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Mercury Dental Amalgams - Analyzing the Debate
Revised May 2001
Note: The information on this
website is not a substitute for
diagnosis and treatment by a qualified, licensed professional.
The ADA Controversy
How great is the danger from mercury amalgam? That question stirs hot debate between those who question its use and those who promote amalgam as a safe and effective compound.
By conservative estimates, the average adult American has 10 fillings of three surfaces each piece. If each of these surfaces leaches one microgram of mercury per day (the generally accepted figure), then the average adult faces potential exposure to 30 micrograms of mercury a day from amalgams alone.(156) The Food and Drug Administration cautions against any increase in the daily mercury exposure rate from food of 2.89 micrograms.(157)
The Toxic Element Research Foundation estimates that people with 13 or more amalgams exceed the World Health Organization's daily mercury limit of 42.9 micrograms. Says TERF: "The compelling fact about this data is that it does not include the mercury exposure received from all possible sources, such as the altogether different categories of food, air and saliva".(158)
Other experts agree that even low doses of mercury exposure deserve careful investigation. "It is tempting to summarily conclude that such exposures result in no adverse effects since there is no readily identifiable, general affliction associated with the use of amalgam and stainless steel in dentistry," states Dr. Swartzendruber of the University of Colorado.
"However, low-dose, chronic exposure to any substance tends to have insidious and often highly complex sequelae which may be multifactorial and interactive," he explains. "Also, recent innovative experiments demonstrate that low-dose mutagenesis is significantly greater than previously purported."(159)
Despite these concerns, the American Dental Association claims that amalgam is unsafe only for the 1% of Americans that it estimates to be hypersensitive to mercury. While offering no proof of amalgam's safety, the ADA insists that "the continuous use of dental amalgam as a restorative material does not pose a health hazard to the nonallergic patient."(160)
The results of other research, however, call the ADA's estimate of mercury hypersensitivity into question. Studies cited by the Journal of the Massachusetts Dental Society indicate that the level of hypersensitivity is 10 times higher. One study of 1,538 people found 9.6% to be hypersensitive; another study of 1,000 subjects put the number at 11.3%. (161)The Ziffs cite two studies showing that prevalence of allergy to amalgam can be as high as 44.3%.(163,163) One of the studies tested a population of dental students! Yet these studies are conveniently overlooked in all ADA publications and public statements." Amalgam restorations remain safe and effective. Dentists should educate patients and other health care professionals who may be mistakenly concerned about amalgam safety," says a recent article in the Journal of the ADA.(164)
And what if the ADA's estimate were accurate, asks TERF. Even that 1% is 1,000 times greater than the level of exposure considered adequate grounds for a recall in the auto industry. In one instance, says TERF, more than 100,000 vehicles were recalled because of a single non-fatal injury caused by a hazardous automobile material.(165)
In its staunch support of amalgam, the ADA claims that "when mercury is combined with the metals used in dental amalgam, its toxic properties are made harmless." As a result, it says, "For most patients...dental amalgam remains a safe and effective material for filling cavities."(166)
But when it comes to the cold, hard facts, the ADA's defense of mercury stands on shaky ground. The ADA no longer maintains that amalgam's safety has been scientifically proven, says the Academy, and it offers no certification of the safe and effective use of mixed amalgam. In fact, the ADA says amalgam cannot be certified because it is mixed by individual dentists who must take responsibility for the material's safety.(167, 168)
Indeed, in Tolhurst v. Johnson & Johnson, a California lawsuit in which a dental patient sued his dentist, two amalgam manufacturers and a distributor, and the ADA itself, the ADA filed legal briefs making it clear that it has abdicated any responsibility for the damage done by mercury amalgams. The brief contains the following language: "The ADA owes no legal duty of care to protect the public from allegedly dangerous products used by dentists. The ADA did not manufacture, design, supply, or install the mercury-containing amalgams. The ADA does not control those who do. The ADA's only alleged involvement was to provide information regarding its use. Dissemination of information relating to the practice of dentistry does not create a duty of care to protect the public from potential injury."(169) Apparently we are expected to ignore the fact that the ADA holds the patents on the high-copper amalgam currently in use by most dentists, that the ADA is responsible for certifying all dental schools in the United States, and that the ADA carries on a campaign of intimidation and harassment against cutting edge dentists who use any product or procedure other than what they were taught in dental school.
The ADA relies heavily on amalgam's widespread use over the past 150 years as evidence of its safety. The organization suggests that "the most convincing support we have for the safety of dental amalgam is the fact that each year more than 100 million amalgam fillings are placed in the U.S."
