Saturday, 2 April 2011

Extensive evidence of lack of truthfulness and credibility of those who defend the use of dental amalgam

Extensive evidence of

lack of truthfulness and credibility

of those who defend the use of dental amalgam

Those who defend dental amalgam as being supposedly safe habitually fail to mention the evidence which runs counter to their assertions:

· Pro-amalgam official reports, authored by committees of supposed experts, fail to mention the studies that run counter to their assertions of safety. And criticisms pointing this out are ignored, as if they did not exist.

· The defenders then habitually cite those grossly-biased reports as supposedly showing that amalgam is safe, but never cite the other official reports which conclude it is harmful (or uncertain) instead.

· Innumerable other documents and presentations defending amalgam as supposedly categorically safe likewise fail to alert the readers to the existence of these many contradicting facts.

· Whenever patients appear to possibly have dental amalgam poisoning, or themselves suggest that they might have, the NHS take extensive evasive measures to avoid any proper investigation of the possibility.

These habitual omissions and evasions, of which instances are indicated below, call into question whether any testimony of the defenders of amalgam is worthy to be believed. (The reports cited below are those which the Dept of Health cite in justification of their assertion that no harm results from amalgam storage in the mouth.)

Historical reasons to suspect harm

Pliny (23-79 AD) stated: “Those who polish cinnabar in workshops tie loose masks made of bladder-skin over their faces to prevent inhalation of dust as they breathe; the dust is a very serious health hazard.” (Naturalis Historia XXXIII; 122).

Plutarch (c.45-125 AD) recommended that only criminals be used in mercury mines. He said that it is unjust to expose non-criminals to the poisons.

Paracelsus (1567): “so much harm arises from mercurius”; “there arises …. many such diseases such that they cannot all be mentioned.”; “mania, frenzy, … lethargy, and the like….”; “if the brain is affected, the thoughts wax and wane”. (Von der Bergsucht und anderen Bergkrankheiten, 1533-4, pub 1567).

Bernadino Ramazzini (1633-1714): “Very few [mercury workers] reached old age, and it was also said that even if they did not die young, their health was so terribly undermined that they prayed for death”.

John Hill (1751): Hatters breathing mercury vapour developed “mental disability”.

1800s: Mad Hatter syndrome: characterised by erethism (pathological shyness, timidity and social phobia), mental deterioration, personality changes, tremors.

1860: Transactions of the Medical Society in New Jersey: clinical description of “mercurialism” in hatters. Symptoms such as trembling, loss of coordination, slurred speech, loosening of teeth, memory loss, depression, irritability and anxiety.

BMJ 287:1961 (1983) Did the Mad Hatter have mercury poisoning? HA Waldron:
“The principal features of erethism were excessive timidity, diffidence, increasing shyness, loss of self confidence, anxiety, and a desire to remain unobserved and unobtrusive. The victim also had a pathological fear of ridicule and often reacted with an explosive loss of temper when criticised.”

Dental Amalgam specifically:

1844 Amos Wescott; Am J Dent Sci: The bad effects of mercury precluded its use in all cases.

1855 Amalgam. Am J Dent Sci: Many dentists considered it “producing grave and lasting disturbances of health”.

1874 Payne; Chicago Med J.: Dental profession poisoning “thousands of people all over the world”.

1878 Canada Lancet: “introduction of so virulent a poison ….. is radically wrong and should not be ventured upon…..”.

1899 Tuthill: “makes a mental wreck of its victim”.

1926 Alfred Stock: “recommended removal of amalgam fillings if “neurasthenic conditions develop”.

1974 J Am Dent Soc 98(4),904: “symptoms include …. self-consciousness, embarrassment without justification, disproportionate anxiety, indecision, poor concentration, depression, irrational resentment of criticism, and irritability.”

Etc. etc. etc.

28 studies showing benefits of amalgam removal

(a) Numerous published scientific studies have supported the notion that dental amalgams have serious adverse effects on those having them. Not least are 28 studies of amalgam removal, featuring 6622 patients. There are 25 of these studies cited and discussed in a publicly online meta-review by Mats Hanson (“Effects of amalgam removal on health; 25 studies of 5821 patients”), and three later studies are Prochazkova Sterzl Kucerova 2004; Sterzl Prochazkova Hrda 2006; Wojcik Godfrey Haley 2006.

