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For Patients Articles Education and Information THE TOXIC EFFECTS OF THE MERCURY IN DENTAL AMALGAM FILLINGS ON THE ENVIRONMENT & HUMAN HEALTH
| THE TOXIC EFFECTS OF THE MERCURY IN DENTAL AMALGAM FILLINGS ON THE ENVIRONMENT & HUMAN HEALTH |
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| For Patients - Information and education |
| Written by IAOMT |
| Thursday, 25 August 2011 11:24 |
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1 THE TOXIC EFFECTS OF
THE MERCURY IN DENTAL AMALGAM FILLINGS
ON THE ENVIRONMENT AND HUMAN HEALTH
A FACT SHEET PREPARED BY
The International Academy of Oral Medicine and Toxicology
www.iaomt.org
“For medical reasons, amalgam should be eliminated in dental care as soon as possible.
As a result, one of our largest sources of mercury in the environment can be eliminated.’’
1
--Dr. Maths Berlin, the Dental Material Commission of Sweden, 2003
About IAOMT
Representing a network of dental, medical, and research professionals with members in North
America and affiliated chapters in over fourteen other countries, the International Academy of Oral
Medicine and Toxicology (IAOMT) has been researching the damage dental mercury inflicts on the
environment and humans since the non-profit organization was created in 1984.
Brief Overview of Mercury Used in Dentistry
Millions of dentists around the world routinely use dental amalgam as a filling material to repair
decayed teeth. Often referred to as “silver” fillings, amalgam fillings actually consist of 45-55%
metallic mercury.
2
According to the United States Environmental Protection Agency (EPA), there are currently over
1,000 tons of mercury in the mouths of Americans, which is more than half of all the mercury being
used in the U.S. today.
3
Also according to the EPA, dentistry accounts for 14% of the U.S. domestic
usage of mercury annually.
4
Controversy has surrounded the use of mercury in dentistry since the 1800’s, when the neurotoxin
was first widely introduced as a filling material. The American Society of Dental Surgeons, the
predecessor to the American Dental Association, made its members pledge not to use mercury
because of its known toxicity,
5
and in more recent years, government officials, scientists, dentists,
consumers, and many others have raised serious concerns about the threats dental mercury poses to
humans and to the environment at large.
Today, authorities including the United Nations Environmental Programme (UNEP), the United States
Food and Drug Administration (FDA), and the European Commission (EC) are actively assessing
health risks associated with dental amalgam.
6 7 8
However, the governments of Norway, Sweden, and Denmark have already banned the use of
mercury fillings in dentistry,
9
Germany and Canada have limited their use for pregnant women,
10 11
and France, Finland, and Austria have recommended that alternative dental materials be used for
pregnant women.
12
Meanwhile, scientific studies continue to demonstrate the harm that mercury in dentistry inflicts upon
each one of us and our environment.
The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org 2
Dental Amalgam Pollutes the Environment in a Variety of Ways:
A 2002 report from the New York Academy of Sciences found that
40-60% of the mercury in New York/New Jersey harbor is a result of discharges from dental offices.
13
1) Wastewater from Dental Offices
According to the EPA, dental offices were found to have been the source of 50% of all mercury
pollution entering publically-owned treatment works in 2003.
14
Studies in the United States, Canada, and other countries have also shown that dental offices play a
significant role in causing mercury to enter the environment.
15
In the United States, the dental
industry is the third largest user of mercury, accounting for over 45 tons of mercury per year,
16
and the
discharge per dentist ranges from 270 to 484 milligrams per day.
17 18
Because wastewater treatment facilities are designed to process human waste, not heavy metals, the
mercury from dental discharges is separated out into sludge, or biosolids.
19
These biosolids are
usually incinerated or used as fertilizer, with the mercury content again being directly emitted into the
environment.
20
“If the average fecal excretion was applied to the entire Swedish population,
a total emission of 150 kg/yr (330 lb/year) can be estimated.
This is roughly comparable to the yearly mercury leakage from a modern chloralkali plant.”
