Tuesday, March 07, 2006

Gasp! Mercury!!

So, a couple weeks ago, the award-winning local daily put this article on the front page.

Pretty standard alarmist stuff. I was mad that although they quoted the directors of local dental societies, who ostensibly represent dentists, they didn't bother going to the trouble to find an actual dentist to discuss this issue. Oh, they found Dr. Fischer, "past president of the International Academy of Oral Medicine and Toxicology." His site, which I won't even justify with a hyperlink (google if you like) discusses the imminent danger not only of silver fillings but of fluoridating the water.

Now here's my deal. If someone asks me not to use silver fillings due to concerns about mercury, I'm OK with that. Better safe than sorry, maybe (even tho', as all dentists know, there's no scientific evidence to support the "silver fillings will hurt/kill you theory). Hey, I personally have an unproven superstition that if you hit the "To Cross" button at the crosswalk an even number of times, it will DEactivate the signal. (On...off...on...off) So I always do it 3-5 times.

But when you get to the anti-fluoridationists, I just get mad. I can respect anti-mercury filling people despite their lack of evidence. But the others.... wow, they feel compelled to lobby against the single most cost-effective public health practice on the planet, thereby primarily harming those who can least afford it: Uninsured children, or kids with non-compliant parents.

The other thing seems to be the way the article is structured. They lead off with all these super-scary mercury facts. THEN, at the END of the article, the opponent of mercury fillings states, "We can’t say it will cause harm, but we know there is no benefit."

We can't say it will cause harm, but.... Kinda specious, in my opinion. The SAME poll they use (Zogby) states that of those patients who actually discuss fillings with their dentists, more than HALF feel that they'd be likely or somewhat likely to go ahead and use silver if necessary. Not reported in the article. Thbbt.


hankwillisdds said...

I'll tell you, I'm sick of trying to educate patients that there is no scientific evidence to support any problems with amalgam fillings. In fact, there is a mountain of evidence that says they are harmless. But people don't want those fillings so I roll my eyes because we don't really know if composite ("white") fillings cause harm... they do contain xeno-estrogens and THOSE could be bad... but we just don't know!

Dr Nate said...

Ooh, xeno - ESTROGENS! gosh, I dunno; you'd think w/ all the manly red-staters you've got out there, Hank, you'd have a hard time selling them on that kind of hormone/filling replacement therapy!

I find it pretty effective to say, "Hey, I've studied it, and I'd use them on myself, my mom, friends, whatever." or even "Yeah, I had a bunch of silvers replaced w/ composite in '99, and if I knew then what I know now...."

the "know now" is basically poor cantacts and propensity for cervical decay interproximally due to the effect of the filling curing towards the light source.

course, if you assume my amalgams WERE all defective (and I have a hard time imagining this was the case; more like the dentist figured, hey, let's just do the whole quad; course I wasn't 'there'...), then you wouldn't want to replace amalgams w/ BIGGER amalgams, but I dont' know if I'd do a dozen onlay/inlays on a 22 year old, either.

WindowShopper said...
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WindowShopper said...

As a chemical engineer, I feel reasonably comfortable saying that I have the requisite technical acumen to analyze an article that tries to ignite passionate fear of some otherwise innocuous substance. That being said, I completely agree with you. Have you seen all of the nonsense about Teflon? About how it can potentially outgas a carcinogenic vapor when exposed to high heat. Ridiculous!! Have these people seen the list of chemicals in cigarettes?

Although the connection may not be apparent, this brings me to my thought for the day. Why do people read the word "natural" on consumer products and assume them to be safe, particularly as it pertains to the marketing of vitamins and supplements? I mean hemlock is natural, right? Last time I checked Socrates is still dead, and he still died by drinking hemlock. You get the point, and I have to get back to work...the man is looking at me funny.

DL said...

How can they say that there is no benefit to amalgam fillings? I've heard that composite has been getting better over the years, but amalgam is still just plain stronger. We just started practicing with composite in school and it is more fun and looks better, but what I've heard is that the benefit of composite is aesthetics. period. My understanding is that nowadays dentists generally use composite on the anterior teeth (and sometimes the posterior teeth) because it looks better and is good enough, but that amalgam is clearly stronger and more effective. As for the mercury I agree the worries about it are absurd.