in the ears or diarrhea. The symptoms were only very mild, and they could have come from exposure to almost any substance produced in our industrialized world.

Dentists have claimed that amalgam is the filling material of choice. It it relatively harmless, they say. It is, in any case, better than not filling cavities at all. The question poses itself: Is there even a way to connect amalgam to the many symptoms that have been attributed to the exposure of mercury from amalgam, and could one deduce from empirical studies whether amalgam causes poisonings that are not easily correlated to the amounts of mercury in blood or urine samples at a given time? In order to answer that question, the symptoms have to be definable. There has to be a clear-cut set of signs that separates mercury poisoning from other heavy metal poisonings.

In addition it would be desirable to clarify what the word allergy means, and if it should not be eliminated from the vocabulary when it comes to mercury. The pink skin in mercury poisoning is no more an allergic reaction than the pink skin in scarlet fever or the rash in measles. Just because sensitivity to mercury looks like an allergy does not mean that it is one. The pink skin is the result of toxicity. It was first described as acrodynia or "pink disease". Even though acrodynia is almost always mentioned in the context of teething powders, it can also be the result of inhaling paint vapors containing too much mercury anti-fungicide:

In August 1989, a previously healthy 4-year-old boy in Michigan was diagnosed with acrodynia, a rare manifestation of childhood mercury poisoning. Symptoms and signs included leg cramps; rash; itching; excessive perspiration; rapid heartbeat; intermittent low-grade fevers; irritability, marked personality change; insomnia; headaches; hypertension; swelling; redness and peeling of the hands, feet, and nose; weakness of the pectoral and pelvic girdles; and nerve dysfunction in the lower extremities. A urine mercury level of 65 ug/L was measured on a 24-hour urine collection. Treatment with intensive chelation therapy increased his urine mercury excretion 20-fold. Examination of his mother and two siblings found urine mercury levels greater than or approximately equal to his; his father had elevated, although lower, levels. Parents and siblings were asymptomatic, although electromyographic abnormalities were detected in one sibling.... identified inhalation of mercury-containing vapors from phenylmercuric acetate contained in latex paint as the probable route of mercury exposure for the family; 17 gallons of paint had been applied to the inside of the family's home during the first week of July. Samples of the paint contained 930-955 ppm mercury, the Environmental Protection Agency (EPA) limit for mercury as a preservative in interior paint is 300 ppm. During July, the house was air conditioned, and the windows were not opened...

Because of this case a study was done to see if mercury from latex paint can produce toxic levels. The result was described in the New England Journal of Medicine; Oct. 18, 1990; Volume 323:1096-1101, Nr.16 "Mercury Exposure From Interior Latex Paint", by MM Agocs, RA Etzel, RG Parrish, DC Paschal, PR Campagna, DS Cohen, EM Kilbourne, and JL Hesse:

We found that potentially hazardous exposure to mercury had occurred among persons whose homes were painted with a brand of paint containing mercury at concentrations approximately 2 1/2 times the Environmental Protection Agency's recommended limit.

The problem with the diagnosis of mercury poisoning is that there are so many purported symptoms and that it takes so long for them to develop. And, just because of these two circumstances it is often said about people who blame mercury for everything that they are not realistic and that they must just have latched onto a fad. This criticism can be countered by pointing out that there has never been a limit to how many symptoms a disease may have. It is entirely possible for a disease to have 1,500 symptoms as Professor Hahnemann pointed out. The reason for this is that mercury works on the cellular level of the human organism and that the science of determining symptoms is confined to what a doctor can remember. It is neat and tidy when a disease can be easily recognized and has only very few pathognomonic signs. Therefore it is also not surprising that certain diseases are much more often described and diagnosed. But just because they have not been described and named, doesn't mean that they don't exist

The symptoms of mercury poisoning, depending on the amount and type of mercury consumed, range from imperceptible to dire. The Merck Manual's Centennial Edition (17th Ed., p.2636) lists the following symptoms in the chronic category: Gingivitis, Mental Disturbances, Neurological Deficits. Mercury vapor is listed as causing severe pneumonitis. The symptoms that go along with any kind of toxicity, such as liver and kidney disease are not mentioned here even though they present themselves often, especially in chronic mercury poisoning. The accumulation of mercury in the liver causes a constant strain on the organism. It causes fatigue and weakness to the body and compromises the immune system. The first signs of kidney disease might be albuminuria, frequent urination, and urgency to urinate. [See: Alfred Stock, Die Gefaehrlichkeit des Quecksilberdampfes, (1926); also Fatal Mercury Intoxication in a Dental Surgery Assistant, BRITISH DENTAL JOURNAL, 127:553-5 (12/16/69): A 42-year-old dental surgery assistant with at least a 20-year history of exposure to mercury developed a rapidly fatal nephrotic syndrome...]