21
--Skare and Enqvist, 1992
2) Human Waste
Research has shown that the average person with amalgam excretes approximately .1 mg of mercury
per day in his/her feces.
22
In the United States, this amounts to over eight tons of mercury per year
eventually being flushed out to sewers, streams, and lakes.
23
“In Sweden, scientists have estimated that as much as 620 pounds of
dental amalgam mercury are released into the atmosphere each year from cremation.”
24
--The Institute of Environmental Medicine, Sweden, 1992
3) Cremation
Cremation of bodies with amalgam fillings adds to air emissions and deposition onto land and
waterways. A Swiss study confirmed that cremation released over 65 kilograms of mercury per year
as emissions, often exceeding site air mercury standards.
25
In 1991, cremation of 320,372 bodies
added an estimated 2,800 pounds of mercury into the atmosphere in the United States.
26
“Hg vapor release to the atmosphere from dental vacuums can be substantial and
can exceed human exposure levels.”
27
--Stone, Cohen, and Debban, Naval Institute for Dental and Biomedical Research, 2007
4) Mercury Vapor
In offices with air/water separator tanks as part of the central vacuum system, mercury vapor has
been found in air vented to the outside of the dental office.
28 29
Dr. Paul G. Rubin of IAOMT explains,
“[M]ercury-containing material is discharged into waste streams via the dental office vacuum-pump
system. This system also discharges large quantities of air, either into the atmosphere exterior to the
office building or into the sewer system, depending on the type of equipment used.”
30
Furthermore, mercury vapor is continuously emitted from amalgam fillings,
31
which means that people
are directly exposed to the mercury in their mouths. The output of mercury vapor can be intensified
by the number of fillings present and other activities associated with the human mouth, such as
The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org 3
chewing, teeth-grinding, and the consumption of hot liquids.
32 33
Dental Amalgam Harms Humans in a Variety of Ways:
“There is really no place for mercury in children.”
34
--Dr. Suresh Kotagal, FDA Dental Products Panel, December 2010
1) Pregnant Women and Children
International legislation has already warned of the clear and present danger that the mercury in dental
amalgam fillings poses to pregnant women and children: as stated earlier in this document, the
governments of Norway, Sweden, and Denmark have banned the use of mercury fillings in dentistry,
35
while Germany and Canada have limited their use for pregnant women,
36 37
and France, Finland, and
Austria have recommended that alternative dental materials be used for pregnant women.
38
Additionally, 19 members of the United States Congress wrote a letter to the FDA in 2009 to express
their concern about mercury used in amalgam fillings, with a focus on potential dangers to pregnant
women and children,
39
and when Representative Diane Watson of California introduced the Mercury
Filling Disclosure and Prohibition Act (H.R. 2101), she explained, “It is, in fact, children who are at
greatest risk from these fillings.”
40
Scientific studies proving the devastating impact of mercury on pregnant woman and children are
abundant, which is why pregnant women and children are advised not to eat certain types of seafood
that might contain methylmercury.
41 42 43
The dangers of fetal and infant exposure to mercury via maternal dental amalgam have likewise been
scientifically established.
44 45 46 47 48 49 50 51 52 53 54 55
Although two studies (commonly referred to as the “New England Children‘s Amalgam Trial”
56
and the
“Casa Pia Children’s Amalgam Trial”
57
) have repeatedly been referenced to defend the use of
amalgam in children, researchers and commentators have demonstrated that these studies failed to
take essential factors such as long-term effects, genetic predisposition, detection of smaller effects,
and measurement errors into account.
58 59 60 61 62 63 64
Furthermore, the most up-to-date science continues to expose the havoc that the mercury in dental
amalgam fillings wreaks upon pregnant women and children. A study published in the April 2011
edition of Environmental Monitoring and Assessment notes, “As we showed, the number of amalgam
filled teeth in breast-feeding mothers strongly influences the mercury level in their milk. Take it into
consideration that maternal milk is the only source of nutrition during the first few months after birth.”
