CONEM

Council for Nutritional and Environmental Medicine

Environmental Medicine

Evidence Supporting a Link between Dental Amalgams and Chronic Illness, Fatigue, Depression, Anxiety, and Suicide

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Norway and Sweden have banned amalgam, reportedly due to environmental concerns. However, the use and toxic risk of dental amalgam fillings is still a subject of ongoing debate in many countries. Now, a review conducted by a team of international researchers has provided new evidence that mercury exposure from dental amalgam may cause or contribute to many chronic illnesses, as well as depression, anxiety and suicide.

The review article by Janet K. Kern and coworkers is published in Neuroendocrinology Letters (2014; 35 (7): 537-552). Three of the authors, Kern, Geir Bjørklund and Boyd E. Haley, are members of the Council for Nutritional and Environmental Medicine (CONEM). Kern is a director of CONEM. Bjørklund is founder and president of the association. 

 

Janet K. Kern, David A. Geier, Geir Bjørklund, Paul G. King, Kristin G. Homme, Boyd E. Haley, Lisa K. Sykes, and Mark R. Geier

Evidence supporting a link between dental amalgams and chronic illness, fatigue, depression, anxiety, and suicide

Neuro Endocrinol Lett 2014; 35 (7): 537-552 

 

ABSTRACT

The purpose of this review is to examine the evidence for a relationship between mercury (Hg) exposure from dental amalgams and certain idiopathic chronic illnesses – chronic fatigue syndrome (CFS), fibromyalgia (FM), depression, anxiety, and suicide. Dental amalgam is a commonly used dental restorative material that contains approximately 50% elemental mercury (Hg0) by weight and releases Hg0 vapor. Studies have shown that chronic Hg exposure from various sources including dental amalgams is associated with numerous health complaints, including fatigue, anxiety, and depression – and these are among the main symptoms that are associated with CFS and FM. In addition, several studies have shown that the removal of amalgams is associated with improvement in these symptoms. Although the issue of amalgam safety is still under debate, the preponderance of evidence suggests that Hg exposure from dental amalgams may cause or contribute to many chronic conditions. Thus, consideration of Hg toxicity may be central to the effective clinical investigation of many chronic illnesses, particularly those involving fatigue and depression.

 

Copper Amalgam and Norwegian Dental Health Personnel

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Fig 1 Heating of copper amalgam
Fig 1 Heating of copper amalgam

Copper amalgams, consisting 60-70% mercury (Hg) and 30-40% copper (Cu) (1, 2), were used very commonly in Norway for children with caries – allegedly because they were thought to inhibit the development of new caries. But they were used in a way making them far more dangerous for dental health personnel than other types of amalgam because the amalgam powder was heated in a metal spoon in a gas flame until Hg droplets could be observed (Fig 1). In poorly ventilated rooms, this gave an enormous Hg exposure by inhalation to the dental health personnel, but even more to the dental assistants than to the dentists.

The average levels of occupational exposure to Hg among dental health personnel was earlier very high, at least in the Scandinavian countries including Norway, and in some cases (not very infrequently) excessively high (3, 4), especially in public dental health clinics with large numbers of schoolchildren as patients, where copper amalgam was used as a matter of routine to make fillings for the children because of its assumed cariostatic effect. A medical student at the University of Oslo made a student thesis, where he studied the Hg concentration in the air in dental health clinics, and in some of them found excessively high levels far exceeding (by more than a factor of 10) what was at that time the maximal permitted levels of exposure (3). This student thesis was carried out under supervision of his older brother, who was working in a leading position at the Norwegian Institute of Occupational Health. But the older brother, who had been the supervisor, did never inform the Directorate of Occupational Health about his younger brother’s observations, as nevertheless had been his duty (because of his job in a leading position at the institute) to do (Olav Albert Christophersen, personal communication).

