In a recent post on the different types of cavity fillings that are available, I mentioned that I wasn't a huge fan of dental amalgam fillings -- you know, those silver fillings we all got as kids. I don't like them because they contain Mercury.
I also referenced how the Food and Drug Administration had recently changed its stance on amalgam fillings. I'd like to talk a little more in depth about that today, as I feel it's important.
In a nutshell, here's what happened: For years, the FDA said amalgam fillings were just fine and we believed it. Just look in the mirror for proof -- it's a given that most of you still have an amalgam filling in your mouth somewhere.
Then, the FDA reversed its stance and basically said something like "Ok, wait, maybe this isn't so good for pregnant women and young children."
Then, in 2009, they changed their tune again, and said (once again), that there was little to no risk. The roller coaster does not end, however -- there was another "it's bad" reversal in 2010, which is still their position today.
As of right now, the FDA considers amalgam fillings as class II (higher risk), when it used to be class I (low to no risk).
The first thing that I believe should be somewhat troubling to everyone is the trust factor. In essence, we're not all scientists and, until very recently, "regular people" really didn't have much access to scientific data -- and even if we do, who really has the time to peruse it all and make heads or tails of it? So we trust organizations like the FDA to tell us what is harmful and what isn't.
That trust seems to sometimes be somewhat misplaced. Because really, going back and forth on something like this is not comforting. Are amalgam fillings harmful or not?
Now I know some commenters will extol that we've known this for years and shouldn't always trust the FDA blindly. Hey, I happen to agree. But again, unless you are conducting tests yourself, our knowledge of most things scientific is limited to choosing which "report" or "finding" to believe.
The FDA changed its mind essentially due to pressure from four different groups who all said "Wait -- this is harmful -- take another look." So they took another look and did the about-face.
What this says to me is that the FDA is not infallible. Essentially, what I glean from this situation is that an FDA endorsement is temporary, akin to "as far as we know now, it's ok. But in 20 years, if people start growing a third leg, we'll revisit it".
Again, not exactly comfy.
What's the reason for this? Why not have allof the facts and findings before deciding that something is safe? I suppose one valid reason is that then, nothing would get released. If we had to wait 20, 30 or 50 years to see if a substance is harmful for the long-term, well ... let's just say no new drug would ever see the light of day. Since we don't want that, we're left with the imperfect system that we currently have.
Let's look at a few other substances that were deemed "OK" by the FDA, but turned out to be "not so good" (or the other way around).
• The FDA recently reversed its position on a Menaflex Knee Device. It had been given approval, but then, under pressure, the FDA re-evaluated its position. It would appear that the device was given a speedy approval because it was somewhat similar to others. However, it's fair to note that political and industry pressure may possibly influence the FDA -- and decisions such as this one -- to a degree.
• The FDA also reversed itself on Olestra, a fat substitute. Before 2003, the FDA required that Olestra packaging include warning labels about cramping and loose stools. You probably remember that -- potato chips that could allegedly give you diarrhea. But in 2003, the FDA decided that warning labels were unnecessary. I mean, who would buy chips that could cause "loose stools"? When I think about the commercial interests that may have influenced the FDA's decision, it makes me take pause.
• On a different note, the FDA reversed a stance on liquid Morphine, saying that it can stay on the market. Since liquid morphine is essentially a last resort, end of life, hospice drug, this actually makes sense to me. In my opinion, there is a point where "bad for you" might be irrelevant.
Ultimately, I personally believe that you should trust your gut more than anything. The FDA might be useful in providing a guide as to what's safe and what isn't, but as the previously mentioned reversals indicate -- it's not always perfect.
Until next time, keep smiling.
Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly
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Dental Amalgam > About Dental Amalgam Fillings - FDA
FDA to review mercury testing of amalgam fillings in teeth
FDA APPROVES FAT SUBSTITUTE, OLESTRA
Unapproved liquid morphine can still be sold in U.S.: FDA | Reuters
The JADA is clearly not unbiased . Even dentists admit that hg is released from filling and that the bonds in amalgam do not prevent hg release. There have been many tests done measuring the mercury vapor in people who have many amalgams and they have found high vapor levels that translate into exposures of more than 50 micrograms hg /day in many .Anything over 0ne microgram a day is a toxic level. the exposure is greatest in the hour after eating but is too high at other times.It is absurd to conclude that no hg "bleeding" occurs . Did you ever study chemistry ? Tell me the concentration in micrograms/ cm3 in mouths people with several amalgams.I have studied chemistry extensively so perhaps you can tell me what happens to hg that prevents its release once in amalgam .Can you tell me why it is illegal to toss amalgam into the trash ?
There is no data to back up the safety claims of amalgam dentists. Hg is hg regardless of whether it comes from paint, fillings , fish coal burning etc and it is extremely toxic . Where did the expression mad hatter come from ? It came from the fact that hat makers used to be exposed to hg vapor and hg is a neurotoxin that causes anxiety , depression and other psychiatric symptoms.