This rationale offers little comfort to those who question amalgam's use. "This is a chilling thought, says the International Academy of Oral Medicine and Toxicology, Calgary. "It should be a cause for concern that approximately 72 million tons of mercury are used annually in dentistry, much of it being placed into the teeth of Americans."(170)
The ADA also has claimed that people are exposed to more mercury from fish than from dental amalgams, a statement the Academy challenges because the scientific evidence proves otherwise. Says the Academy: "Autopsies of people with fillings confirm that the amount of exposure to dietary mercury is apparently much less than that from dental amalgam mercury. Authorities in the field of metal toxicology have concluded that this chronic exposure from dental fillings makes the predominant contribution of human exposure to mercury."(171)
The ADA's position may be best illustrated by its response in 1983 to a study that measured mercury in the expired air of humans. The ADA stated: "We wish the public to be as certain as we are that dental amalgam is safe, and we will pursue this matter until that certainty is assured."(172) Note the wording, "until that certainty is assured." A scientific study does not set out to "assure" any one viewpoint, but to conduct an open inquiry that not only recognizes new information but follows that evidence wherever it may lead. In 1984, the ADA did alter its position slightly to admit that mercury does indeed escape from amalgam. But it still maintained that the amounts in question were too small to cause any damage to the body.(173)
But the ADA continues to deliver its flawed argument through the popular press. One recent Reader's Digest editorial, which was adapted from the ADA News, reports that "about 0.7 nanograms of mercury were in each gram of blood in people with silver fillings, compared to 0.3 nanograms in those without fillings."
Since the FDA considers 20 nanograms per gram of blood to be safe, says the editorial, "researchers calculate that it would take 100 fillings to reach this level - to reach the lowest toxic level of mercury, a person would require 1,000 fillings." The article ends with the standard ADA conclusion: "Silver fillings do not pose a health hazard to the nonallergic patient."(174)
But again, this argument conveniently overlooks some basic facts about how mercury is stored in the body. As Dr. Huggins explains: "The logic is based on the erroneous assumption that blood mercury levels for subacute exposures are indicative of actual mercury contamination. The fact that the blood mercury levels are not good indicators of total body burden is well-established in literature."
Thirty years ago, a study reported that mercury is rapidly cleared out of the blood after an intravenous injection, says Dr. Huggins. In 1972, researchers Friberg and Vostals found that mercury concentrations in blood were "hardly suitable" in evaluating retention.(175) And in 1980, Phelps and Clarkson found that "a low mercury level in blood may falsely imply that significant mercury exposure has not occurred when, in fact, a dangerously high target tissue exposure may have existed."(176)
While the ADA defends the use of mercury amalgam, the Environmental Protection Agency has defined it as a hazardous substance. On behalf of the EPA, the U.S. Justice Department brought a lawsuit in 1988 against a group of New England dentists and dental companies for damages caused by the faulty disposal of scrap amalgam. All parties involved eventually signed consent decrees that required them to reimburse the EPA a total of roughly $350,000 for its clean-up costs.(177) According to a 1989 issue of the ADA News, when the EPA was asked whether it considered dental amalgam to be a hazardous substance, it replied that "any substance that contains a listed hazardous substance is itself a hazardous substance," provided that there is "a release, or threatened release, of a hazardous substance into the environment and where the government has incurred response costs."