The late Dr. Hans Tjønn, who at that time was chief doctor at the Institute of Occupational Health, had suspected that the conditions at Norwegian dental health clinics were not satisfactory from the point of view of occupational hygiene, and had taken up this question in meetings both with the Norwegian Directorate of Health and professors at the Faculty of Dentistry at the University of Oslo (Olav Albert Christophersen, personal communication). But he had been assured both by the people in the Norwegian Directorate of Health and the professors at the Faculty of Dentistry that everything was O.K., and that there was no need for him to be worried (Olav Albert Christophersen, personal communication). If he had been informed about the findings of Jon Norseth, he would have had the evidence he needed to tell the people in the Norwegian Directorate of Health that their assumptions about good occupational health conditions in the Norwegian dental health clinics were far from correct (Olav Albert Christophersen, personal communication). And the Norwegian Directorate of Occupational Health had the necessary legal mandate in Norwegian law (Arbeidsmiljøloven) that it would not have been necessary for them to ask the Directorate of Health for permission in order to stop the problems. If that, historically counterfactually, had happened, several hundred Norwegian dental health assistants and dentists might have been spared for sometimes severe health problems caused by Hg poisoning, and also because of poisoning by some of those organic toxic substances that have been much used in dental health clinics, such as chloroform and hydroquinone.

This article is based on/excerpted from material by Olav Albert Christophersen and Geir Bjørklund.

 

References

1. Bjørklund G. The history of dental amalgam (in Norwegian). Tidsskr Nor Laegeforen 1989; 109: 3582-3585.

2. Bjørklund G. Health authorities and copper amalgam (in Norwegian). Tenner & Helse 1995; No. 2/3: 3-6.

3. Norseth J. Exposure to mercury in public dental clinics in Oslo–an occupational hazard evaluation (in Norwegian). Nor Tannlaegeforen Tid 1977; 87: 371-376.

4. Bjørklund G. Mercury in dental workers’ occupational environment. A toxicological risk evaluation (in Norwegian). Tidsskr Nor Laegeforen 1991; 111: 948-951.

 

Medical Geology: An Emerging Discipline in Environmental and Human Health

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Olle Selinus, PhD
Former geologist at the Geological Survey of Sweden (SGU), and now Associated Professor at Linneaus University in Kalmar, Sweden. Board member of CONEM.

Medical geology is the science dealing with the influence of geology on the distribution of health in humans and animals. Medical geology is a rapidly growing discipline that has the potential of helping medical and public health communities all over the world pursue a wide range of environmental and naturally induced health issues. Medical geology brings together geoscientists and medical/public health researchers to address health problems caused, or exacerbated by geological materials (rocks, minerals, atmospheric dust, and water) and processes.  Among the environmental health problems that geoscientists are working on in collaboration with the medical and public health community are: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc.

Among the medical geology described are examples of both deficiency and toxicity of trace element exposure. Goiter is a widespread and serious health problem in many developing countries caused by deficiency of iodine. Deficiency of selenium in soil is the principal cause of juvenile cardiomyopathy and muscular abnormalities. Overexposure to arsenic is one of the most widespread medical geology problems affecting more than one hundred million people in Bangladesh, India, China, Europe, Africa and North and South America. The arsenic exposure is primarily due to naturally high levels in groundwater, but combustion of mineralized coal has also caused arsenic poisoning in several developing countries. Dental and skeletal fluorosis also impacts the health of millions of people around the world and is due to naturally high concentrations in drinking water and, to a lesser extent, coal combustion. Other medical geology issues described include geophagia in developing countries, exposure to radon, natural global dusts and ingestion of high concentrations of organic compounds in drinking water.

Promotion of medical geology under ICSU, UNESCO etc, under leadership from Sweden, has been carried out at meetings in many countries, organization and sponsoring of symposia on medical geology and also providing financial support for students and professionals to participate. Short courses have been presented in almost 45 countries since 2001, attended by thousands of students and professionals with backgrounds in geoscience, biomedical/public health science, enviromental science, chemistry, etc.

The International Medical Geology Association (IMGA) was established in January 2006. This was done from Sweden. Every second year IMGA has an international conference. The next will be in Portugal July 2015. Information can be found on the website http://www.medicalgeology.org.

 

References

Selinus O, ed. Medicinsk geologi. Lund: Studentlitteratur, 2010.

Selinus O, Finkelman B, Centeno J, eds. Medical Geology: A Regional Synthesis. Dordrecht: Springer, 2010.

Selinus O, Alloway B, Centeno JA, Finkelman RB, Fuge R, Lindh U, Smedley P, eds. Essentials of Medical Geology: Revised Edition. Dordrecht: Springer, 2013.