(b) And these are the studies of the most powerful kind, namely direct evidence, and positive evidence. Such simple direct evidence trumps any amount of opposing speculative inferences via intermediary concepts such as urine or plasma levels (which are demonstrably misleading anyway) . And given 28 positive studies, a lot more than 28 negative studies would be required to cancel them out (because an instance of failing to find evidence is a lot less significant than an instance of succeeding in finding it). And yet there is no more than a handful of (methodogically dubious) negative studies, which come nowhere near countering them.

(c) And these findings cannot be dismissed as merely placebo effects. As Mats Hanson’s review indicates, “Often the removal of amalgam is a final, unpleasant and expensive measure after many years of ill health where conventional medical therapies have not improved the situation”, and patients regularly experienced long-term resolutions of problems which had affected them for many years previously.

(d) Nor can the findings be dismissed due to some of them lacking controls, or being confounded by nutritional or chelation treatments. For such objections to have any merit we would have to accept the fantastic thesis that chelation or nutrition alone can suffice to produce miraculous prompt and sustained resolutions of longstanding intractable serious problems.

In the context of the already-existing studies indicated in the preceding paragraph, the paper by Kingman, A. et al., Amalgam exposure and neurological function, Neurotoxicology, Vol. 26, pp. 241-255, 2005, begins with the words: “Concerns regarding the safety of silver–mercury amalgam fillings continue to be raised in the absence of any direct evidence of harm.”. It follows that the authors of that Kingman et al. paper must be either very incompetent or very dishonest.

Reports citing only studies opining in favour of amalgam while not mentioning those that contraindicate.

(a) The 2008 SCENIHR report, even though 72 pages long, failed to mention any of the above-cited 28 references. Commentaries by various authors (see appendix) pointed out extensive additional serious omissions. And yet the SCENIHR did cite the Kingman paper which was shown in the paragraph above to be unfit for inclusion, and did cite numerous patently unworthy papers relating to blood and urine levels which are well-known to be seriously misleading because what matters is the level of mercury in brain etc cells rather than in blood or urine.

(b) The 1997 COT statement merely refers to an EC report which in turn reviews five other reviews from pre-1994. Whatever the merits of that opaque audit trail, it anyway likewise failed to relate to any of those removal studies (about half of which were before its date), and then ended with a citation of:

Larsson KS (1995). The dissemination of false data through inadequate citation. J Internal Med, 238:445-450.

And the very next year the COT issued a statement on vitamin B6, which was described in the Lancet as “one of the worst examples of pseudoscience I have ever encountered”. COT’s recommendation of a 10mg limit was abandoned in the face of an unprecedented level of public protest against their charlatanism pretending to be expertise.

(c) The FDA 2002 report likewise failed to mention those removal studies. It dismissed as “methodologically flawed” all of the many uncited studies that contradicted its premises. You can see in our appendix a list of 236 studies which the FDA 2002 thus dismissed unmentioned and of which a commentator states: Compare the quality of the studies and journals that the FDA includes in their following References section with those "methodologically flawed" studies that fooled so many impartial reviewers and editors of some of the finest peer reviewed, scientific and medical journals in the world.” It would logically be expected that flawed studies would be no more frequent among those suggesting harm rather than safety, and yet the FDA 2002 somehow managed to find a spectacularly improbable preponderance of flawed studies among those pointing towards harm rather than safety. The extreme improbability of this constitutes proof, far beyond reasonable doubt, of extreme bias on the part of these FDA 2002 authors.

(d) The 53-page Clarkson TW, Magos L.(2006) Crit. Rev. Toxicol. 36:609-662 omitted mention of the large number of contrary studies, while endorsing numerous patently unsound or misleading ones (such as relating to blood and urine levels), as documented by Mutter J, Naumann J, Guethlin C (2006) Crit. Rev. Toxicol. 37:537-549 (herewith appended).

(e) The FDA 2002/2009 cited that Clarkson/Magos 2006 sloppy review but failed to mention the Mutter et al damning commentary on it that was published in that very same journal. How much more charlatanic is it possible to get? (The next paragraph?)