In addition, the EPA sent a letter to one of the dental supply firms in 1988 that specifically refers to amalgam as a hazardous substance: "The term 'hazardous substance' shell have the same definition as that contained in Section 101(14) of CERCLA and includes scrap or waste dental amalgam and any mixture of such hazardous substances with any other substances."(178)
The Food & Drug Administration, for its part, has neatly skirted the issue of amalgam safety over the years. When 1976 legislation required the FDA to classify all medical and dental devices, the agency "grandfathered" its approval of the long used amalgam fillings under the GRAS (generally recognized as safe) category, according to Joyal W. Taylor, DDS, who founded the Environmental Dental Association to spearhead a movement for informed consent legislation concerning amalgam's use.(179)
One decade later, in 1987, the FDA's Classification of Dental Devices was published in the Federal Registry. Dental amalgam, it turned out, was not even listed as a dental device, based on the rationale that amalgam is a reaction product. Instead, the FDA classified the components of amalgam, which means that amalgam itself has never been approved as a dental device, says the Environmental Dental Association. "Thus, amalgam has never been subjected to the rigorous biocompatibility testing required of all other medical implant devices."(180)
In early 1991 the FDA clarified its position on mercury amalgam. After "reviewing" the subject, the agency announced that the use of amalgam could not be condemned based on current evidence. It recommended that more studies on the subject be conducted. At the same time, the FDA's Dental Products Panel of the Medical Devices Advisory Committee held a public meeting and, again, declared that the evidence against dental amalgam was not sufficient to prove its harm. This panel also said that amalgam should be researched further.(181)
The National Institutes of Health has taken the same stance on the amalgam issue. The NIH's mid-1991 conference on the "Effects and Side Effects of Dental Restorative Material" reached the following conclusion: "There is no scientific evidence that currently used restorative materials cause significant side effects. Available data do not justify discontinuing the use of any currently available dental restorative materials or recommending their replacement." Interestingly, however, the NIH did recommend that dentists could "reduce environmental contamination" by installing devices in their offices to recover waste amalgam residue for recycling.(182)
The ADA's position on mercury carries considerable weight. Since state dental boards operate as the long arm of the ADA, its philosophy trickles down to the local level. In fact, dentists who malign mercury as hazardous are threatened with expulsion from the ADA in four states.(183) And the dental leadership in several states threatens to censure dentists who inform patients that amalgam contains mercury.(184)
What's more, the ADA systematically harasses dentists who place alternative fillings. Those who remove amalgams, even at the patient's request, may face blacklisting in the dental and business communities. In states that require dentists to have liability insurance, the dental boards can exert some influence on the insurers, perpetuating the myth that it's dangerous to remove amalgams.
If an insurance company then cancels a dentist's policy, the state dental board may suspend his or her license for failing to maintain insurance.(185)
The attempts at censorship continue to this day. A case in point: In late 1991, the Washington Dental Disciplinary Board proposed legislation that would make it unethical for dentists to replace "clinically serviceable" amalgam fillings for health purposes, reports the Environmental Dental Association. The proposal, which would have made replacement work a punishable offense, did not pass at that time.
Several months later, the board dropped its final proposal to regulate amalgam replacement. This move followed the demand of anti-amalgam advocates that two of their experts be allowed to testify. As a result, the board withdrew its previous statement that the safety of amalgam has been scientifically proven. Had the proposal passed, it would have required dentists to inform patients of the scientific difference of opinion regarding amalgam before removing serviceable fillings. The board dropped this idea when it realized that dentists would have to inform patients of the same schism before they placed fillings.(186) The ADA also vehemently opposes any legislation that seeks to inform patients of dental amalgam's contents. This position, of course, appears to contradict its argument that amalgam does not cause harm. But the ADA has managed either to lessen the impact of informed consent legislation at the state level (such as Alaska's 1989 initiative to inform patients of the content of various dental fillings) or to defeat it entirely. The end result is that dental patients remain ignorant of amalgam's contents and do not have a choice of using alternative materials.(187)
In New Mexico, for example, such legislation was voted down by the very committee that had unanimously passed the same legislation one week earlier, according to the Environmental Dental Association. And in Illinois, the House of Representatives passed a Right-to-Know, Informed Consent Resolution in 1991 that eventually backfired. The resolution directed the State Department of Health to examine the amalgam issue and report its findings to the General Assembly. The position paper resulting from this directive took the ADA's position that mercury dental amalgams are safe.(188)
As recently as early 1992, however, one state offered a ray of hope in getting such legislation on the books. The California State Assembly became the first to pass an informed consent bill that requires dentists to tell patients about mercury exposure before placing fillings. Although the bill (SB 934) awaits final approval, says the Environmental Dental Association, "it represents a significant victory in the process to provide dental patients with their due rights."(189)