There are no thorough U.S. studies as yet to quantify the level of distress the human body feels as a function of the amount of mercury absorbed from inhaling it as a vapor, swallowing it, or absorbing it through the skin. As mentioned already, the results of a U.S. study in this direction are not expected until 2005. A very exhaustive study on 20,000 people at the University of Tuebingen in Germany ( "Field Study on the Mercury Content of Saliva", by Peter Krauss, Universität Tübingen - Institut für Organische Chemie - AK Prof. Dr. Peter Krauß) deals with the saliva content of mercury from amalgam. It has so far not evaluated the effects of mercury on the people studied. In the meantime the overt symptoms, gathered empirically over centuries, have been well documented. The only U.S. study that deals with the question whether amalgam actually releases mercury into the human body by testing blood and urine samples (Mercury Concentrations in Urine and Whole Blood Associated with Amalgam Exposure In a U.S. Military Population, by Kingman, A., Albertini, T., Brown, L.J., J Dent Res, 1998;77(3): 461-471) http://nnd40.med.navy.mil/Gen_Dent/Gen_Dent/Pearlsb5.htm states the following:

...Correlations between amalgam exposure and Hg concentrations in urine were statistically significant. Hg concentrations are modeled as a function of amalgam exposure, adjusted for age, alcohol consumption, and the presence of restorations containing other metals for each measurement scale separately. The whole blood organic mercury concentration and the current number of alcoholic drinks per day were also consistently statistically significant. As alcohol consumption increases, lower urinary total mercury levels are to be expected...

Could this mean that the liver of a person drinking alcohol is not able to detoxify mercury as efficiently as necessary? That conclusion is likely, yet equally as unproven as the hypothesis that people who drink alcohol have found a way to eliminate their mercury overdose more effectively via the digestive tract, thus bypassing the already damaged kidneys. In any case there is a known correlation between alcohol consumption and mercury levels in urine and blood. This thought leads to the next question: Could it be that alcoholics, by getting drunk, are really choosing the lesser of two evils? Unfortunately, rather than becoming only mercury impaired they also become alcohol impaired. Either way the liver suffers.

None of those above mentioned studies evaluate the symptoms that might accompany higher blood or urine mercury levels in persons with amalgams compared to those without. And do the blood and urine levels really tell the whole story? The inference that the alcohol-impaired liver changes the urine levels of tested subjects demands this question. What other substances are there to change the values? The horrible physical effects on the body don't show up until the mercury has damaged the interior of the affected cells. By the time mercury has done its damage you might not find it in bodily fluids but only inside the cells. It takes quite a different test to assess the amount of mercury a cell might contain.

The Merck Manual describes the symptoms of mercury poisoning rather superficially. A physician is presumed to know what it means to have mental and neurological deficits. Mental and neurological deficits are rather subjective terms, however. What exactly do they mean when it comes to mercury? For a general description of what the terms entail please read this University of Iowa Web site on Neurotoxicity

The "Mad Hatter" whom Lewis Carroll's described in "Alice In Wonderland" had only a few symptoms and they appeared to be more behavioral than neurological. This particular hat maker did not even show erethism the way it is described in the dictionary. He had few signs of mood swings or at best only very mild ones, unless we are already too jaded by all the craziness around us in today's polluted world to think of him as mad. He seems merely a little confused, or perhaps excentric, in his choice of words. He is forgetful. But who doesn't forget things once in a while? And he shakes at one point when he is put under stress on the stand when he is being asked about what he knows about a theft. After all, he is being threatened with execution if he can't answer. Wouldn't we all shake? Could his behavior be considered a neurological symptom of mercury poisoning? Lewis Carroll apparently thought so. He was a mathematician who was familiar with the afflictions of hat makers. Carroll describes the "Mad Hatter's" sense of time. The hatter's interpretation of it could be one of the most telling signs of early onset mercury poisoning. The subtleties in his logic and his insistence on it are the beginnings of a certain willfullness that at this point escape Alice; she sees him as rude. But the reader sees the "Hatter's" logic as not entirely farfetched and even somewhat philosophical. The problem is not in his logic (he seems rather intelligent), but in his unwillingness to communicate patiently with Alice who cannot understand what he means when he comes up with a new way of looking at time. After all she is only a child. Off-hand what we can tell from the hatters behavior is that he is childish, slightly moody, unable to communicate with people, and, in the end, not unintelligent. It is known that hatters had all those symptoms and more.

