By Dr. Mercola
Exposure to hazardous substances while on the job is a reality for many occupations, from farmers and construction workers to firefighters — and dentists. In the latter case, the use of toxic substances like mercury for amalgam fillings is not only dangerous for patients but also for those working with the material in the office.
In fact, a cluster of eight dentists and one dental technician from Virginia were diagnosed with idiopathic pulmonary fibrosis (IPF), a chronic and progressive lung disease with no known cure, and sought treatment at the same specialty clinic in the state from 2000 to 2015.
One of the dentists contacted the U.S. Centers for Disease Control and Prevention (CDC) in April 2016, concerned that a number of dentists were all being treated for the same relatively rare disease. While IPF has been associated with certain occupations in the past, especially exposure to certain dusty environments like those that may occur during agricultural work, textile manufacturing or exposure to wood dust,1 dentistry was an entirely new connection.
Dentists 23 Times More Likely to Develop IPF Than General Population
In June 2017, the CDC reviewed medical records from 894 patients diagnosed with IPF and treated at the above-mentioned specialty clinic from September 1996 to June 2017, looking for those with an occupation of dentist, dental hygienist or dental technician. Nine of the patients, or 1 percent, were dental personnel. Considering the small number of dentists in the U.S. relative to the overall population (0.038 percent in 2016), the fact that they represented nearly 1 percent of patients being treated for IPF at one clinic was noteworthy.
In fact, the CDC analysis revealed that the dental workers were 23 times more likely to develop IPF compared to the general population. Seven of the patients died during the study period, and only one of the remaining patients (the dentist who originally contacted the CDC) could be interviewed, which revealed that he had not worn protective equipment during much of his career and later transitioned only to a surgical mask. The CDC reported:2
“The interviewed patient, who had never smoked, reported not wearing a National Institute for Occupational Safety and Health-certified respirator during dental activities throughout his 40-year dental practice; he wore a surgical mask for the last 20 years of his dental practice. He reported performing polishing of dental appliances, preparing amalgams and impressions, and developing X-rays using film developing solutions.”
The CDC also queried the National Occupational Respiratory Mortality System for 1999, 2003, 2004 and 2007, which revealed 35 deaths from IPF or related pulmonary diseases in people working in the “office of dentists” and 19 categorized as having the occupation “dentist.” “These findings suggest that a higher rate of IPF might occur among dental personnel than among the general population,” according to the CDC, which also acknowledged:3
“This investigation revealed the first described cluster of dental personnel with diagnosed IPF. The eight dentists identified in this cluster exceeded the number of expected cases, consistent with National Occupational Respiratory Mortality System data regarding IPF mortality and the proportion of U.S. residents who are dentists.
Dentists and other dental personnel experience unique occupational exposures, including exposure to infectious organisms, dusts, gases and fumes. It is possible that occupational exposures contributed to this cluster. After this analysis, another IPF case was diagnosed in a dentist treated at this specialty clinic.”
What Is Idiopathic Pulmonary Fibrosis?
IPF is a disease that causes scar tissues to build up deep in your lungs. This starts in the lungs’ air sac walls, through which air passes into your blood. As the walls thicken with scar tissue, it causes your lungs to stop functioning properly, which means they can no longer get enough oxygen into your bloodstream, brain and body. People with IPF commonly experience shortness of breath, which may first only occur during exercise but eventually progresses to the point where you may feel short of breath even when you’re at rest.
IPF may also cause a dry, hacking cough or uncontrollable coughing, as well as weight loss, fatigue, aching muscles, rapid breathing and rounding of the tips of your fingers or toes, known as clubbing. Eventually, as the disease progresses it leads to respiratory failure, pulmonary hypertension and heart failure; most people survive only three to five years after being diagnosed.
Exposure to environmental pollutants, including inorganic dust (silica and hard metal dusts) and organic dust (bacteria and animal proteins), is known to cause pulmonary fibrosis, as are certain medications, including nitrofurantoin (an antibiotic), amiodarone (a heart medicine) and the chemotherapy drugs methotrexate and bleomycin.4 It’s estimated that 200,000 Americans have IPF.5
Is Exposure to Mercury and Other Toxins to Blame?
While the CDC report maintains an air of surprise about the findings, in reality, when you drill mercury in people’s mouths day after day, while you’re sitting above them inhaling everything, it’s probably going to affect your lungs, as well as your overall health. The fact that the American Dental Association (ADA) has historically defended mercury’s use for fillings, and continues to do so to this day, has surpassed the point of ignorance and reached that of malice.
Mercury is a known lung-damaging agent and, according to the U.S. Centers for Disease Control and Prevention (CDC), is “toxic … through inhalation of mercury vapors.”
