Mercury From Amalgam Fillings:

A Major Factor in Periodontal Disease and Oral Health Problems

Mercury is one of the most toxic substances in existence and is known to
bioaccumulate in the body of people and animals that have chronic
exposure. Mercury exposure is cumulative and comes primarily from 3 main
sources: occupational exposure, food(mainly fish), and silver/mercury
dental fillings. Whereas mercury exposure from fish is primarily methyl
mercury, mercury from occupational exposure and dental fillings is
primarily from elemental mercury vapor. But bacteria in the mouth and
intestines methylate other forms of mercury to methyl, and some
demethylation also occurs.

The most common type of occupational exposure comes from dental office
exposure and is documented to result in significant adverse health
effects(602). Mercury in amalgam fillings, because of its high
volatility and galvanic action due to presence of dissimilar metals in
the mouth, has been found to be continuously vaporized and released into
the body (192,600,etc.), and has been found to be the largest source of
mercury in the majority of people who have amalgam fillings
(WHO:183,199,209,601, 18). The level of daily exposure commonly exceeds
the U.S. EPA health guideline for daily mercury exposure(2,217,601).

Concentrations of mercury in oral mucosa for a population of patients
with 6 or more amalgam fillings taken during oral surgery were 20 times
the level of controls(174). Studies have shown mercury travels from
amalgam into dentin, root tips, and the gums, with levels in roots tips
as high as 41 ppm(192). Studies have shown that mercury in the gums such
as from root caps for root canaled teeth or amalgam tattoos result in
chronic inflammation, in addition to migration to other parts of the
body(200,47,35). Mercury and silver from fillings can be seen in the
tissues as amalgam "tattoos", which have been found to accumulate in the
oral mucosa as granules along collagen bundles, blood vessels, nerve
sheaths, elastic fibers, membranes, striated muscle fibers, and acini of
minor salivary glands. Dark granules are also present intracellularly
within macrophages, multinucleated giant cells, endothelial cells, and
fibroblasts, and metals also accumulate in tooth roots and the jaw
bone(47,35). There is in most cases chronic inflammatory response or
macrophagic reaction to the metals(47), usually in the form of a foreign
body granuloma with multinucleated giant cells of the foreign body and
Langhans types(192). In a group of patients with amalgam tattoos that
were tested, 74% of the patients revealed high lymphocyte reactivity
(positive MELISA test) to one or more metal components of dental
restorations(47k). The majority of MELISA positive patients suffered
from serious health problems (various allergies, autoimmune diseases,
Parkinson\'s syndrome etc.). Nickel and inorganic mercury were the most
common sensitizers in vitro. The cytokine assay revealed that mercury
chloride activated predominantly TH2 lymphocytes, while nickel chloride
activated mainly TH1 lymphocytes.

Most dentists are not aware of the main source of amalgam tattoos, oral
galvanism where electric currents caused by mixed metals in the mouth
take the metals into the gums and oral mucosa, accumulating at the base
of teeth with large fillings or metal crowns over amalgam base(192).
Such mercury including that in the commonly formed amalgam tattoos moves
to other parts of the body over time in significant amounts and more
rapidly than the other metals. Macrophages remove mercury by
phagocytosis and the mercury moves to other parts of the body through
the blood and along nerves(47). Another study (47l) demonstrated a dense
mononuclear inflammatory infiltrate associated with large and powdered
debris and positivity for HLA-DR and MT in inflammatory cells. While
blood vessel walls and connective fibers impregnated with powdered
particles were negative for HLA-DR, they were positive for MT. In
addition, wherever epithelial basement membrane impregnation by powdered
amalgam particles was observed, a strong positivity for MT was detected.
These findings demonstrate that residual elements of AT still have
noxious local effects over tissues. Such metals are documented to cause
local and systemic lesions and health effects, which usually recover
after removal of the amalgam tattoo by surgery (47fghim). The high
levels of accumulated mercury also are dispersed to other parts of the
body.