At the other extreme, the inventor of homeopathy Dr. Samuel Hahnemann, a physician, who had seen quacks use mercury and became increasingly concerned about its indiscriminate use, listed over 1200 distinct symptoms of mercury poisoning. Because of the huge differences in opinion about what constitute symptoms of mercury poisoning it seems wise to look for other sources. The question is: Which symptoms could realistically be attributed to the effects of mercury?

There are two prominent examples of mercury poisonings in recent times. The first one, which occurred in the mid-fifties and early sixties at and around the Japanese fishing village of Minamata, affected thousands of people, and killed hundreds. The agent here is presumed to have been methyl mercury. It had made its way into Minamata Bay as an end-product in the process of making acetaldehyde. The people ate the mercury-laced fish caught in the bay and became sick. Many of them died. In a website from American University (TED Case Studies, Case Number 246) http://www.american.edu/TED/MINAMATA.HTM a paragraph gives the following account:

Not until the mid-1950's did people begin to notice a 'strange disease'. Victims were diagnosed as having a degeneration of their nervous systems. Numbness occurred in their limbs and lips. Their speech became slurred, and their vision constricted. Some people had serious brain damage, while others lapsed into unconsciousness or suffered from involuntary movements. Furthermore, some victims were thought to be crazy when they began to uncontrollably shout. People thought the cats were going insane when they witnessed 'suicides' by the cats. Finally, birds were strangely dropping from the sky. Series of these unexplainable occurrences were bringing panic to Minamata.

See also: LewRockwell.com: Minamata: Real Life Horror Show, by Mike (In Tokyo) Rogers,

The second incident refers to the poisonings and deaths of peasants in Iraq. Approximately 100,000 tons of grain had been shipped to a starving population. Because it was already fall in Iraq, not spring when it might have done them some good for planting, they baked pink bread made from the grains coated with a pink-colored mercury-containing preservative. This Purdue University website http://abe.www.ecn.purdue.edu/~mercury/src/iraq.htm describes the following scenario:

In 1956 over 100 people were poisoned in Northern Iraq by eating flour mixed with wheat seed. The wheat seed had been treated with a fungicide containing 7.7% ethylmercury-p-toluene sulfonamide. Fourteen deaths were reported, and probably even more occurred. As a trial, the seeds had been fed first to chickens for several days and no ill effects were observed. Besides central nervous system manifestations, a number of other clinical symptoms were observed: polydypsia, polyuria, weight loss, severe proteinuria, deep musculoskeletal pain refractive to analgesics, and pruritus of the palms, soles, and genitals. Researchers credit the other symptoms to the prevalence of a parasitic disease called ancylostomiasis, and to dietary deficiencies of protein and vitamins. The event repeated itself 4 years later when an additional 100 people were poisoned by a flour and wheat seed treated this time with a fungicide containing 1% ethylmercury chloride and phenylmercury acetate. Four of 34 patients died, and it is probable that others died as well after refusing hospitalization and medical advice.

According to Medicine-Worldwide 100,000 Iraqis came in contact with the mercury and about 2,000 people died of mercury poisoning.

These two cases illuminate the major impact mercury had on the affected populations in Japan and Iraq. Both countries had deaths. In both countries the poisoning resulted in a permanently maimed part of the population. What is significant in Iraq is that the people there knew that the seed grain was poisonous. They just didn't know in which way. They didn't know that it may take a long time to poison with mercury. Because, even though acute poisoning can kill within a few days, the insidiousness of chronic mercury poisoning lies in the delayed effect of methyl and ethyl mercury. It takes months even for a potentially lethal dose to take effect. The people fed the grain to the chickens to see if those chickens might show signs of poisoning. When nothing happenend, after what seemed a reasonable time, the grain was used to bake bread. The poisoned chickens did not die as had been expected. So they were slaughtered and eaten, too. That, too, caused poisoning.