The science courses required at Medical and Dental Schools: 2 Semesters of General Chemistry, 2 Semesters of Organic Chemistry, one semester of Biochemistry, 2 Semesters of Physics (Trig-based), 4 Semesters of Biology and one semester of College Calculus. Very few applicants with overall GPA's of less than 3.5 are accepted. I scored in the top 5% of the DAT. I graduated Magna Cum Laude (hook 'em horns). I graduated 2nd in a Dental class of 90 students. I scored in the top 2% on the MCAT. Was I supposed to be impressed with your microgram and Hg references?
I stand by my claim. You merely stated the symptoms of pure Mercury poisoning, making the leap to amalgam. Like almost everyting else, after being mixed in the "amalgamator", it was medical waste and was disposed of accordingly. You're obviously not a Dentist or a Physician (Dental Assistant?). You would've known about the OMFS residency options. After 20 years, still no solid evidence that precludes the use of amalgam.
Nowadays, if parents take their children to the dentist starting when they're small, and they can be given the anti-cavity sealants and be taught proper brushing and flossing methods, they may well grow to adulthood without ever needing a filling, whether amalgam or composite or whatever. A young adult in my family went about 8 years during college and onwards without ever going to the dentist for even a cleaning -- stupid, but it's not like he could be kidnapped and forced to go -- and when he finally got it together and went in for an evaluation, the only cavity that was found was on one of his unremoved wisdom teeth.
Maybe there are better solutions now, but amalgam is cheaper and more durable than some others. Avoid it? OK, but make it a crime? Nonsense.
As far as your relative who didn't go to a dentist for years and then found just one cavity , that may be because dentists are filling healthy teeth . When I was younger and more trusting , i had several fillings on teeth that were not bothering me at all.
Gold fillings are much more durable.
That's a pretty strong statement. Got some data to back that up? Maybe even a definition of "many"? I would imagine there are at least 100,000,000 people in this country who have had at least one amalgam filling.
I wouldn't trust the FDA to my own children if I had no choice.
I don't know why that point was so important to you to make a request for documentation, though. Do you think the FDA is infallible?
If all people want are unwavering answers, they should stick to their holy books.
APPERENTLY GREEN DOCTORS [ HOLISTIC DENTISTRY ] DONT USE MERCURY AMALGAM
SOEM SAY THE MERCURY IS MORE DANGER TO THE DENTIST THAN THE PATIENT
ONE CONCERN IS THAT THE PRESSURE OF CHEWING CAUSES THE MERCURY TO PRODUCE TOXIC VAPOUR
Getting mercury safely out of your teeth and body is quite tricky. The process of amalgam removal should be performed by biological dentists trained in procedures that minimize inhalation and ingestion of mercury during the procedure.
The next trick is to choose a replacement material that, itself, is not toxic. Many plastic composites contain BPA, and other replacement metals may cause toxic reactions. Compatibility testing, including the Melisa test, should be performed. My favorite replacement material is zirconia. Care also should be taken in choosing a compatible bonding agent.
Once amalgam replacement is complete, the next step is to remove at least some of the mercury that has been stored in your body over a lifetime. There is much conflicting information as to the proper methods of removal, including using true chelating agents such as DMSA, DMPS, and alpha lipoic acid. Used incorrectly, chelators can redistribute mercury throughout the body, increasing toxicity. In addition to chelation, there are various compounds that can adsorb and/or displace mercury from tissues.
A discussion and references concerning mercury detoxification, including some new approaches based on how nature removes heavy metals from the environment, can be found in "The Wellness Project."
Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization
Regarding “gold” as a filling material, its toxicity strongly depends on the other major alloy material. Much of the gold alloy dental filling material being used today contains large quantities of palladium, which is quite toxic. Thus, it is important to be sure the “gold” put in your mouth is a platinum alloy, free of palladium, tin, nickel, copper, and chromium.
Here is an example of data on Melisa testing of dental filling materials and CFS:
http://www.melisa.org/chronic-fatigue.php
What gold alloy is in your mouth?
What is your experience with the accuracy of Melisa testing?
Zirconia is a crown material.
SCIENCE is not infallible, our knowledge of biology, human or otherwise, is miniscule, "risk" is a very fuzzy, hazy term opening to signficant argument by highly intelligent, well intentioned people, and no one is in the omnipotent/omniscient position to give guarantees.
In other words, the FDA is composed of people doing their best in the face of an impossible mission and their vacillation should be seen as the consequence of conscientious people doing their best in the face of an impossible mission.
Your advice to "trust your gut" is just horrible. Trusting your gut is what led to the Salem witch trials: it is a resort to superstition. The better advice is this: go with the latest conclusions, refuse to worry about it, and go with the next set of conclusions when they come out, and refuse to worry about that. Or, do your own research.
[3]http://www.drbicuspid.com/index.aspx?sec=wom
[2]http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/DentalProductsPanel/UCM242363.pdf