(f) A prominent article by Ben Goldacre (recipient of numerous awards as supposedly a heroic debunker of pseudoscience) began with the words: “You might remember the scare stories about mercury fillings from the past two decades: they come around every few years…” (Guardian 6 May 2006 His article mentioned only studies supporting amalgam. Then Goldacre later published an article condemning exactly those who “selectively reference only research which supports their case, rather than the totality of the evidence.” (Guardian 8 August 2009
Someone posted a comment below that article, pointing out how Goldacre himself had failed to cite the amalgam removal studies in his 2006 article. You can see that Goldacre steadfastly ignored this challenge to his falsehood, instead further engaging in chat with his acolytes about philosophers of science.

Those documents are also examples of criticisms also being ignored and blanked out: None of them (or their issuing agencies or endorsers) acknowledge the existence or validity of the severe, damning criticisms that were made of them in commentaries.

Documents citing only reports that support amalgam while omitting any mention of those that contraindicate it ((e.g., Swedish Government Forskningsrådsnämnden report 1998, Maths Berlin, Dental Materials Commission 2002; Amalgam: Eine Risikobewertung unter Berücksichtigung der neuen Literatur bis 2005. J. Mutter, J. Naumann, H. Walach, F. Daschner. Gesundheitswesen 2005; 67(3): 204-216 DOI: 10.1055/s-2005-857962.; Berlin M. Mercury in dental-filling materials – an updated risk analysis in environmental medical terms. An overview of scientific literature published in 1997-2002 and current knowledge. 2003.)):

(a) a letter from Andy Burnham (30 Nov 2009) mentioning only SCENIHR 2008, FDA 2002, WHO 1998, EC 1998, and COT 1997;

(b) a reply to a Freedom of Information request from Tim Hayward filed on 26 August 2009, essentially identical to (a) above:

(c) a 2008 letter of reply from the Chief Denial Officer which cited only the SCENIHR report;

And again, these letters give no indication that these “expert” reports have been subject to severe damning unrebutted criticisms.

Evasive mis-management of patients with possible mercury poisoning.

(d) Other patients: Mats Hanson’s commentary on the SCENIHR report states: “Patients in both Norway and Sweden have repeatedly complained to the health authorities about the way they have been (badly) treated and their reports on health changes after amalgam removal have been ignored.”

(e) This patient’s own experience of six years of evasions by NHS staff:

2004 Requested Dental Hospital to show evidence of safety; defective response; then they failed to answer my rebuttal; they abruptly shooed me away from their other victims of uninformed consent.

Dental Hospital said I should see a doctor instead.

2006 GP Dr Daniell made referral to the QE Hospital for amalgam removal “as a precaution”.

QE Hospital said they could not do the removals.

Referral switched to Dental Hospital.

Dental Hospital Consultant Stephen Chambers said a student would do the removals.

Six months later, on attending the student appointment, was told that Dental Hospital could not do the removals after all.
Stephen Chambers sent a secret letter containing three nastily-calculated libels.

2008 (After two relocations), new GP Peter Wright of Karis asserted that there was no basis for amalgam referral, supposedly on grounds of secret letter from Dental Hospital. In reality that libellous letter from Chambers contained not the slightest evidence about mercury except for accidentally confirming my severe memory difficulty which is actually a most pathognomic symptom of amalgam poisoning.

Harley Street dentist el-Essawy found I had world record 460mcg/m3 oral mercury vapour (unprovoked) and recommended melisa test.

2009 Melisa test positive 3/3 mercury, 3/3 nickel, 3/3 silver.

New GP Dr Peter Gini of Broadway Centre said I should see a dentist instead.

NHS Dentist Deborah Morse said I should see a doctor instead.

Dr Gini said I should instead get the dentist to send a request.

After a lot of chasing, eventually the request was received by GP’s fax.

Dr Gini wrote back saying he didn’t have anything to say about it.

I raised again with Dentist D Morse in a first letter, detailing three violations of directions for use of amalgam.

Dentist replied that not her responsibility.

I sent letter 2 in reply.

Dentist again not her responsibility.

I sent letter 3 in reply.

Dentist again dismissed the matter, citing defunct Healthcare Commission.

Dentist’s phone never answered. Eventually I travelled there myself and the Practice Manager told me they were not contracted to do or refer for Advanced Mandatory and so approval from Contracts Manager Steve Connelly was required.

Steve Connelly said the dentist must do the referral instead.

Dentist practice manager again said Steve Connelly must do it (as not normally NHS funded).

Steve Connelly said I should see a doctor

I asked Dr Verma for a referral to a toxicologist; she said she would have to confer with Dr Gini.

On enquiring two weeks later I was told a (‘urgent’) referral was being sent.

