Mercury Safe Article
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[published in the Well Being Journal, Feb. 2002]
Is Your Dentist “Mercury Safe?”
Many dentists have taken to using the phrase “mercury free” to describe that
their practice does not use mercury amalgam fillings. This is a welcome trend, though
the most recent national survey showed that half of all dentists still use this “silver”
dental filling material. This article will address the distinction between “mercury free”
and “mercury safe.”
First, some background information. All “silver” (amalgam) fillings contain
approximately 50% mercury. This is one of the most toxic substances on earth, and
even a very small amount of mercury can be harmful to the body. It is a fact that dental
amalgam is an inherently unstable compound, and all amalgam fillings “leak” some
mercury. This is usually in the form of mercury vapor, which is inhaled or swallowed or
absorbed into the soft mouth tissues. Mercury is the only metal that is a liquid at room
temperature. It is also volatile, emitting colorless, odorless mercury vapor. Any
increase in temperature significantly increases mercury vapor release. The same is true
for an amalgam filling. It is easy to demonstrate that mercury vapor escapes from the
surface of an amalgam filling, and that this escape is dramatically increased by raising
the temperature. Think: hot coffee, friction from chewing food, or friction from getting
your teeth polished at a dental office. For a dramatic and graphic demonstration of this
mercury release from an amalgam filling, see the “Smoking Teeth” video on the web
page www.iaomt.org , the official website of the International Academy of Oral
Medicine and Toxicology (IAOMT). This has led to a decades-old controversy over
whether this filling material should still be used in dentistry. This article won’t address
that issue, but rather the potential hazards of unsafely removing old amalgam fillings.
Let’s try and make this a little more real with some numbers. How much
mercury exposure is safe? It would be fair to say that no level of exposure can be
guaranteed to be safe. Some agencies have looked at what exposure levels have
correlated with known mercury toxicity problems. This includes the Occupational
Safety and Health Administration (OSHA), the World Health Organization (WHO) and the
National Institute for Occupational Safety and Health (NIOSH). They have set exposure
limits to workers with potential exposure to various toxins in the work place. For
mercury, it has been determined by WHO and NIOSH that employers must not expose
workers to a mercury concentration in the air in excess of 50 micrograms per cubic
meter of air (50mcg/m3), averaged over an 8 hour work day. Other agencies have set
this limit at 25mcg/m3, and as low as 10mcg/m3 for women of childbearing age. There
is also a “ceiling limit”, which means a level of exposure that should never be exceeded
even for an instant. The ceiling limit OSHA has set is 100mcg/m3. So, what happens in
a dental office? If amalgam fillings are polished by the dentist or dental hygienist,
levels can be measured over 200mcg/m3. Grinding into an amalgam filling to remove
it, without specific protective protocols, can release mercury levels over 1,000mcg/m3!
These levels are generated right at the breathing zone of the patient, the dentist, and
the dental assistant! By the way, simple toothbrushing can release mercury vapor at a
level over 200mcg/m3. Please don’t take this to mean you should stop brushing your
teeth!
That means a potentially hazardous exposure to all three (patient, dentist and
assistant), every time an old amalgam filling is removed for any reason. This is an
occupational exposure that is often overlooked, even by many dentists who consider
themselves “mercury free.” From the standpoint of OSHA regulations, a huge number
of dental offices would be in violation with respect to employee exposure. OSHA has no
jurisdiction over the patient or the dentist, but both are being unnecessarily exposed
also. Does this mean amalgam fillings should never be replaced? Absolutely not. It
means amalgam fillings should never be removed and replaced unsafely.
There are a number of protective protocols that have been developed by the
IAOMT and others, designed to protect from this unnecessary mercury exposure. A
dentist who incorporates these effective protocols is properly protecting his or her
patients. Also protected are the dentist and the dental staff. And, if the dentist has
taken proper measures to protect the discharged office wastewater from mercury, the
environment is also being protected. Such a dentist can be considered “mercury safe.”
The aforementioned IAOMT website also has a short video with a brief outline of some
of the mercury safe protocols. Any dentist should adopt these procedures as a
minimum of appropriate protection. There is a more detailed and extensive training
available for dentists on being mercury safe from New Directions Dentistry
(www.newdirectionsdentistry.com), now available as a DVD training course for dentists.
So, it can be said that “mercury free” is really a misnomer. All dentists who ever
replace an amalgam filling are dealing with mercury in the office. How they deal with
that step has a significant impact on the potential for unnecessary, harmful exposure
to toxic mercury. A dentist who no longer places amalgam fillings and has learned and
is committed to effective protective protocols while replacing old amalgam fillings is
mercury safe.
How do you know if your dentist is mercury safe?
You could ask a few simple
questions. Has the dentist taken extra, specific training in mercury safe protocols from
the IAOMT or New Directions Dentistry? Is the patient given an oxygen nosepiece so
that their breathing air is separate and clean? Does the dentist use a rubber dam or
other protective barrier when removing amalgam fillings? Do the dentist and assistant
both wear specific mercury protection masks themselves? There is a lot more to it, of
course, which is why training courses are offered, but if a dentist answers “yes” to at
least the above questions, they are more likely to be committed to being mercury safe.
Is your dentist?
Paul G. Rubin, DDS, MIAOMT
9730 3rd Ave. NE #205
Seattle, WA 98115
206-367-4712
www.drpaulrubin.com
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