Mercury vapor given off by amalgam fillings accumulates in the teeth,
tooth roots, gums, jawbone, and oral tissue. The number of amalgam
surfaces has a statistically significant correlation to the level of
mercury in oral mucosa and saliva (18,77,79,182,199,211,222,292).

The amount of mercury in saliva averaged between 1.5 to 1.9 micrograms
per Liter for each amalgam filling(199ab).

The amount of mercury released by a gold alloy bridge over amalgam over
a 10 year period was measured to be approx. 101 milligrams(mg)(60% of
total) or 30 micrograms(ug) per day(18), and other studies have found
similar results(182). The average mercury levels in gum tissue near
amalgam fillings are often over 100 ppm(192), and levels in oral mucosa
removed during oral surgery averaged over 2 ppm(over 20 times controls )
and levels in root tips of 41 ppm(174,192,47).

Having dissimilar metals in the teeth(e.g.‑gold and mercury) causes
galvanic action, electrical currents, and much higher mercury vapor
levels and mercury levels in tissues. (182,191,192,18,19,27,
30,47,48,8,174). The level of mercury in the gums or jaw bone is often
1000 ppm near a gold cap on an amalgam filling (30,25,35,48,58), and
similar levels as high as 5600 ppm have been found in the jaw bone under
large amalgam fillings or gold crowns over amalgam by German oral
surgeons(436). These levels are among the highest levels ever measured
in tissues of living organisms, exceeding the highest levels found in
chronically exposed chloralkali workers, those who died from mercury in
Minamata, or animals that died from mercury poisoning. The FDA action
level for warnings of dangerous levels in fish or food is 1 ppm and the
EPA health criterion level is 0.3 ppm. In patients with galvanic cell in
their oral cavity we found decreased levels of antiinflamatory markers,
such as secretory IgA, IgA 1, IgA 2, and lysozyme, and increased levels
of the proinflammatory marker albumin (192i).

Amalgam also releases significant amounts of silver, tin, and copper
which also have toxic effects, with organic tin compounds formed in the
body being even more neurotoxic than inorganic mercury.

German studies of mercury loss from vapor in unstimulated saliva found
the saliva of those with amalgams had at least 5 times as much mercury
as for controls(179,199\]. Much mercury in saliva and the brain is also
organic, since mouth bacteria convert inorganic mercury to methyl
mercury. Oral bacteria streptococommus mitior,S.mutans, and S.sanguis
were all found to methylate mercury(81,600),as well as Candida albicans.
Methyl mercury, like mercury vapor, crosses the blood-brain barrier, and
both forms are converted to very neurotoxic inorganic compounds which
have a long half-life in the brain. The process also results in
formation of hydrogen sulfide and metal protein compounds that are
involved in mouth odor(334).

A large study of 20,000 subjects at a German university found a
significant relation between the number of amalgam fillings with
periodontal problems(199). **Some of the oral effects documented in the
literature to be caused by amalgam include gingivitis, oral gum tissue
inflammation, bleeding gums, bone loss, mouth sores, oral lesions, pain
and discomfort, burning mouth, metallic taste, chronic sore throat,
chronic inflammatory response, lichen planus, autoimmune response, oral
keratosis, oral cancer, bad breath, mouth dryness, burning mouth tender
teeth, trigeminal neuralgia, sinusitis, orafacial granulomatosis, oral
lichen planus, leukoplakia, amalgam tattoos,** etc.
(27,29,48a,86,87,90,95,192a,341,525a,582,5). **Removal of amalgam
fillings led to cure or significant improvement for most of such oral
health problems** (8,27,56,57,75,82,86, 87,90,94,95,101,
115,133,145,167,168,192abcf,212,222,233, 313,317, 320,321,341,525a,
582,etc.) and oral keratosis(pre cancer) (87,251). For example, in one
clinic(95) that replaced amalgams for a large number of such patients,
there was cure or significant improvement in over 90% of cases for
metallic taste, tender teeth, mouth sores, and bad breath and in over
80% of cases for bleeding gums and throat irritation. A Jerome meter was
used to measure mercury vapor level in the mouth, and many had over 50
micrograms mercury per cubic meter of air, far above the Government
health guideline for mercury(217).

