MercolaWatch: Misrepresentation of dental amalgams

Joe Mercola just published another of his articles which presents dental amalgams (silver fillings) as all bad and also calls out "dental review boards" for revoking licensure of dentists who remove amalgams. While ideally we would release no mercury into the atmosphere, dental amalgams remain an effective and (relatively) safe method of restoration of teeth damaged by tooth decay.

In his January 8 article "Disregarding Half of US Dentists and Ignoring the Environment, ADA Shills for Dental Amalgams" (which seems to be a follow-on from a previous article of his discussing some of the same material), Mercola picks a couple of quotes from aWHO reporton dental amalgams where they indicate a goal to phase out their use world wide over time. What he of course does not quote are the sections in that same report where the WHO points out that the alternatives to mercury-based amalgams themselves carry risk and are also not as reliable. I may discuss the details of the WHO report in a "Part II", but in the interests of space I will focus on some other aspects.

ADA, APHA, FDA statements on Dental Amalgams

Much of the article is taken up with lambasting the American Dental Association (ADA) and American Public Health Association (APHA) for releasing a policy statement stating that (at least in the US) dental amalgams are "safe and effective". Unlike Mercola's article, the APHA actually cites the studies that demonstrate their point, so I will just link to them and let the reader decide. The ADA (who are apparently the puppet masters for the APHA according to Mercola) also has a policy statement on the use of amalgams. In addition to the APHA, the FDA, in their 2009 reclassification of amalgams as a Class II medical device(which the ADA notes is the same classification as the other composite alternatives to amalgams), states that:

FDA has found that scientific studies using the most reliable methods have shown that dental amalgam exposes adults to amounts of elemental mercury vapor below or approximately equivalent to the protective levels of exposure identified by ATSDR and EPA [ed: intended for pregnant women, those who are sensitive, and children under 6]. Based on these findings and the clinical data, FDA has concluded that exposures to mercury vapor from dental amalgam do not put individuals age six and older at risk for mercury-associated adverse health effects.

Both the ADA and FDA cite the studies that they are basing their statements on. While Mercola has a large disagreement with the US FDA, ADA and APHA, he does not actually bring much in the way of actual evidence to bear in his efforts to refute their policy statements and decisions. The bulk of the WHO report he cites is about world-wide disposal of mercury (and it's potential entry into the food supply), but this is also addressed by the policy groups above in terms of the US. Additionally, as the WHO report he cites says:

Existing alternative dental materials are not ideal due to limitation in durability, fracture resistance, and wear resistance. Therefore, the meeting recognized the need for strengthening of research into the long-term performance, possible adverse effects, and viability of such materials”.

“It may be prudent to consider ‘phasing down’ instead of ‘phasing out’ of dental amalgam at this stage. A multi-pronged approach with short-, medium- and longterm strategies should be considered. Alternatives to dental amalgam exist but the quality of such materials needs to be further improved for use in public health care.”

Dentists losing license for removing fillings?

Also buried in Mercola's article was a rather remarkable claim that I wanted to discuss for a bit:

At one time they even declared that removing mercury fillings is unethical and many dentists lost their licenses for removing them. The ADA aided and abetted dental boards to yank licenses from dentists who truthfully told patients that amalgam is mainly mercury and who advised against its use.

Now that sounds rather Orwellian on the face of it. But what's the real story here?

Not too surprisingly, there is no citation or even a name mentioned. However, there is a good chance this is in reference to one Hal Huggins, who lost his dental license for just what Mercola says. Well, for "gross negligence and professional misconduct". Hal Huggins actually wrote an article for mercola.com in October of 2012, so he clearly has links to Dr. Mercola.

Stephen Barrett’s QuackWatch has some extracts from the 71-page Administrative Law Judge's rulingposting on Hal Huggins. In short, Huggins had created a dental practice, which at one time included 50 other dentists, which specialised in doing nothing except removing mercury-containing amalgams. The judge's ruling is a frightening read, and it notes that Huggins was unable to come up with any evidence to even support his claims about the dangers of amalgams (though he claimed to have “thousands” of studies).

