I was just thinking over the amazing events of the last 24 hours and had to share with you some of what I saw and heard.
Yesterday, November 7th at the LAX Embassy Suites Hotel in Los Angeles the California Dental Board held an informational hearing regarding the veracity of their existing dental fact sheet. The question asked was, What scientific evidence, if any, exists that suggests that there are health risks for pregnant women, children, and diabetics from mercury in dental amalgams? The present fact sheet states; The research literature in peer-reviewed scientific journals suggests that otherwise healthy women, children and diabetics are not at increased risk for exposure to mercury from dental amalgams. Read the whole mishmash of innuendo and misstatements on the Dental Board web page. http://www.dbc.ca.gov/news.html
Both sides were represented by distinguished experts. The pro-unlimited-mercury-exposure-and-use side was presented by Harold Slavkin, DDS the current Dean of the University of Southern California Dental School and Alton Lacy, DDS Professor of dental materials at the University of California San Francisco.
The voice of caution and concern was aptly represented by Boyd Haley, PhD Head of the Department of Chemistry at the University of Kentucky and Fritz Lorscheider, PhD.
Dr. Lorscheider is now Professor Emeritus University of Calgary, Canada School of Medicine and former head of the Department of Medical Physiology. Their latest research has linked mercury to rapid neuron death at levels well below that found in the CSF of amalgam bearers. That research was published in Neuroreports and can be seen on their web sight. http://www.neuroreport.com/ 30mar01. I also found the entire paper on this web sight. I don't know what www.mindfully.org is or their policies are but they have the paper and video posted on their sight. http://www.mindfully.org/Health/Mercury-Exposure-Nerves.htm
Each speaker was given just 30 minutes to make their point. At California Dental Board member Chet Yokoyama's request, I furnished all of the audio visual projection equipment and he brought his VCR from home. We showed power point, both IBM and Mac, the neuron degeneration video and slides too. Ray Blavatt, my good friend and the video editor on the "Smoking Teeth Poison Gas!" video, made a complete video record of the meeting. Both Drs. Lorscheider and Haley gave magnificently precise and scientific presentations where facts were stated as such and references from the peer-reviewed scientific literature were supplied.
Dr. Lorscheider took great pains to address the board with the utmost respect and explained the research protocols he has followed for the last 17 years. He reviewed the earlier work in sufficient detail for the board to see that a considerable body of evidence exist that mercury leaks from set dental amalgam and that it transfers across placenta and gets into the fetus. He showed the work of Aposhian and Echeverria and the higher mercury levels in amalgam bearers after DMPS challenge. He concluded his balanced presentation with the Neuroreports video.
Dr. Alan Kay BOD President asked why there was more statistical variation in the levels of mercury found in the students with amalgam (n 10) than the controls without amalgam (n 10). Dr. Lorscheider patiently explained the wide variation that people experience when exposed to mercury and even DMPS. Some absorb a great deal and excrete it poorly while others are good excreters and do not accumulate it as much. He then went on to explain that even with the variation in findings the results were highly statistically significant. He added that the later work with dentist ( over 1,000) found the same results and neurological impairment of dentists.
Dr. Slavkin used much of his time telling us about his past teaching positions and his jobs with the government. He is the former head of the National Institute for Dental and Cranial Facial Research. He then cited the dental review conclusions from the 1993 US PHS panel and the WHO dental panel as though they constituted a significant contribution to the discussion. Then Dr. Slavkin unfortunately lost his place while in his Power Point presentation and couldn' t seem to get it to work. Dr. Haley graciously got him up and going again and put him back on the right slide.
Dr. Slavkin went on to explain that we needed prospective studies of humans to be able to say for certain if amalgams cause any problem and that such studies were underway as we speak. (Personally I d like to see the minutes of the Medical Review Board that Oks prospective studies of neurological impairment in children. I wouldn' t allow it to be done to my children, if I had any.)
He also pointed out that retrospective studies have so far failed to uncover any problems. Dr. Yokoyama pierced the vale of authority and asked a simple question. Something we were all to afraid to do with the professors 30 years ago. He simply asked Dr. Slavkin if the controls in the retrospective study also had amalgams. After some stammering the good doctor did acknowledge that there were no controls without amalgams but went on to claim that having just a few amalgams was just as good . . . well almost. So much for his science.
Dr. Haley was at his finest. He dazzled them with his metabolic pathways, bioconversion of mercury into numerous other forms and very consistent data showing mercury to be highly toxic. When Alan Kay questioned the toxicity of mercury, Boyd was taken aback slightly and explained that he hadn' t realized that anyone was still uncertain about that and referred the good dentist to his chemistry textbook. He showed with his autoradiograph how mercury knocks out tubulin and was severely toxic to neurons. He showed AD brain with high mercury and tubulin knocked out.
He showed data on autism and mothers hair, mothers dental work and children s hair and even their genetic make up. He carefully explained how APOE-2 was protective and APOE-4 produced the highest risk of both autism and Alzheimer s Disease. APOE-2 excretes mercury from brain and APOE-4 does not. He showed how synergism between testosterone and mercury could be used to explain the much higher impact on men than women and how more men than women have AD and more males than females have autism. A fantastic presentation if you haven t sniffed too much mercury already.
The mop up guy for the pro-mercury side was Alton Lacy. Dr. Lacy was the paid consultant to the California Dental Board that was there to defend his Fact Sheet. He is a materials scientist and had some very pretty Power Point Slides of other peoples work. He started his slides by explaining that there are certain facts that everyone agrees upon. First is that amalgam is an alloy and no free mercury exists. (NOT) He claimed that more mercury is taken into the body through the diet (notably seafood) and through exposure to environmental sources than from dental amalgam restorations and offered no science to support his contention.