Mercury accumulates in the trigeminal ganglia(325,329ab) and can cause
trigeminal neuralgia from which most recover after amalgam
replacement(525a,192a,35d,222,437b).

Cavitations from improperly healed tooth extractions also commonly cause
trigeminal neuralgia and most such recover after cavitation
surgery(437b,35a). The periodontal ligament of extracted teeth is often
not fully removed and results in incomplete jawbone regrowth resulting
in a pocket (cavitation) where mouth bacteria in anaerobic conditions
along with similar conditions in the dead tooth produce extreme toxins
similar to botulism which like mercury are extremely toxic and
disruptive to necessary body enzymatic processes at the cellular level,
comparable to the similar enzymatic disruptions caused by mercury and
previously discussed(35,437ab).

Extremely toxic anaerobic bacteria from root canals or cavitations
formed at incompletely healed tooth extraction sites have also been
found to be common factors in Fibromyalgia and other chronic
neurological conditions such as Parkinson's and ALS, with condensing
osteitis which must be removed with a surgical burr along with 1 mm of
bone around it(35,200,437ab). Cavitations have been found in 80% of
sites from wisdom tooth extractions tested and 50% of molar extraction
sites tested(35,200,437ab). The incidence is likely somewhat less in the
general population.

. The interruption of the ATP energy chemistry results in high levels of
porphyrins in the urine(260). Mercury, lead, and other toxics have
different patterns of high levels for the 5 types of porphyrins, with
pattern indicating likely source and the level extent of damage. The
average for those with amalgams is over 3 time that of those without,
and is over 20 times normal for some severely poisoned people(232,260).
The FDA has approved a test measuring porphyrins as a test for mercury
poisoning. However some other dental problems such as nickel crowns,
cavitations, and root canals also can cause high porphyrins. Cavitations
are diseased areas in bone under teeth or extracted teeth usually caused
by lack of adequate blood supply to the area. Tests by special
equipment(Cavitat) found cavitations in over 80% of areas under root
canals or extracted wisdom teeth that have been tested, and toxins such
as anaerobic bacteria and other toxics which significantly inhibit body
enzymatic processes in virtually all cavitations(200,437ab). These
toxins have been found to have serious systemic health effects in many
cases, and significant health problems to be related such as arthritis,
MCS, and CFS. These have been found to be factors along with amalgam in
serious chronic conditions such as MS, ALS, Alzheimer's, MCS, CFS,
etc.(35,200,204,222,292,437). The problem occurs in extractions that are
not cleaned out properly after extraction. Supplements such as
glucosamine sulfate and avoidance of orange juice and caffeine have been
found to be beneficial in treating arthritic conditions as well(35).

Nickel and beryllium are 2 other metals commonly used in dentistry that
are very carcinogenic, toxic, and cause DNA malformations(35,456).
Nickel ceramic crowns, root canals and cavitations have also been found
to be a factor in some breast cancer and other cancers and some have
recovered after TDR, which includes amalgam replacement, replacement of
metal crowns over amalgam, nickel crowns, extraction of root canaled
teeth, and treatment of cavitations where
necessary(35,200,228a,486,530). Similarly nickel crowns and gold crowns
over amalgam have been found to be a factor in lupus(456,35,229) and
Belle's Palsy from which some have recovered after TDR and Felderkrais
exercises(35).