Months later told that Dental Hospital had declined a referral.

Dr Verma recommended referral to a psychiatrist.

Six months later psychiatrist Dr Pradhan stated there was no capability for making mercury diagnosis within the BSMHFT, and nothing could be done.

GP Dr Zaman talked to toxicology Mrs Khan who proposed a urine test, despite that even Dr Daniell had correctly ruled that out as useless five years before.

(ad infinitum, thanks for all the “help” great NHS).

At no time in all this five year farce did any of these NHS personnel attempt to make any diagnosis or conduct any tests.

Chief Dental Officer Barry Cockroft failing to mention unfavourable evidence. "England's Chief Dental Officer has dismissed a TV documentary highlighting the dangers involving mercury amalgam as ‘scare mongering' and ‘sensationalist'.” But see for yourself his parade of falsehoods (on ITV in 2009) ( from 5m30s):
“I’m not sure that’s true” (that mercury vapour is continually released); “not measureably”; and “I’m not sure that’s actually true” (that amalgam is the main source of mercury in the body**).

· Svare, C.W., Peterson, L.C., Reinihardt, J.W., et al. (1981): The effect of dental amalgams on mercury levels in expired air. J Dent Res 60:1668-1671.

· Patterson, J.E., Weissberg, B.G., Dennison, PJ. (1985): Mercury in human breath from dental amalgams. Bull Environ Contam Topical 34:459-468.

· Vimy, M.J., Lorscheider, F.L. (1985): Serial measurements of intra oral air mercury: estimation of daily dose from dental amalgam. J Dent Res 64:1072-1075.

· Berglund, A., Pohl, L., Olsson, S., Bergman M. (1988): Determination of the rate of release of intra-oral mercury vapor from amalgam. J Dent Res 67: 1235-1242.

· Vimy, MJ., Lorscheider, FL. (1985): Intraoral air mercury released from dental amalgam. J Dent Res 64:1069-1071.

· Clarkson, T.W., Friberg, L., Hursh, J.B., Nylander, M. (1988): The prediction of intake of mercury vapor from amalgams. In: Clarkson, T.W., Fribert, L., Nordberg, G.F., Sager, P.R. editors. Biological Monitoring of Toxic Metals, New York. Plenum Press: 247-260.

· Vimy, M.J., Lorscheider, F.L. (1990): Dental amalgam mercury daily dose estimated from intra oral vapor measurements: a predictor of mercury accumulation in human tissues. J Trace Elem Exp Med 3:111-123.

· Mackert, J.R., Jr. (1987): Factors affecting estimation of dental amalgam mercury exposure from measurements of mercury vapor levels in intra oral and expired air. J Dent Res 66:1775-1780.

· Olsson,, S., Berglund, A., Pohl, L., Bergman, M. (1989): Model of mercury vapor transport from amalgam restorations in the oral cavity. J Dent Res 68:50~508.

· Olsson, S., Bergman, M. (1987): Intraoral air and calculated inspired dose of mercury [Letter]. J Dent Res 66:1288-1289.

**Criteria 118 WHO 1991 states that amalgam is up to 6x the other sources combined;

Aposhian HV, Environ Health Perspect 1998 – 2/3 comes from amalgam.

Richardson GM. Assessment of mercury exposure and risks from dental amalgam. Health Canada 1995. Tolerable Daily Intake is exceeded in adults with 4 or more amalgams.

Childrens merc levels directly prop to mothers amalgams.

Poison in the Mouth (BBC TV Panorama 1994) (fifteen years before the Chief Denial Officer was asserting the unmeasureableness above):

“Mangold (BBC): …. It's easy to demonstrate how the mercury vapor escapes from their small fillings. We invited an expert to bring a mercury vapor tester to check. The air around the fillings is measured. Even without stimulation some mercury vapor is escaping from the filling. Then the filling is rubbed to simulate chewing, brushing or grinding. This time there is no doubt that mercury vapor has begun to leak copiously. This is the actual reading as the needle goes off the scale.”
Transcript at

The compilation of facts above here points to an outstanding record of untruthful misrepresentation among those purporting to speak as experts in support of the supposed safety of amalgam. (And more could have been included.)

Even the most key advisors and decisionmakers on public health policy have participated in this untruthful misrepresentation. So it calls into question whether any testimony or documentation of purported experts in defence of amalgam is worthy to be believed.