This is the background behind the case against Douglas J. Phillips, a Palm Beach dentist practicing amalgam-free, biological dentistry. In October, 2000, the Florida Dental Board initiated an attack on Phillips and his practice. The board wanted him to practice according only those techniques and treatments that are taught in dental schools, and to stick to the "standard of care" recognized by the dental establishment.(190) Dr. Phillips sees things differently. To his way of thinking, "What happens in your mouth affects your whole body, radically. That means that dentists must be aware of, and trained in, health/medical issues, or work directly with other health disciplines."(191) Other areas of concern for Phillips include root canals, which often create an area of chronic infection that compromises the patient's immune system; and cavitations-holes in the gum and bone left from tooth removal-that require special procedures for the removal of infected tissue before the wound can be closed. More generally, Phillips insists that the dental profession must start acting responsibly with regard to health issues, and stop acting as a propagandist, apologist, and obfuscator.(192)
Dr. Phillips often uses the concept of a paradigm in describing the difficulty traditionally trained dentists have seeing beyond the limitations of what they were taught in dental school. "Your paradigm is the way you see the world in terms of perceiving, understanding, and interpreting. So what the person studies and what they learn in school they really believe in their hearts to be true. So they can't imagine so off-the-wall sounding, so far outside of their paradigm, could be true. But it is true. And that's the problem?-traditional means are not helpful for these people with chronic illness and chronic pain. They have to search outside the traditional means to a non-traditional practitioner like myself who has evolved outside those areas. And that non-traditional area will someday be traditional."(193)
"It's time to let the government know that it's not the government's business to legislate health care," says Phillips. "Let us have the freedom to evolve into areas that we know our patients are asking for. And then let us provide for the patients. And don't try to have all the health care the same, because where are those people going to go?"(194)
The Phillips case highlights the doggedness, and the desperation, of the dental establishment in persecuting open-minded dentists who put their patients' health first. The Florida board's case against Phillips is a patchwork of ill-defined, unsupported claims based on Phillips's treatment of a single patient whose own testimony was deemed too unreliable for inclusion in the court proceedings. The board accuses Phillips of using an unproven diagnostic test. This refers to Autonomic Response Testing, also called kinesiology, which Phillips uses to assess the condition of his patients' autonomic nervous system. Had this ill-informed dental board bothered to do their homework, they would have learned that this is a useful, informative, non-invasive form of testing used by health practitioners all over the world. They also accused Phillips of using remedies not approved by the FDA. In this case, Phillips used homeopathic antibiotics made in Germany. And guess what? They have been approved by the FDA! This gives you an idea of the quality of the case against Phillips.(195)
"The State Board in Florida is run by the traditional people," Phillips explains, "and they think everybody should practice the same. They have what they call a 'standard of care.' But I tell you what, if I work with the standard of care today, in six months the standard of care would be outdated. Because, in that time we will learn more than we know today, and we'll do better than we're doing now. I know from experience that it's going to expand. And thank God for that!"(196)
"They're trying to make an example out of me, and they're trying to take my license away to scare other doctors from evolving into this area. They're scaring them, and limiting their freedom of choice for treatment options that are safe. Also what they're doing is limiting the public's choice in health care."(197)
Still, the Phillips case is no joke. Defending himself in court has cost the dentist considerable time and money, and the outcome is still unpredictable-although Phillips is confident of ultimate victory. Each case of this type puts pressure on all dentists to stick to the party line, and to hesitate before trying anything new, even with patients who are suffering and can't be helped by traditional means. It's also a comfort to traditionally-oriented dentists who see innovators like Phillips as a threat.
Indeed, the ADA's relentless support of mercury may come back to haunt it when the organization can no longer hold back the tide of evidence at its gate. Already, in late 1991, a large group of dentists filed a class-action lawsuit against the ADA, charging the organization with fraud and negligence, among other things, in its promotion of amalgam as a safe material despite evidence to the contrary. The plaintiffs claim that their reliance on the ADA's misrepresentation of the facts regarding amalgam's adverse effects has harmed the doctor-patient relationship and the public health.(198)
What's more, the public sector has been galvanized in recent years regarding the amalgam issue. Since 1988, a grassroots movement of Dental Amalgam Mercury Syndrome (DAMS) patient support groups has taken hold; and in one six-month period in 1991, more than 500 "Amalgam Adverse Reaction Reports" were filed with the FDA. Also in 1991, the first product liability lawsuit related to mercury poisoning was filed against a dental amalgam maker in Tennessee.(199)
In the coming years, then, patients who are harmed by mercury amalgam may begin to bring lawsuits against the dentists who placed toxic substances in their mouths without the patient's knowledge or informed consent and those who purposely concealed facts about the filling's content.(200)
It's no great stretch, after all, to question whether the ADA has covered up information about amalgam's dangers. As Dr. Huggins says, there's no logical reason for the ADA's refusal to recognize amalgam as a problem. At this point, thousands of patients have responded favorably to its removal. "There's been an active effort to keep the information from getting out," he says.