Toxic/allergic reactions to toxic metals such as mercury/amalgam often
result in autoimmune conditions such as lichen planus lesions in oral
mucosa or gums, eczema, pustulosis, dermatitis and play a roll in
pathogenesis of periodontal disease(313,314,etc.). A high percentage of
patients with oral mucosal problems along with other autoimmune problems
such as chronic fatigue(CFS) have significant immune reactions to
mercury, palladium, gold, and nickel(313,118,369). 94% of such patients
had significant immune reactions to inorganic mercury(MELISA test) and
72% had immune reactions to low concentrations of HgCl2(\<0.5 ug/ml).
61% also had immune reaction to phenylHg, which has been commonly used
in root canals and cosmetics(313) . Removal of amalgam fillings usually
results in cure of such lesions. \[75,82,86,87,90,94,101,118,133,
145,167,168,313\]. Patients with other systemic neurological or immune
symptoms such as arthritis, myalgia, eczema, CFS, MS, diabetes, etc.
also often recover after amalgam replacement(313,118,369,600,etc.) 10%
of controls had significant immune reactions to HgCl and 8.3% to
palladium.

In a recent study of patients with OLP, 60 % showed sensitization to 1
or more allergens using a patch test(85). The greatest frequency of
positive reactions was to dental metals. The order of tested metals
according to frequency of positive reactions was mercury, amalgam nickel
, palladium , cobalt, gold , chrome , and indium. However, patch tests
have been found to not be a reliable indicator of mercury immune
reactivity or allergy. In large number of clinical trials by doctors
treating OLP, between 39 and 53% of patients tested by patch tests were
indicated to be reactive to mercury . However when patients had amalgams
replaced, the majority recovered or significantly improved in a
relatively short time period irregardless of patch test results . Thus
the authors recommend replacement of amalgam in all cases of OLP and
similar conditions. The MELISA blood lymphocyte immune reactivity test
appears to be a more accurate indicator of immune reactivity than the
patch test. When patch tests are to be used it should be noted that the
clinical trials found that mercury immune reactivity is often a delayed
reaction, with positive patch test observed only later on the 10th or
17^th^ day of the test. Patients with OLP also commonly have been found
to be immune reactive to gold or nickel so that replacement of gold or
nickel crowns may be beneficial in such patients when amalgam
replacement is not sufficient to resolve the problem(85).

Oral lichen planus and oral lesions, caused most commonly by reactivity
to mercury, are inflammatory pre-cancerous conditions that have been
well documented in the literature to often develop into oral squamous
cell carcinoma(OSCC)(85). Infection and chronic inflammation have been
found to contribute to carcinogenesis through inflammation-related
mechanisms(85). Inflammatory bowel diseases are associated with colon
carcinogenesis and inflammatory oral conditions such as oral lichen
planus (OLP) and leukoplakia are associated with OSCC.

Mercury(as well as toxins from root canals and cavitations) interact
with brain tubulin and disassembles microtubules that maintain neurite
structure(207b,258,35,200,437). Thus chronic exposure to low level
mercury vapor can inhibit polymerization of brain tubulin and creatinine
kinase which are essential to formation of microtubules. Studies of
mercury studies on animals give results similar to that found the
Alzheimer brain. The effects of mercury with other toxic metals have
also been found to be synergistic, having much more effect than with
individual exposure(35).

Teeth are living tissue and have massive communication with the rest of
the body via blood, lymph, and nerves. Mercury vapor (and bacteria in
teeth ) have paths to the rest of the body. (34,325,etc.) Mercury has
direct routes from the teeth and gums to the brain and CNS, where it
accumulates to high levels in those with a large number of amalgam
fillings(34,327,329).

Due to galvanism of mixed metals, amalgam fillings produce electrical
currents which increase mercury vapor release and may have other harmful
effects(14,19,27-30,35,47, 100,192, 600). These currents are measured in
micro amps, with some measured at over 4 micro amps. The central nervous
system operates on signals in the range of nana-amps, which is 1000
times less than a micro amp(28). The metals also have electrical
potentials which can be measured in millivolts(mV). One clinical study
determined that electrical potential differences of over 50 mV were
pathological(48b), causing galvanism, leukoplakia, oral lichen planus,
or toxic or allergic reactions to restorations(48a,etc.). In most
subjects with amalgam fillings, potential differences of more than 50 mV
are present between restorations(48a), with potentials ranging from -417
mV to +150 mV. Negative potentials may be more pathological than
positive ones. The average potential for metal crowns and bridges was
154 mV and for brace brackets was 74 mV(48a).