He said that these fillings are silver amalgam. It was just plain wrong to call them mercury amalgam. Like calling a person a female woman. Redundant and ridiculous! He also quibbled about amalgams being 50% mercury. That is by weight you know. If you had a cannon ball and a Styrofoam ball that were equal in size you wouldn' t say that they were 50% each would you? I didn' t quite get the analogy. He theorized that the dentist was able to magically squeeze all the excess mercury out of the filling.
His facts were his facts and not supported by any scientific evidence that I could discern. Then he went into his most astounding assertions. First that we must agree to disagree if we were of different minds and that opposition to the use of mercury in dentistry was like a religion based upon faith rather than good common science.
He made a very good point though. One camp (his) says amalgam should be used until it is proven to cause a specific disease in humans. The other camp says it should not be used until it is proven safe. These two camps will not agree ever. I think that is a very true statement. He is clearly from the old Tobacco school that says I can do it until you catch me.
He then went on to claim that animals don t count not once but several times. He said, I don t treat sheep in my practice and I don t treat monkeys nor do I work on snails so while studies of these animals might be interesting they bear no relevance to the issue at hand. He did show an amazing slide of some poor bloke with about 74 surfaces of amalgam complete with blue gums and blue/black teeth. He seemed to think this was the finest that dentistry had to offer only the wrong color.
How do you argue with that?
He went on to show much of the research into the exposure to mercury from amalgam leaving little doubt in anyone's mind that there is a considerable body of evidence that people are exposed to a lot of mercury from dental amalgams. This is cause for concern but Dr. Lacy applies his own logic to the evidence and declared that the evidence did not show a causal relationship to any specific disease. Dr. Yokayama had to stop him at one point to clarify what the research Drasch had done. Dr. lacy claimed that Drasch had not found a causal relationship to mercury and disease. Dr. Yokayama pointed out that Drasch did not look for such a relationship. He had only related the amount of mercury in the fetus and small children to the number of fillings in the mothers teeth. Dr. Lacy finally admitted that the conclusion of causal was in fact his own addition to the research and was his opinion and not Dr. Drasch s.
He then claimed that the safest way to remove amalgam was extraction. Apparently he has not read the Frykholm paper that showed using radioactive Mercury 203 that extraction too exposes the patient to mercury. (Frykholm KO: On mercury from dental amalgam. Its toxic and allergic effects and some comments on occupational hygiene. Acta Odont Scand 15:7-108, suppl 22, 1957)
At the end of the presentations Dr. Slavkin had split so it was up to Alton to defend the cause. Dr. Lorscheider in his most medical way had to explain in the 3 minute rebuttal that animals do count and that medicine relies almost exclusively upon animal studies to make their therapeutic decisions. A lively discussion ensued and I can t do it justice. Let me know if you want a draft slightly edited video and you can see for yourself.
Following the presentations the public is allowed to speak. The ADA and the CDA gave their version of scare tactics. Dentistry would cost so much more that all the poor children would have to have their teeth pulled. Disease would become rampant if their favorite material were banned. One even claimed that amalgam worked under water.
Ray and I showed the first 6 minutes of our video "Smoking Teeth Poison Gas!". (let me know if you want 100 copies) We only got three minutes each because the dental board is so pressed for time they can only stand snippets of conversation.
Anita Tibeau from Consumers for Dental Choice and a whole army of local activists from the NAACP to nursing sororities came up and endorsed prohibitions on the use of amalgam. Numerous mercury-free dentists from the US and even Mexico spoke about the amalgam issue. Dr. Grant Layton of the Environmental Dental Association spoke from his heart as he greeted Alton with fond words. Alton had been his professor many years earlier when they both were younger. Then he went on to tell Alton that he was wrong. Amalgam was not the only way to fix teeth and that he (Grant) had been mercury-free for 20+ years and had no trouble using the newer materials.
Sam Queen spoke eloquently about the roll of mercury and disease. He was so well spoken and polished I felt proud to have known him for the last 15 years.
Ward Eccles of Pleasanton expressed the shock that everyone shared that amalgam could be used under water. He never knew that and neither did any other good dentist present. I thought water contamination made amalgam expand a lot and crack teeth.
LA Congresswoman Diane Watson s representative gave a very good outline of the Watson-Burton bill and urged the dental board to listen carefully. He in a very pleasant fashion explained exactly what the basis of the AB 934 informed consent law was and how they, so far, have failed to comply. The Lawyer representing the Fellmeth USD Consumer Advocates thanked the board for the informational hearing (as had many others) and went on to say that the Fact Sheet was totally inadequate and failed to fulfill the AB 934 requirements.
Other than the three representatives of disorganized dentistry no one else spoke in favor of this 200 year old blunder. One might have noticed that a good many in the room chose not to speak. Wandering among them and exchanging business cards it quickly became apparent that Los Angeles has more toxic tort lawyers per capita than people with amalgam. More power to them.
The A-Team retired to the hotel restaurant for refreshments. After a leisurely lunch Ray and I packed up the cameras, projectors, equipment and drove the traffic clogged LA freeway back to San Diego and Boyd and Fritz waited until almost midnight to hop the red-eye back east. Both had duties the next morning after flying all night. Fritz had a tennis game and Boyd had another lecture. My hats off to both these fine gentlemen who took time away from their work and families to fly some 3000 miles and three time zones to share with the California Dental Board in 30 minutes what they have learned over the last 40 years. We sincerely hope they were listening. If not, we ll still protect the public even if we must legislate away the dentists ability to practice independently.
Contact your representative in support of the Watson/Burton bill HR 4163. Locate your congress person by zip code at http://www.congress.org/ Then send them an email as to why they should support HR 4163. The hearings start November 14th 10AM.
These are my opinions and recollections. Others may differ.
David Kennedy, DDS