65
Another recent study published in Science of the Total Environment cautions, “Changes in dental
practices involving amalgam, especially for children, are highly recommended in order to avoid
unnecessary exposure to Hg.”
66
Meanwhile, mercury has been found to be a factor in autism,
67 68 69 70 71 72 73 74 75 76
and as such
dental amalgam fillings (maternal) have been directly linked to autism as well.
77 78 79 80 81
“Dental amalgam fillings are the primary source of mercury exposure for the general population
(Skare,1995; Health Canada, 1997).”
82
--Cited in paper published under the joint sponsorship of the United Nations Environment
Programme, the International Labour Organization, and the World Health Organization
2) The General Population
An extensive number of international research studies thoroughly document the human health risks
The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org 4
associated with the use of dental amalgam. Scientific data from reputable scientists all over the world
has investigated how the mercury in amalgam fillings can relate to dysfunction of the immune
system,
83 84 85 86 87 88 89 90
multiple sclerosis,
91 92 93 94 95 96
kidney ailments,
97 98 99 100 101
chronic
fatigue syndrome,
102 103 104 105
allergies,
106 107 108 109
reproductive issues,
110 111 112
cardiovascular
problems,
113 114
absorption of heavy metals in the brain,
115 116
Lou Gehrig’s disease,
117 118
Alzheimer’s
disease,
119 120
antibiotic resistance,
121 122
hearing loss,
123
and a myriad of other health problems.
124
125 126 127 128 129 130 131 132 133 134 135 136 137 138 139
“Provide pre-placement and periodic medical exams for those regularly exposed to mercury with
emphasis directed to CNS-central nervous system, skin, lungs, liver, kidneys, and G.I. tract.”
140
--Material Safety Data Sheet (MSDS), Safe Handling and Use Section,
provided with dental amalgam product by Original D Wykle
3) Dentists and Dental Personnel
Dentists and their staffs are occupationally exposed to constant levels of mercury released from
dental amalgam on a routine basis, and thus, researchers have also raised concerns about the safety
of dental personnel who work with amalgam.
141 142 143 144 145 146 147 148 149 150 151 152 153 154 155
“…we urge you to consider the many ill effects of mercury amalgam…
Even though dental amalgam is the predominant source of human exposure to mercury,
it is not regulated by the FDA.”
156
--Letter to the FDA from 19 Members of Congress, 2009
4) Additional Considerations about Dental Amalgam and Human Health
Reference Exposure Levels
After Health Canada was sued by a group of consumer activists over safety of medical devices, they
hired Dr. G. Mark Richardson to make recommendations about dental amalgam. Dr. Richardson
presented a chart summarizing seventeen separate estimates of mercury exposure due to amalgam
in adults. If the US Agency for Toxic Substances and Disease Registry (ATSDR) minimal risk level
(MRL) for non–occupational exposure of .014 µg Hg
0
/m
3
in air standard is used, even one amalgam
filling would expose the individual to more mercury than would be allowed by Dr. Richardson’s
proposed tolerable daily intake.
157
In new research published this year, Dr. Richardson reports that more than 67 million Americans aged
2 years and older exceed the intake of mercury vapor considered “safe” by the U.S. EPA due to the
presence of dental amalgam fillings, whereas over 122 million Americans exceed the intake of
mercury vapor considered “safe” by the California EPA due to their amalgam fillings.
158
Methylization of Mercury in the Human Body
Research has also already begun to explore how the mercury in amalgam and its vapor can be
altered into methylmercury (commonly accepted to be the most toxic form of mercury) within the
human body. Bacteria in soil and water can convert mercury into methylmercury, a form of the
element sometimes consumed by fish and shellfish,
159
and as noted above, pregnant women and
children are advised not to eat seafood that might contain methylmercury.
160 161 162
Several studies have documented the ability of metallic mercury rooted in the human system (such as
that from amalgam fillings) to be transformed into methylmercury in the mouth
163 164 165
and by
specific strains of yeast and bacteria that dwell in the gut,
166 167 168
thus revealing that the problem
already addressed in maritime environments is one which even more intimately impacts human
health.