Negatively charged fillings or crowns push electrons into the oral
cavity since saliva is a good electrolyte and cause higher mercury vapor
losses(35,192). Patients with autoimmune conditions like MS, or
epilepsy, depression, etc. are often found to have a lot of high
negative current fillings(35). The Huggins total dental revision(TDR)
protocol calls for teeth with the highest negative charge to be replaced
first(35). Other protocols for amalgam removal are available from
international dental associations like IAOMT(153) and mercury poisoned
patients organizations like DAMS(447). For these reasons it is important
that no new gold dental work be placed in the mouth until at least 6
months after replacement. Some studies have also found persons with
chronic exposure to electromagnetic fields(EMF) to have higher levels of
mercury exposure and excretion(28).

In a large German study of MS patients after amalgam revision,
extraction resulted in 80% recovery rate versus only 16% for filling
replacement alone (302,308). Other cases have found that recovery from
serious autoimmune diseases, dementia, or cancer may require more
aggressive mercury removal techniques than simple filling replacement
due to body burden. This appears to be due to [migration of mercury into
roots and gums that is not eliminated by simple amalgam
replacement.]{.underline}, providing a lasting residue for chronic
mercury exposure. . That such mercury(and similarly bacteria) in the
teeth and gums have direct routes to the brain and CNS has been
documented by several medical studies(34,325,etc.).

Periodontal offices also often are a source of exposure to mercury for
staff and patients. Both dental hygienists and patients get high doses
of mercury vapor when dental hygienists polish or use ultrasonic scalars
on amalgam surfaces(240). Pregnant women or pregnant hygienist
especially should avoid these practices during pregnancy or while
nursing since maternal mercury exposure has been shown to affect the
fetus and to be related to birth defects, SIDS, etc.(38, 61,272), and
breast milk contains up to 6 times higher mercury than in the mother\'s
blood(20,186). There is considerable exposure as well when polishing
amalgam fillings and hygienists are generally advised not to polish
amalgam fillings.

The component mix in amalgams has also been found to be an important
factor in mercury vapor emissions. The level of mercury and copper
released from high copper amalgam is as much as 50 times that of low
copper amalgams(191). Studies have consistently found modern high copper
non gamma-two amalgams have greater release of mercury vapor than
conventional silver amalgams (298). While the non gamma-two amalgams
were developed to be less corrosive and less prone to marginal fractures
than conventional silver amalgams, they have been found to be unstable
in a different mechanism when subjected to wear/polishing/ chewing/
brushing/bleaching, etc. they form droplets of mercury on the surface of
the amalgams (297,136,182,192). This has been found to be a factor in
the much higher release of mercury vapor by the modern non gamma-two
amalgams. Recent studies have concluded that because of the high mercury
release levels of modern amalgams, mercury levels higher than Government
health guidelines are being transferred to the lungs, blood, brain, CNS,
kidneys, liver, etc. of large numbers of people with amalgam fillings
and widespread neurological, immune system, and endocrine system effects
are occurring(34,35,199,212,222,313,118,600).

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\(334\) Univ. of Kentucky Dept. Of Chemistry web page,
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\(486\) Dr. Hulda Clark, The Cure for All Cancers, 1998,
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\(525\) Cheshire, William P., Jr. The shocking tooth about trigeminal
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*(530)* Cancer case histories followed by doctors,
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note: etc in a list denotes that author is aware of more references on
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\(601\) B. Windham(Ed), Annotated bibliography: Level of Exposure to
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\(602\) B. Windham(Ef), Occupational exposure to mercury in dental
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[www.flcv.com/dental.html](http://www.flcv.com/dental.html)

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