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As a medical doctor who has been working with amalgam toxicity for seven years in a clinical setting, I wish to comment the EU preliminary draft on dental amalgam. My remarks are to be seen in context with the excellent commentaries by Dagfinn Reiersøl, Henrik Lichtenburg and Poul Møller, which reflect the seriousness with which this issue is considered by growing numbers of people in the United States, Canada and Europe, who are not prepared to accept “business as usual” from closed-door panels of experts, who dismiss the growing body of information on the dangers of amalgam fillings in such biased fashion as evidenced by the draft report.

My clinic in Aarhus Denmark has functioned as a kind of “place of last resort” for Scandinavian patients, who have health problems, which they suspect have arisen because of mercury toxicity. Typically, these persons have sought help in the established hospital system before finding their way to my medical practice. Many have spent considerable sums of money with alternative therapies such as acupuncture or zone therapy, which oftentimes give temporary relief of symptoms, but which in the long run do not solve the major problem, in so far as that problem turns out to be mercury toxicity.

The health risks associated with dental amalgam are part of the larger problem environmental illness. Sensitivity to heavy metals, chemicals and other toxic factors from the environment present a new kind of challenge to the clinician. Chronic toxicity from environmental factors is often not accompanied by a typical set of symptoms. Diagnosis is therefore one of the more difficult challenges in medical practice. Unless a doctor has taken a special interest in this area, it is unlikely that he will have it on his list of possibilities, when the patient consults him for help.

Chronic mercury toxicity exemplifies this. Because the patient will often present with mental, emotional and/or neurological complaints, there is the tendency to see them as psychogenic, especially when lab results fail to turn up anything. Their symptoms are considered as either psychiatric in origin or the effects of psycho-social stress. In both situations the real problem goes untreated. In section 5.3.8.2 of the draft report the working group makes this mistake. They cite scores of studies which argue for a psychogenic component as the cause for why some persons complain that dental amalgams are making them sick. The working group seems to have forgotten that symptoms of mental-emotional agitation are cardinal signs of mercury’s neurotoxicity.

This tendency of orthodox dentistry to dismiss the symptoms of the mercury toxic person as psychosomatic goes hand in hand with blood- and urine-mercury determinations to disprove the diagnosis. The draft report is true to form in this respect and totally out of step with medical toxicology. Its conclusion that “…no systemic toxic effects have been shown to be related to the release of mercury from dental amalgam fillings” is based upon numerous scientific articles, that are unaware of the well documented fact among researchers, who have studied the subject, that mercury levels in the blood and urine are not reliable measures of toxic effect for low level chronic mercury exposures. As Dagfinn Reiersøl has pointed out in his commentary, even their own expert references (1991 WHO report, p. 61; 1993 USPHS report, p.III-4) point this out. Indeed, their is evidence that persons who suffer mercury poisoning show “retention toxicity”, - that is, urine mercury levels that are exceedingly low despite high tissue levels of mercury. Therefore, the tendency of the working group to disqualify vast amounts of patient data showing possible systemic toxic effects from dental amalgam on the basis of blood and urine mercury levels is not only unacceptable, but also raises questions as to their knowledge level and/or motives.

There is a growing body of international experts who argue that a mobilisation test is required in order to evaluate the mercury toxic patient. It has been shown that the level of mercury exposure is best quantified by analysis of urine both before and after administration of the compound 2,3-dimercapto-propan-1-sulfonat (DMPS). Without such a metal-binding (chelating) agent the accumulated deposits of mercury in the various tissues will not show themselves in urine or blood . In my own practice we have used the DMPS-mobilisation test (a.m. Daunderer) as the gold standard for evaluating patients who suspect their symptoms arise from dental amalgams.

I would like to conclude this short commentary with a question. In this day and age of ours when environmental toxicity is so widely spoken of in the media with regards the alarming rise in cancer, especially among young people, who among us truly believes that they can afford extra toxicity in the form of mercury from dental amalgams? It was proven during the 1980’s that mercury vaporizes from amalgam and accumulates in the body as an inner pollutant, especially in the nervous system. These are commonly accepted facts. In 1997 the amalgam debate hinges solely on the question of how much is enough to give you MS, ALS, Alzheimers, Parkinsonism and other forms of free radical degenerative disease. Do we want amalgams in the mouths of our children? No right thinking, rational person can answer “yes” to that question, when presented with the scientific evidence that is available today.

Here we must emphasize that an intuitive sense for just how poisonous mercury is, is an important prerequisite for interpreting the voluminous number of new studies and data concerning the amalgam problem. Chang et al (1972 and 1974) showed in animal studies that less than 1 ppm (part per million) of mercury damaged the blood-brain barrier within hours of test exposure, hereby increasing permeability for other substances from the plasma that would normally have been excluded. In other words, mercury’s effect enhances the damaging effects of other pollutants by introducing a toxic synergy on the level of nerve cells, the medium of thinking and emotion for us as human beings.

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