Apr
Hello Dr. Copeland,
I am looking for information about amalgam removal and have some questions.
How do the fillings add to toxicity?
How does their removal affect my health?
How much does the procedure cost? I’ve been advised by my Naturopathic Physician to have my mercury amalgam fillings removed, as I have been very toxic for quite some time. I have around six fillings that should come out.
Thank you so very much,
Felicity
Dear Felicity,
Thank you for your questions.
Amalgams are a mixture of the metals mercury (48-52%), silver (20%), copper, tin and zinc.
Individuals may have sensitivities to any of these metals. Yes, even those that are necessary in trace amount for good cellular function. However, of the five, mercury is an extremely potent neurotoxin.
There really isn’t any safe amount of exposure – just like with smoking. There are folks who do okay with some levels of exposure and those who do not.
There are some whose bodies do not remove mercury efficiently. This has both to do with genetics and general health. Like any heavy metal, mercury may build up to levels which have adverse affects to overall health; enzyme pathways and neurological tissues are found to be most vulnerable.
How does the exposure from filling material occur? Mercury is a liquid metal. In other words it behaves more like water than like how we assume metals behave. A pool of mercury left on a countertop at room temperature easily evaporates. With increased temperature, there is more evaporation of mercury molecules. We commonly call this “off gassing”. Off gassing has been shown to occur on the surface of all mercury amalgam fillings. This small but constant exposure can have adverse health affects as it is absorbed into the oral mucosa and ingested during routine swallowing.
If one is concerned about mercury amalgam fillings, one may determine their exposure and excretion ability by using a mercury speciation test. This test plots blood, hair and urine quantities of mercury against each other. This testing is far better than testing any single (blood, hair or urine) entity alone. Test results help your DDS, ND, or MD make recommendations on steps (if any) to treat mercury body burden.
If your health practitioner feels there is good cause to remove metals from the body, the above test can be a good baseline. It may just be best to have the fillings removed and replaced with a biocompatible material.
A note on biocompatibility of dental materials. ‘White’ does not necessarily mean biocompatible, neither unfortunately does ‘gold’. Biological dentists may recommend MELISA (metal sensitivity) or dental materials biocompatibility testing. Most dentists familiar with these types of testing are going to only use materials that already test well with very sensitive patients.
A note on dosage. Fish consumption, occupational exposure and amalgam fillings are all potential sources of mercury. Actual dosage is determined by amount and time. Also, with dental fillings, there are ‘tiny amalgam fillings’ and ‘HUGE AMALGAM FILLINGS’. Obviously the larger the exposed surface area of the filling and the length of time it has been in the mouth together determine exposure.
If one is also exposed to another heavy metal, lead, for instance, the combined toxic affect may be nearly ten times more than either mercury or lead alone.
How removing mercury amalgam fillings affects one’s health is challenging to nail down. The best I believe the most logical answer is that removal prevents constant micro-dosage of the heavy metal. If this is one’s greatest exposure source, what mercury the body can excrete is at least not being replaced continuously. Mercury is best excreted through the bowel (as opposed to kidney), and most safely mobilized slowly (to avoid re-uptake). Don’t expect to feel instantly better directly after removal. This will take time and be a project you and practitioner should work on together.
Feeling better after amalgam removal is common, however. But whether this is due to placebo, or lowering the galvanic (electrical) contribution to sensitive neural tissues or to the extra-cellular matrix itself (my thoughts) is unknown. I am all for folks feeling and therefore being better.
What are the costs of removal? Every dentist will agree, I believe, that every time a tooth is monkeyed with, there is the potential for pulpal (living tooth tissue) inflammation. So, if we are going to insult the tooth (however gently), we had better make sure it is one- up to it, and two- worth doing. In other words, the tooth should be vital and in an adequate structural state. And the restoration that replaces the mercury amalgam filling had better be serviceable for the long haul. This is based on the 2Q’s.
Quality and Quantity of tooth structure AFTER the filling has been removed. Removing a filling can be like taking up floor boards- you end up finding things that now need addressing because you can see them clearly and it doesn’t make any sense to cover them up. With teeth this includes tooth decay, fractures and wear. The final restoration needs to be what makes that individual tooth whole for many years to avoid another insult. The final restoration may be a simple replacement of the filling, a larger filling, an onlay or crown. I avoid crowns and prefer onlays about 90% of the time for tooth conservation reasons.
There is the occasional instance when a practitioner and patient will convince me to remove all metal restorations quickly and place biocompatible material temporaries because they are unwilling to proceed with some types of therapies (Lyme Disease for instance) without being mercury free. I try to avoid this because it is ultimately more expensive for the patient and because replacing those temporaries is another tooth insult that could be optionally avoided.
The take-home message is that the cost of amalgam removal is the cost of the optimal restoration for the teeth in question- plus safe protocol procedures such as an alternative oxygen source (and in some cases, IV nutritional support). Simple fillings run around $250, onlays and crowns $1250 and up depending on material.
I suggest discussing the MELISA or mercury speciation testing with your medical practitioner. Either of you may determine that fillings should be replaced anyway. You should then share your goals with your dental practitioner.
Best,
Dr. Cynthia Copeland