By DAWN SAGARIO
Register Staff Writer
When Melody Ebert stepped out of the dentist's chair after a visit in 1996, she left behind more than the remnants of nine amalgam fillings.
The Keosauqua resident said she shed the fatigue she'd battled for six years, which doctors had attributed to multiple sclerosis.
She said she also reversed her poor coordination and endometriosis - a condition where the uterine lining grows outside the normal area in places that include the ovaries, bowel and bladder.
A year after removing the amalgams, she claimed almost all of her energy had returned. Since then, the 36-year-old added, her immune system has improved.
Ebert is one of a number of patients nationwide who say amalgams - composed mainly of mercury - are at the root of their ailments. Dental amalgam - commonly referred to as"silver" fillings - are comprised of about 50 percent mercury, along with silver, copper and tin.
Controversy is brewing as opponents of amalgam insist they are dangerous to the health of the millions of Americans who have them. They also say patients are unaware of the toxicity.
Several medical experts disagree.
They say amalgam has proven to be a safe material for more than 150 years. They tout its durability and ease of use, saying that only in rare cases have patients had allergic reactions to the fillings.
They say there currently is no concrete evidence linking the mercury in amalgam to chronic diseases like Alzheimer's and multiple sclerosis.
In March, the Food and Drug Administration, in conjunction with other organizations of the U.S. Public Health Service, released a statement saying that while they continue to investigate the safety of amalgams, there is no valid proof that they cause harm, except in rare cases of allergy.
Complaints recently filed in Georgia against the American Dental Association are claiming that mercury in the fillings of some mothers caused their children to be born with autism.
One Altoona woman is part of a lawsuit filed against the Maryland State Board of Dental Examiners, claiming that the board supports a "gag rule" enforced by the American Dental Association that prevents dentists from initiating conversations with patients regarding the mercury amalgam controversy.
The mercury in amalgam is inert, and therefore nontoxic, a Chicago physician said.
"There's been no cases that have been documented where we can show that amalgam has caused a disease process," said Dr. Alan Boghosian, a researcher in dental materials in the division of dental surgery at Northwestern University Medical School.
He said there have been fewer than 50 cases of an allergic reaction to dental mercury to date, versus the more than 1.5 billion amalgams placed.
While fillings daily emit amounts of mercury vapor, the levels are safe and do not compromise individuals' health, Boghosian said. There has been only anecdotal evidence showing that the removal of amalgams has helped cure disease.
Dr. George North of Allison said he routinely uses amalgam in his practice.
"I've looked at literally thousands of patients, and I've seen absolutely no adverse effects at all" from amalgam fillings, said North, vice chairman of the Iowa Board of Dental Examiners.
The board's current rule says it is "improper and unacceptable" for dentists to remove fillings or recommend it as a way to remove toxic substances from the body when the patient is not allergic to amalgam.
"It's unethical for a dentist to tell a patient to have all of their fillings taken out just because they're silver fillings," said Dr. Mark Latta, associate dean for research at the Creighton University school of Dentistry.
Opponents of amalgam like Florida dentist Michael Ziff say the mercury in fillings is toxic. Doctors are obligated to fully disclose that information to patients, he said.
"It's like saying it's OK to hold seven, leaking mercury thermometers in your mouth, 24 hours a day, 365 days a year," said Ziff, executive director of the International Academy of Oral Medicine and Toxicology.
He said the average American has seven of the mercury-based fillings.
Studies have shown that the mercury in fillings causes the same type of pathological damage seen in Alzheimer's patients, he said.
While amalgam is still used by many dentists nationwide, an Iowa City physician predicts a gradual phasing out of the material in the next five to 10 years.
Composites can now replace amalgam in many situations but still has its limitations, said Dr. Jerry Denehy, chairman of the department of operative dentistry at the University of Iowa College of Dentistry.
What patients don't understand is that right now there is no universal alternative for amalgam that is as durable, cost effective and versatile, he said.
Alternatives like composites and porcelain are more expensive, and may not be as durable in some situations.
"If a dentist wants to phase amalgam out of their practice and can properly use the alternative material in the manner which they are attended and has the expertise, then I don't have a problem with the amalgam-free practice," said Denehy, an expert in restorative surgery.
Dentists should tell their patients about the choices available, a Fairfield physician said.
Dr. Robert Yudin said he prefers using composite fillings and most of his patients request them.
Determining whether dental mercury is the main cause for an individual's ailments is difficult, Yudin said. Some people naturally process out heavy metals like mercury with more ease than others, making it hard to determine how much mercury is in a person's system.
Yudin cautions that while white fillings are currently presumed to be safer than amalgams, it's still unknown whether the plastic used in composites will cause problems later on.
In 1990, Altoona resident Mary Davis replaced 13 amalgams with composites. Davis, who was suffering from multiple sclerosis, had the amalgams removed after an acquaintance suggested they could be affecting her health.
Davis said her dentist at the time was against her decision, saying it would be a waste of money.
"I felt very much like I wasn't living in a free country, when all I wanted to do was get my fillings replaced," said Davis, 41.
The West Des Moines dentist who did the procedure told her "there was no guarantee that this would help my health whatsoever," Davis said.
But since removing the fillings, Davis said she's had more energy, sleeps more soundly and has a stronger immune system.
"There's no such thing as whether or not you're allergic to mercury,"
said Davis, who is president of the Des Moines chapter of Dental Amalgam
Mercury Syndrome. "It's like saying you're allergic to arsenic. Mercury
is not an allergen. It's a toxin."
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