What to do with tooth fillings made from amalgam?

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Amalgam fillings are a significant health risk

The handling of dental fillings made of amalgam is still controversial in the dental world. While some dentists see significant health risks in the amalgam filling, others assume that due to the mercury released, only the use and removal of the fillings can be hazardous to health.

The way dentists deal with dental fillings containing mercury is correspondingly different. Many dentists have not used amalgam for years, others still work with the controversial material. Although a connection with chronic health problems due to the increased mercury exposure in patients with amalgam fillings has not yet been scientifically proven, it is undisputed that patients with amalgam seals have significantly higher mercury values ​​throughout the organism.

Risk of poisoning from amalgam fillings Patients with amalgam fillings have an average of four times higher mercury concentrations in the blood than people without amalgam in the teeth, according to numerous previous studies, such as the German Amalgam Trial, conducted by the Center for Naturopathic Research at the Technical University of Munich. So far, however, the consequences of this for the health of those affected have been extremely controversial. While amalgam-critical physicians warn of a significant risk of poisoning, other dentists rate this as negligible. Although mercury is one of the most toxic non-radioactive substances on the planet, although a dose of two grams can be fatal for adults, but in a bound form, as with amalgam, the heavy metal does not pose an increased health risk, according to the amalgam advocates . According to them, only the insertion and drilling out of the amalgam fillings, which consist of around 50 percent mercury, is critical, because the material is only acutely toxic in dissolved form. Reiner Zaijtschek from the Free Association of German Dentists explained to the trade magazine "Apotheken Umschau" that amalgam fillings "can, of course, like any foreign body that remains permanently in the human organism, have undesirable side effects". In general, however, the risk to health can be classified as rather low "and there is no study that has shown a clear connection between them (the amalgam fillings) and chronic health problems," emphasized Zaijtschek.

Amalgam seals against continuous mercury free However, other experts such as Claudia Hesse from the Society for Holistic Dentistry in Berlin cannot accept this assessment by the representative of the Free Association of German Dentists. Hesse emphasized that "the fillings continuously emit small doses of mercury", which in the long term can have considerable negative effects on health. Over time, more and more mercury is deposited in the organism, whereby the mercury is not only released from the fillings by mechanical abrasion, but also mercury ions are released from the seals by acidic foods and reach the digestive tract via the saliva. From here, the mercury reaches the bloodstream and is distributed throughout the body, the expert explained. "The mercury vapor, which is released when hot food and drinks are consumed," is particularly dangerous, continues Claudia Hesse. The steam is breathed in through the nasal and oral cavity, also gets into the bloodstream and reaches all tissues. The so-called blood-brain barrier for mercury is not an obstacle, so that the heavy metal is also deposited in the brain, Hesse explained with reference to several autopsy studies. In patients with amalgam fillings, these would have shown a significantly increased mercury content both in the organs and in the brain. For example, the Italian Association for Metals and Biocompatibility Research found in a study in dead people who had more than twelve amalgam fillings that mercury levels were ten times higher than in patients with fewer than three amalgam seals.

Increased risk when inserting and removing the amalgam seals There is also agreement among experts that amalgam must be handled with particular responsibility. Reiner Zaijtschek emphasized that patients should be informed about the risks of the mercury-containing material, and contraindications such as a mercury allergy must be queried and taken into account in any case. Special safety precautions must also be taken during processing, such as thorough vacuuming and the use of special drills, since "mercury in vapor form is particularly dangerous - and this arises when the fillings are placed and drilled out", explained the expert from the German Free Association Dentists. However, there is agreement among the experts anyway about the risks involved in inserting and removing the amalgam filling. The possible health risks from the permanent contact with the seals containing mercury are controversial. The spectrum ranges from the statement by the Vice President of the German Dental Association in Berlin, Dietmar Oesterreich: "As soon as the filling has hardened, free mercury is no longer available", to the critical assessment of the Society for Holistic Dentistry. Austria also assumes that mechanical stress releases traces of metallic mercury from the seals, but “both the absorption rate and the quantities released are so low that health impairments can be almost completely ruled out.” As already mentioned, Claudia comes Hesse from the Society for Holistic Dentistry on a fundamentally different assessment here. It assumes that the continuous release of mercury from the amalgam fillings can lead to considerable mercury pollution in the organism in the long term.

Mercury causes numerous health problems Regarding the consequences that a chronic mercury exposure can have on health, Peter Jennrich from the Medical Society for Clinical Metal Toxicology explained, "The health damage can be serious." Often, those affected suffer from symptoms such as inner restlessness, feel aggrieved , have a headache or discomfort in the gastrointestinal tract. In addition, "poisoning with the heavy metal can also be a co-factor for almost all chronic diseases," explained Jennrich. So mercury is also considered a risk factor for the occurrence of diseases such as diabetes, multiple sclerosis and rheumatism, emphasized Jennrich with reference to the results of a meta-study by the Institute for Environmental Medicine and Hospital Hygiene at the University of Freiburg. According to Jennrich, the effects of mercury pollution on the organism do not only depend on the amount of amalgam in the body, but are also significantly influenced by other toxins to which those affected are exposed, such as drinking water containing lead. The general state of health also has a significant impact on the severity of the mercury poisoning, Jennrich continues. According to the expert, people "in good physical shape" have a better "detoxification ability" and their "exercise tolerance" is usually higher. According to Jennrich, both detoxification ability and tolerance to exercise vary greatly from person to person. That is why it is so difficult to determine the consequences of mercury pollution. Some people remain symptom-free despite high levels of heavy metals, while others react very quickly, the specialist explained. In addition, the symptoms of chronic poisoning are usually rather non-specific, which makes a clear diagnosis even more difficult. This also has the consequence that the health consequences of the “permanent exposure to mercury” are still controversial.

Special methods for determining mercury poisoning According to the expert, a special examination is necessary in order to track down possible mercury poisoning from the amalgam fillings, since “neither a regular blood analysis nor a urine sample shows everything”. Only with a so-called provocation test can mercury contamination in tissues and organs be demonstrated, explained Jennrich. The provocation test is based on the administration of chelating agents, which as an organic compound are able to bind hidden metal ions so that they can be flushed out with the urine. In this way, the actual extent of the urine load can be measured, emphasized Jennrich. Depending on the mercury concentration the doctors determine during this special examination, the next treatment steps such as removal of the amalgam fillings or detoxification measures (heavy metal discharge with the help of chelating agents) are planned, the expert explained. In view of the health risks that have been described many times, it hardly seems understandable that amalgam is still used in dentistry today and that the legislature has not yet banned the amalgam fillings, but has even favored them as the cheapest tooth fillings in the service catalog of the statutory health insurance companies. (fp)

Image: Claudia Heck / pixelio.de

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