What could have prevented the poisoning? Maybe nothing. However, the failure to detect the poisoning of the chickens showed the basic lack of understanding of how slowly organic mercury may poison the body. They gave the ckickens too little time to be poisoned. If they had waited half a year, the chickens would have died from mercury poisoning and the grain would not have poisoned anyone. But Iraq had a famine at the time, and it is not certain how long the population could have waited. Still, if the people had been better informed, they might have lived.

Why do I mention these two examples of mercury poisoning when amalgam seemingly does not cause any overt symptoms? My point is that it took time to discover that mercury had caused the deaths in those countries. Mercury from amalgam has the same potential for harm as any other mercury. Its toxicity depends mainly on how the mercury binds to organic or inorganic matter in the body. Neither in Minamata nor in Iraq was mercury suspected right away. In Minamata the prime suspect for the characteristic animal and people behavior was at first thought to have been the acetaldehyde, a building block for plastic, that had been manufactured at the Chisso plant in Minamata since the 1930s. But to discover the connection to mercury still took close to thirty years. Mercury was a necessary ingredient for the manufacture of acetaldehyde.

The symptoms were so subtle that at first the population was in denial. They were perceived as behavioral deviations. Furthermore, in Japan any disease process was considered a reflection of the individual's own failure. Therefore quaint names were given to the behavior so nobody would hold it against you if you acted strange. The behavior in cats was called "dancing cat" disease. The corresponding human behavior was called the "elegant" disease. Only after years of investigations and worsening symptoms was it discovered that mercury used in the process of making plastics was the cause of birth defects and deaths (Bitter Sea, Akio Mishima, The Human Cost of Minamata Disease, 1992).

The difficulty diagnosing vague symptoms coming from continued slow leakage of mercury vapors or compounds from dental amalgam thus becomes much more plausible when it is put in perspective.

Chronic mercury poisoning has many faces. Some are psychological, some behavioral and some are physical. The following quote was part of an article published by the Zeitschrift für angewandte Chemie under the title "Die Gefährlichkeit des Quecksilberdampfes," Von ALFRED STOCK, Berlin-Dahlem, Kaiser-Wilhelm-Institut für Chemie, (Eingeg. 9. Febr. 1926):

Seit beinahe 25 Jahren litt ich an Beschwerden, die, anfangs schwach und nur gelegentlich auftretend,allmählich mehr und mehr, schließlich fast bis zur Unerträglichkeit zunahmen, so daß ich schon daran verzweifelte, weiter wissenschaftlich arbeiten zu können. Die Ursache wurde von mir und vielenausgezeichneten Ärzten, die ich um Rat anging, nicht erkannt. Man hielt für möglich, daß sie in besonders engem Bau der Nasenwege und in einer ungewöhnlichen Reizbarkeit der Nasenschleimhaut zu suchen sei. Ich unterzog mich infolgedessen jahrzehntelanger Behandlung der Nase mit Ätzen, Brennen, Massieren, Elektrisieren, blutigen Operationen. Ohne Erfolg! Vor etwa zwei Jahren endlich kam durch einen Zufall - einige meiner Mitarbeiter erkrankten unter ähnlichen Erscheinungen - heraus, daß es sich um eine schleichende Vergiftung mit Quecksilberdampf handelte. (web link vide infra, Alfred Stock, Die Gefaehrlichkeit des Quecksilberdampfes, 1926; translated by Birgit Calhoun: The Dangerousness of Mercury Vapor)

In the above-mentioned quote Dr. Afred Stock, head of a Berlin University laboratory, talks about his 25-year long illness [headaches, sinus infections sore throats etc.]. He reports that he consulted numerous outstanding physicians without finding relief. It was thought possible that the reason for his problems could be found in the narrow built of his nasal passages and the unusual irritability of his nasal mucosa. Because of this he underwent decade-long treatments of the nose with cauterizations, burnings, massages, electrical stimulations and bloody operations. Without success! By accident he found out about the illnesses in some of his co-workers with symptoms similar to his.