Some choice quotes from the decision (emphasis mine):

For the past 22 years, Respondent [Huggins] has limited his practice of dentistry to the diagnosis and treatment of patients he believes are mercury toxic due to the placement in their mouths of dental amalgam filings which contain mercury.

Respondent is the only dentist in the United States who trains other dentists how to treat patients with alleged mercury toxicity due to dental amalgams.

espoused treatment offers to remedy a host of conditions, including tremors, seizures, MS, ALS, Alzheimer's disease, emotional disturbances, depression, anxiety, unprovoked suicidal thoughts, lupus, scleroderma, rheumatoid arthritis, unexplained heart pains, high and low blood pressure, tachycardia, irregular heartbeat, osteoarthritis, chronic fatigue, "brainfog," digestive problems, and Crohn's disease. The sheer breadth and number of these diseases is staggering.... Respondent has taken advantage of the hope of his patients for an easy fix to their medical problems and has used this to develop a lucrative business for himself.

“ Instead of referring patients to physicians who could actually treat their underlying medical diseases and who could make a diagnosis of the mercury toxicity which Respondent suspects, Respondent simply ignores the limits of his qualifications and licensure and proceeds to treat these patients. He subjects patients to a wide array of tests and treatments. which have no clinical justification.”

“Respondent's encouraging D.A. to believe in her son's wish that she sell her wheelchair is so out of proportion to any benefit which could be anticipated that it is cruel. The Huggins Center treatment caused actual harm to A.G.'s mouth and gums, as well as her appearance, under circumstances when her prognosis was very poor.”

“Given his steadfast and longstanding commitment to his theories in the face of substantial reasoned evidence to the contrary, it is evident that nothing will stop Respondent from practicing the treatments he has developed short of revocation of his license to practice dentistry. Such disciplinary action is also justified by the multiple violations of the Dental Practice Act proven in this matter, especially those involving grossly negligent care.”

And this is someone that Dr. Mercola is happy to have write articles (dental related!) for his blog. "Conventional" medical professionals are portrayed as being in it purely for the money or in the pockets of "Big Pharma", for treating the the symptoms rather than the cause, or for generally not caring about their patients. There are no doubt bad apples, as there are in every single walk of life. But those people are properly kicked out of the profession when found out. As portrayed by the judge's ruling, Huggins epitomized that.

Conclusion

While ideally we would never release any mercury into the environment, the amount released by dental amalgams appears to be relatively negligible versus other sources of mercury. Additionally, amalgams are currently the most cost effective and "proven" of the available methods of filling. Hopefully the research continues into its alternatives to make amalgams actually obsolete, but that has not happened yet. More importantly, there simply is not scientific evidence that mercury-based dental fillings represent a danger to those who have them (regardless of age). One cannot simply associate the dangers of mercury with amalgams and those very few practitioners who have done so and dangerously diagnosed "mercury toxicity" have rightfully lost their license.

REFERENCES
1. American Dental Association. "Statement on Dental Amalgams". Published August 2009.
2. American Publish Health Association. "Dental Amalgam -- Preserving a Proven Dental Material". Publish October 30, 2012.
3. US FDA. "Summary of Changes to the Classification of Dental Amalgam and Mercury". Published August 8, 2009.
4. World Health Organization. "Future Useof Materialsfor DentalRestoration:Report of the meeting convened at WHO HQ, Geneva, Switzerland". November 2009.
5. Colorado State Board of Medical Examiners. "IN THE MATTER OF THE DISCIPLINARY PROCEEDINGS REGARDING THELICENSE TO PRACTICE DENTISTRY IN THE STATE OF COLORADO OF HAL A.HUGGINS, D.D.S., LICENSE NO. 3057". Case No. DE 95-04.