Dr. Huggins, for one, used to spend a great deal of time lecturing to dental associations on the topic of dental amalgam. But then the engagements came to a screeching halt. "I used to lecture 100 days a year to dental groups, and all of a sudden I was told that if I were on a dental program, there would be no postgraduate credit given for that program," he says. "And there's never been an invitation since. Approximately 18 months of bookings were canceled in one week."(201)
Dr. Sam Ziff, an author and researcher who has studied this topic for years, believes that a political power play is at work, with the issue of legal liability lurking in the background. "I think what they're really hoping for is that the problem will just slowly fade away as more and more of the alternative materials are used and the use of amalgam is stopped" says Ziff.
He points to a similar situation that took place in Sweden several years ago. A special commission declared amalgam to be an unsuitable dental filling, says Ziff, but the medical and dental establishment applied political pressure until the commission recanted its statement publicly.
When scientists took the commission to task on national television, says Ziff, the Swedish Social Welfare and Health Administration made an historic about-face and supported the original statement against the use of amalgam. As this case illustrates, says Ziff, "There is a lot of political pressure being brought to bear. They've been using it for 150 years, and nobody likes to admit they've been wrong for that long."(202)
That's exactly what the Swedish agency did, however, when it declared amalgam to be "an unsuitable and toxic dental filling material which shall be discontinued as soon as suitable replacement materials are produced," according to a Swedish newspaper. An official said: We now realize that we have made a mistake. This has caused people to suffer unnecessarily."(203)
In 1991, Sweden announced that the use of amalgam will be banned. In 1998 the Swedish government decided to stop the reimbursement by the social security service of the use of amalgams as fillings with effect from 1999, a total ban is scheduled for 2001.(204) And in early 1992, Germany's Department of Health followed suit by prohibiting the sale of "conventional" (gamma-2) amalgam. (The agency maintained that non-gamma-2 amalgams are safer than the banned variety, a position the Environmental Dental Association questions.) Much like the ADA, the German Dental Association had claimed all along that mercury cannot escape from amalgams. This position, of course, was in direct contrast to the scientific evidence on the subject. 98 In 1997, a consensus was reached in Germany for a case-by-case approach leading to an official contraindication of the use of amalgams in children of less than six years of age, pregnant or breast-feeding women and patients with kidney problems.(205)
Scientific objectivity and public outcry over the dangers of amalgam do not always win the day, however. In 1995 Health Canada, Canada's national health agency, assigned G. Mark Richardson, Ph.D., one of its own risk assessment specialists, to perform a risk assessment study of dental amalgam. After a rigorous study of the available evidence, Richardson recommended a "tolerable daily intake" (TDI) of 0.014 micrograms of mercury per kilogram of body weight per day. In order to keep individual mercury exposure below the TDI, the report prescribed certain limits on amalgam filling implantation: 1 filling in toddlers or children; three fillings in teens, and 4 fillings in adults and seniors.(206)
Despite the fact that the Richardson report was accepted and fully accredited by Health Canada, it "created intense opposition from the Canadian Dental Association which convened a 'Panel of Experts' (CDAEP) to review it," according to Dr. Roman Lohyn, President of The Australasian Society of Oral Medicine and Toxicology (ASOMAT), a non-profit professional organization of dentists and doctors created to promote concepts of Bio-Compatible dentistry which are supported by scientific, peer reviewed research. "The panel report was compiled by Dr. Derek Jones, a professor in the faculty of dentistry at Dalhousie University in Canada," Lohyn explains. "Unsurprisingly the panel disagreed with Richardson's research. To determine the validity of the panel's expertise, an assessment was made of each panel member's research activity and their published works. Significantly, not one of the members had published any articles employing risk assessment protocols similar to that used in the Health Canada Report. A summary of the panel's expertise clearly demonstrates, based on their areas of academic expertise and published research, a severe lack of credibility as well as an obvious bias towards the pro-amalgam position. Another assessment was carried out on the expertise and academic credibility of Canadian Dental Schools. This report, which has not been contradicted by any of the Dental Schools, reveals a decided lack of expertise in the Schools' abilities to assess and comment on this issue."(207)
Lohyn also calls attention to the habit of the dental associations in Canada and the US of misrepresenting the outcome of research. He cites a letter in which Dr. Richard S. Tobin, Ph.D., the Director of the Canadian Medical Devices Bureau, castigated the Canadian Dental Association for misleading its members and the general public with its printed matter. The letter quotes a series of "Questions and Answers" published by the CDA, and criticizes each one, as follows:
COMMENTS ON THE QUESTIONS AND ANSWERS
Q. Who is responsible for the safety of medical devices and dental materials?
A. In Canada, medical devices and materials require approval of the Health Protection Branch of Health Canada.
Not all devices and materials require approval by the Health Protection Branch. Only those listed in the table to Part V of the Medical Devices Regulations must obtain "approval" (more precisely a Notice of Compliance) before they may be sold. Dental filling materials are specifically exempted from this requirement.