The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org 5
Genetic Predisposition
The issue of genetic predisposition to mercury poisoning has also been noted in several studies.
169
170 171 172 173 174 175
One study specifies that roughly 25% of the U.S. population is polymorphic for a
specific genotype associated with sensitivity to mercury toxicity,
176
which amounts to 78 million
Americans today.
Mercury allergies
In 1972, the North American Contact Dermatitis Group determined that 5 - 8% of the U.S. population
demonstrates allergy to mercury by skin patch testing,
177
which would amount to approximately 21
million Americans today. Since dentists do not test their patients for mercury allergies prior to using
amalgam, this would mean that millions of Americans are unknowingly allergic to the fillings in their
mouths.
Other scientific research offers even more startling results. In one study, 180 subjects with amalgam
fillings were patch tested, and 16.1% of those without allergic disease and 22.5% of those with
allergic disease tested positive for mercury allergy. Of sixty subjects without amalgam fillings, none
tested positive for mercury allergy.
178
In another study of 29 patients with oral lichen planus, 62%
were positive for mercury allergy.
179
And at Baylor College of Dentistry, of 171 dental students patch
tested, 32% were positive for mercury allergy. The percentage of positive tests correlated with the
students’ own amalgam scores and with the length of time they had been in dental school.
180
Co-existing Factors
Finally, it should be noted that mercury influences each individual differently based on a wide-range of
co-existing factors. Thoughtful research has explored how the number of amalgam fillings in the
mouth,
181 182 183 184 185 186 187 188 189
various routes of exposure from mercury fillings,
190 191 192
gender,
193 194
plaque,
195
consumption of selenium,
196
milk,
197 198 199
or alcohol,
200 201 202
and other
circumstances
203 204 205 206
can play a role in each person’s unique reaction to mercury.
“Dental treatment without mercury is becoming the norm.”
207
--Carsten Lassen and Jakob Maag, Nordic Council of Ministers, INC1, June 2010
Suggested Solutions to Mercury Risks Caused by Dental Amalgam
Since some countries have successfully eliminated dental mercury, banning mercury from dentistry
has already proven to be both feasible and economical.
208
Various considerations should be part of any effort to end the use of mercury in dental amalgam:
1) Amalgam Separators
Amalgam separators can successfully reduce the amount of mercury discharge in wastewater from
dental offices
209 210
and are essential in stopping mercury from entering the environment. However, it
would be helpful to enforce maintenance requirements for amalgam separators, as the Royal College
of Dental Surgeons has done in Ontario, Canada.
211
It should also be remembered that amalgam
separators only contribute to solving the problem of dental mercury in wastewater and not the
additional burdens placed by amalgam fillings on the environment and human health.
2) Alternatives to Amalgam as a Filling Material
The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org 6
Many consumers choose composite fillings because the coloring matches the tooth better, and the
American Dental Association (ADA) explains that the cost for a composite filling is moderate.
212
The
ADA also offers ionomers, indirect restorative dental materials, all porcelain (ceramic) dental
materials, gold alloys, and indirect composites, among other alternatives to amalgam.
213
Although a poll showed that just less than half of dentists are using amalgam in the U.S. today,
214
a
recent survey published in the Journal of the American Dental Association offers statistics
demonstrating that mercury fillings are still being used routinely on ethnic minority groups, including
53.4% of Black/African Americans and 72.9% of American Indians/Alaska Natives/Asians/Pacific
Islanders.
215
Additionally, a study about new recruits to the U.S. Navy and Marines, also published in the Journal of
the American Dental Association, notes that while the use of resin composite among dentists is
increasing, “Our data show that dental amalgam remains the predominant material in use, accounting
for more than 75 percent of all posterior restorations among new recruits.”
216
3) Safe Removal of Existing Amalgam Fillings
Unsafe removal of amalgam fillings can cause more mercury-related health problems to patients
because mercury vapor is released in greater quantities as a result of drilling. IAOMT funds and
studies international research about the safety of dental materials and has created a safe protocol for
taking mercury fillings out of patients’ mouths.
217
4) Educating Dentists
While some dentists have already stopped using amalgam, others will require training in mercury-free
dentistry. Since Norway, Sweden, and Denmark have banned dental mercury, their dental schools
shed light upon how to make a transition away from amalgam.
5) Economic Perspective
In a report entitled “The Economics of Dental Amalgam Regulation,” the authors note that amalgam
use is already declining and that restrictions on mercury are inevitable.
218
The authors conclude, “We
can then make the case that the overall health care expenditures necessary to deal with diseases
and conditions, known or unknown, arising from the continued installation of amalgam could far
exceed the relatively manageable cost increases to the consumer for the alternatives…This is not to
mention the cost to the U.S. economy of lost work time owing to concomitant illness and disability.”
219
…
An international timeline to ban dental mercury would save people and the environment,
while also fostering a cooperative global effort.
"Mercury is among the most dangerous environmental toxins.
Satisfactory alternatives to mercury in products are available,
and it is therefore fitting to introduce a ban."
220
--Erik Solheim, Norway’s Minister of Environment and Development, 2007
The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org
1
Dr. Maths Berlin. “Mercury in Dental Materials—an updated risk analysis in environmental medical terms.” An Overview
of Scientific Literature published in 1997 to 2002. (The Dental Material Commission, Sweden).
2
World Health Organization. Mercury in Health Care. (Geneva, Switzerland: policy paper, August 2005), 1. http://
www.who.int/water_sanitation_health/medicalwaste/mercurypolpaper.pdf
3
United States Environmental Protection Agency. International Mercury Market Study and the Role and Impact of US
Environmental Policy. 2004.
4
Ibid.
5
Health Canada. The Safety of Dental Amalgam. 1996. http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/mdim/dent_amalgam-eng.pdf
6
United Nations Environmental Programme. Reducing the Risk from Mercury. http://www.unep.org/
hazardoussubstances/Mercury/tabid/434/language/en-US/Default.aspx
7
United States Food and Drug Administration. 2010 Meeting of the Dental Products Panel. December 14-15, 2010.
http://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/
MedicalDevicesAdvisoryCommittee/DentalProductsPanel/ucm235085
8
European Commission. Dental Amalgams 9: What further information is needed on the environmental risks of dental
amalgam? Europa DG Health and Consumer Protection. http://ec.europa.eu/health/opinions/en/dental-amalgam/l-2/9-
research-needed.htm#0
9
“Dental Mercury Use Banned in Norway, Sweden and Denmark because Composites are Adequate Replacements,”
Reuters/PRNewswire-USNewswire Online. January 3, 2008. http://www.reuters.com/article/idUS108558+03-
Jan-2008+PRN20080103
10
Working Group on Dental Amalgam for the United States Department of Health and Human Services. Dental Amalgam
and Restorative Materials: An Update Report to the Environmental Health Policy Committee. (Washington, D.C.: update
report, October 1997), 4-6. http://web.health.gov/environment/amalgam2/contents.html
11
Health Canada. The Safety of Dental Amalgam. 1996. http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/
md-im/dent_amalgam-eng.pdf
12
Health and Environment Alliance. Mercury and Dental Amalgams. (Brussels, Belgium: fact sheet, May 2007): 3. http://
www.env-health.org/IMG/pdf/HEA_009-07.pdf
13
New York Academy of Sciences. Pollution Prevention and Management Strategies for Mercury in the NY/NJ Harbor.