Q. Is dental amalgam approved for use in Canada?
A. Yes, dental amalgam is approved for use in Canada by Health Protection Branch.
This statement is categorically false. Dental amalgam has never undergone pre-market review in Canada because it was in use before the Medical Devices Regulations were established. The CDA previously published this misinformation in a paper in the CDA Journal in May 1995. At that time, we informed the CDA of this error, but CDA has repeated it here.
Scientific literature on the topic, as a whole, supports the position that amounts released are generally less than mercury picked up from natural sources.
This may be a misleading over-simplification. The World Health Organization states that dental amalgam is the largest single source of mercury exposure for persons not occupationally exposed (reference World Health Organization. 1991. Inorganic Mercury. Environmental Health Criteria 118. International Program on Chemical Safety. (Geneva)). In some individuals the mercury exposure from amalgam may be as great as from all natural sources combined.
Q. Is the mercury which is released from fillings absorbed into the body?
A. Yes, but in extremely small amounts, i.e. in MILLIONTHS of a gram (this is very small amount, 0.000001 grams.
This answer is rather condescending and insulting to the intelligence of readers. By emphasizing only how small a microgram is it implies that a microgram of toxic material could not be harmful. What is significant is not how many zeroes there are in a microgram, but how many micrograms of mercury are released by amalgam compared to the number of micrograms required to cause illness. The fact is that a level of only one hundred millionths of a gram (only 0.0001 gm) of mercury per gram of Creatinine in urine is considered to indicate clinical mercury poisoning.
Some researchers claim to detect higher mercury in the blood of people with amalgams than in those without amalgams but other researchers could not detect mercury in the blood of patients even with new amalgam restorations.
Although I am not familiar with studies that could not detect mercury in the blood of patients even with new amalgam restorations, there are several reliable studies (one of them by Dr Anders Berglund) which show higher levels of mercury in blood and urine of people with amalgam fillings than in these without. There are also studies which show a strong correlation between the number of amalgam surfaces and mercury levels in the brain and kidney. These studies are discussed in the 1993 US Department of Health and Human Services report "Dental Amalgam; A Scientific Review and Recommended Public Service Health Strategy for Research, Regulation and Education", Appendix 3, pp 10-15
Q. Is the dental profession suppressing information on the dangers of amalgams?
A. No, the dental profession believes in informed patient consent and recognizes the patient interest above any other considerations.
You are in a better position than we are to determine the degree to which this statement is correct. The CDA policy states that "Dentists want patients to be aware of conclusions from the range of scientific studies on dental amalgam so that the appropriate choice can be made." This statement is difficult to reconcile with the CDA's sweeping dismissal of research such as that discussed above, linking mercury levels with the number of amalgam fillings.(208)
Lohyn derides the American Dental Association for the same tactics. "The significance of this," he explains, "is that dentists almost universally accept that what they are told by their Associations is accurate. Combined with a very selective reporting by the Associations of the relevant literature, the end result is that the dentists are particularly ignorant about even the existence of research which does not support the orthodox view. This also leaves them predisposed to dismiss alternative viewpoints with contempt and unwilling to even consider the possibility that there could be problems. The difficulties, from a medical, dental, financial and emotional point of view, which this creates for those patients who do have amalgam related problems and who are seeking some help, are enormous."(209)
The situation is similar in Europe, according to the findings of a colloquium organized by the Green Group in the European Parliament in January, 1999. The official press release following the event points to "the tendency of the associations of doctor-dentists and of their representatives in the ad hoc expert groups …to relativise the toxicological and immunological impact of low doses of mercury. However, numerous studies presented [at this colloquium] confirm the concerns increasingly voiced: A not insignificant number of people are likely to suffer from the presence of amalgams in their mouths (allergic reactions, problems in the central nervous system, disruption of the immune and hormonal systems); Fetuses and young children are particularly at risk, mercury crosses the placenta and accumulates in the organs of the child; The insidious chronic effects on the cells, membranes and enzymes in the organism are difficult to quantify and necessitate recourse to tests and specific analyses in most instances neglected by official bodies; The problems of electro-galvanism provoked as a result of the presence of several metals in the mouth can be aggravating factors…."(210)