June 2002. http://www.nyas.org/Publications/Annals/Detail.aspx?cid=8454dd76-8998-4ee7-b7a2-5a97f68c790c
14
United States Environmental Protection Agency. Mercury in Dental Amalgam. August 5, 2011. http://www.epa.gov/
mercury/dentalamalgam.html
15
Arenholt-Bindslev, D., et al., Mercury Levels and Discharge in Waste Water from Dental Clinics, Water Air Soil Pollution,
86(1-4):93-9 (1996); AMSA, Evaluation of Domestic Sources of Mercury (Aug 2000); Metropolitan Council Environmental
Services (MCES), Controlling Dental Facility Discharges in Wastewater, Twin Cities, Minnesota (1999);
www.pca.state.mn.us/publications/mercury-va-mces.pdf ; Stone ME, et al., “Determination of methylmercury in dental-unit
wastewater,” Dent Mater.,2003, 19(7):675-679; AMSA/U.S. EPA, Mercury Source Control Program Evaluation, Larry
Walker Associates, Final Report (March 2002); Dentist the Menace: The Uncontrolled Release of Dental Mercury in the
Environment, Mercury Policy Project and Healthcare Without Harm (June 2002). www.mercurypolicy.org/new/documents/
DentistTheMenace.pdf; Sustainable Hospitals Program, S.M. Jasindki, U.S. Bureau of Mines, The Materials Flow of
Mercury in the U.S., Information Circular; 9412 (1994); United Nations Environment Program, Global Mercury
Assessment-Appendix: Overview of Existing and Future National Actions, April 25 2002 Draft; al-Shraideh, M., alWahadni, A., The mercury burden in waste water released from dental clinics in Jordan; SADJ, 57(6):213-5 (June 2002).
16
Ibid.
17
Arenholdt-Bindslev,D., Larsen,AH. “Mercury Levels and Discharge in Waste Water from Dental Clinics.” Water, Air, Soil,
Pollution, 86(1-4):93-9, 1996. Abstract available at http://www.springerlink.com/content/pp65v404t276p450/
18
Naleway,C et al. “Characteristics of Amalgam in Dental Wastewater” (abstract). JDentRes. 73:105, 1994.The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org
19
Larose, Pierre. Position Paper. IAOMT Environmental Committee, 2011.
20
Balogh S; Liang L. “Mercury Pathways in Municipal Wastewater Treatment Plants.” Water, Air, Soil Pollution.
80:1181-90, 1995.
21
Skare, I., Enqvist, A. “Amalgam Restorations: an important source of human exposure of mercury and silver.”
Lakartidningen. 15:1299-1301, 1992). http://www.tandfonline.com/doi/abs/10.1080/00039896.1994.9954991
22
Bjorkman et al. “Mercury in Saliva and Feces after Removal of Amalgam Fillings.” Tox. Appl Pharm. 144(1): 156-162.
1997. http://www.sciencedirect.com/science/article/pii/S0041008X9798128X
23
Larose, Pierre. Position Paper. IAOMT Environmental Committee, 2011.
24
Institute of Environmental Medicine (Sweden). Karolinska Institute Report. IMM 1/92.
25
Rivola J; Krejci I; Imfeld T; Lutz F. “Cremation and the Environmental Mercury Burden.” Schweiz Monatsschr Zahnmed
100(11):1299-303, 1990.
26
Fdn for Toxic Free Dentistry, Dental and Health Facts Newsletter, 5(3), Sept 1992.
27
Stone, ME, Cohen, ME, Debban, BA, “Mercury vapor levels in exhaust air from dental vacuum systems,” Dental
Materials, 23 (5): 527-532, May 2007. Abstract available at http://www.sciencedirect.com/science/article/pii/
S0109564106000881
28
Ibid.
29
Rubin PG, Yu M-H, “Mercury vapor in amalgam waste discharged from the dental office vacuum units.” Arch Environ
Health 51(4):335-7, 1996 Jul-Aug. http://www.tandfonline.com/doi/abs/10.1080/00039896.1996.9936036
30
Ibid.
31
Health Canada. The Safety of Dental Amalgam. (Ottawa, Ontario: report, 1996), 4. http://www.hc-sc.gc.ca/dhp-mps/
alt_formats/hpfb-dgpsa/pdf/md-im/dent_amalgam-eng.pdf
32
Advisory Committee on Mercury Pollution. Dental Amalgam Fillings: Environmental and Health Facts for Dental
Patients. (Waterbury, VT: online dental fact sheet, accessed October 27, 2010), 1. http://www.mercvt.org/PDF/
DentalAmalgamFactSheet.pdf
33
State of Connecticut Department of Environmental Protection. Fillings: The Choices You Have: Mercury Amalgam and
Other Filling Materials. (Hartford, CT, USA: Brochure, Revised January 2006), 3. http://www.ct.gov/dep/lib/dep/mercury/
gen_info/fillings_brochure.pdf
34
United States Food and Drug Administration. 2010 Meeting of the Dental Products Panel. December 14-15, 2010.
http://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/
MedicalDevicesAdvisoryCommittee/DentalProductsPanel/ucm235085 Transcript available.
35
“Dental Mercury Use Banned in Norway, Sweden and Denmark because Composites are Adequate Replacements,”
Reuters/PRNewswire-USNewswire Online. January 3, 2008. http://www.reuters.com/article/idUS108558+03-
Jan-2008+PRN20080103
36
Working Group on Dental Amalgam for the United States Department of Health and Human Services. Dental Amalgam
and Restorative Materials: An Update Report to the Environmental Health Policy Committee. (Washington, D.C.: update
report, October 1997), 4-6. http://web.health.gov/environment/amalgam2/contents.html
37
Health Canada. The Safety of Dental Amalgam. 1996. http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/
md-im/dent_amalgam-eng.pdf
38
Health and Environment Alliance. Mercury and Dental Amalgams. (Brussels, Belgium: fact sheet, May 2007): 3. http://
www.env-health.org/IMG/pdf/HEA_009-07.pdf
39
Watson, Diane and 18 other members of Congress. “Dear Acting Commissioner Dr. Joshua
Sharfstein…” (Washington, D.C.: Congressional letter, May 14, 2009). Copy of letter available upon request to
john.donnelly@mail.house.gov
40
Watson, Diane, Congresswoman, Mercury in Dental Filling Disclosure and Prohibition Act, November 5, 2001, http://
amalgamillness.com/Text_DCAct.html.The Toxic Effects of Dental Amalgam; August 2011
Website: www.iaomt.org ; Contact: info@iaomt.org
41
United States Environmental Protection Agency. Mercury: Human Exposure, October 2010, 1. http://www.epa.gov/hg/
exposure.htm
42
State of Connecticut Department of Public Health. A Woman’s Guide to Eating Fish Safely: Special Advice for Pregnant
Women & Young Children, 2010, http://www.ct.gov/dph/lib/dph/environmental_health/eoha/pdf/womans_guide_-
english_2010.pdf
43
United States Food and Drug Administration. What You Need to Know about Mercury in Fish and Shellfish, 2009. http://
www.fda.gov/Food/ResourcesForYou/Consumers/ucm110591.htm
44
Geier, David A, Kern, Janet K., Geier, Mark R. “A prospective study of prenatal mercury exposure from dental
amalgams and autism severity,” Neurobiolgiae Experimentals Polish Neuroscience Society 69 (2009): 1, 4, 6 & 7. http://
www.iaomt.org/news/files/files302/Amalgam_Autism_Geier_2009.pdf
45
London, Susan. “Amalgam fillings during pregnancy linked to infant cleft palate.” Elsevier Global Medical News. July
21, 2010. http://www.medconnect.com.sg/tabid/92/s4/Obstetrics-Gynecology/p21/Pregnancy-Lactation/ct1/c37751/
Amalgam-Fillings-During-Pregnancy-Linked-to-Infant-Cleft-Palate/Default.aspx
46
Laks, Dan R. “Environmental Mercury Exposure and the Risk of Autism.” White Paper for Safe Minds. August 27,
2008. http://www.safeminds.org/about/documents/SM%20Env%20Mercury%20Exposure%20and%20Risk%20of
%20Autism.pdf
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