Acute inhalation of mercury is known to cause inflammation of the lungs and shortness of breath, as well as respiratory failure and death in extreme cases. Over the long term, mercury-induced lung damage may include “increased fibrous tissue in the lung (pulmonary fibrosis), restrictive lung disease and chronic respiratory insufficiency.”6 The World Health Organization (WHO) further states:7
“Mercury is highly toxic and harmful to health. Approximately 80 percent of inhaled mercury vapor is absorbed in the blood through the lungs, causing damages to lungs, kidneys and the nervous, digestive, respiratory and immune systems.
Health effects from excessive mercury exposure include tremors, impaired vision and hearing, paralysis, insomnia, emotional instability, developmental deficits during fetal development, and attention deficit and developmental delays during childhood.”
Meanwhile, mercury is but one lung toxin that dental personnel are exposed to on a near-daily basis. Others include silica, polyvinyl siloxane, alginate and “other compounds with known or potential respiratory toxicity,” the CDC stated.8 But because mercury is the most vaporous of the heavy metals, dental amalgam pollutes dental workplaces full of toxic air — which exposes dentists, dental hygienists, dental assistants and front office staff to eight to 10 hours of dangerous breathing every workday.
A clinic where the dentists regularly place amalgam is a hazardous workplace — but whose hazards are generally left unexplained to the dental staffs, even the pregnant women, which can and does have serious and horrible consequences to the reproductive systems of young women as well as others working in the office. Further, few dental workers employed by pro-mercury dentists are given protective garb or air masks to minimize their exposure to mercury and other toxins.
Air Quality in Dentists’ Offices Is Notoriously Bad
At industrial sites, employees must follow strict protocols to avoid exposure to even tiny amounts of mercury but at dental offices mercury levels may soar — and patients and employees are oblivious to the risks. Alex Hummell, CEO of Mercury Instruments USA Inc., a company that makes equipment to detect airborne levels of mercury, said he’s seen air contamination in dental offices that’s so high, it would be shut down if it were any other office. McClatchy DC reported:9
“‘They would be closing their doors and getting respirators on.’ Instead, [Hummell] said, ‘there are kids running around everywhere. It’s nuts. It’s the exact same toxin, and it’s being treated totally differently. Why is it being allowed to be so unregulated?'”
Despite the known risks, few dental offices monitor their air for mercury levels the way many industrial sites do. It’s so bad that Hummell, a father of five, says he won’t bring his children into just any dentist office, lest they be exposed to mercury even for a second.
In an experiment to determine mercury exposures at a dentist’s office, Hummell found mercury levels up to 30 times the OSHA limit could be released during a procedure to remove mercury fillings. He’s also found that mercury levels rise when a tooth with an old mercury filling is gently brushed. As you might expect, the ADA was not too thrilled to hear about Hummell’s findings. According to McClatchy DC:10
“He [Hummell] said he also showed dentists an American Dental Association pamphlet urging them to periodically monitor their offices for mercury, a circular that mostly drew chuckles and ridicule from the dentists.
‘I got a call the day after the convention from the American Dental Association’s lawyer threatening to take me down if I didn’t stop using their publication,’ Hummell said. ‘I said, ‘I thought the dental association wanted them to know. Right after that, you couldn’t find that publication anywhere … It disappeared from the internet.'”
According to Charlie Brown of Consumers for Dental Choice, “Historically, the ADA has warned dentists about the dangers of mercury in dental offices, but only when the ADA stood to profit.” For example, Brown cites an ADA brochure titled You Owe It to Yourself! Protect Yourself and Your Staff Against the Hazards of Your Profession with the ADA’s Mercury Testing Service.” In the brochure, the ADA acknowledges:
“Office spaces may be contaminated with mercury from leaky amalgam capsules and from the lingering effects of accidental spillage. High speed handpieces and ultrasonic compactors that vaporize mercury can lead to unsuspected inhalation.”
For $75 per person per year, the ADA offered a “complete and confidential” mercury-testing service. There is no evidence that the ADA has continued this mercury testing program. “It appears that the ADA found it more profitable to deny the problem of high mercury levels in dental offices,” explained Brown. Even dental students are at risk, with studies showing dental institutions and hospitals in the Philippines and Pakistan to have hazardous levels of mercury pollutants in the air.
Why Choosing a Mercury-Free Dentist Is so Important
As the health risks of mercury are readily apparent, it’s in everyone’s best interest — patients and providers alike — to opt for mercury-free dental care. According to Consumers for Dental Choice, dental offices that opt to use mercury put dental professionals at risk, as they may come into contact with the poison both directly and indirectly; mercury can even contaminate carpeting and pipes. Exposure to mercury in the workplace has led to:11
- Higher levels of mercury in dental workers compared to the general population
- Increased health problems, including neurological, neuropsychological, respiratory, cardiac and kidney disorders, in dental professionals compared to the general population
- More reproductive problems for female dental professionals compared to the general population
While other countries, including Sweden and Norway, have phased out the use of mercury amalgam fillings completely, in the U.S. only 32 percent to 52 percent of dentists are mercury-free. This means it’s up to you to find a mercury-free dentist when choosing a dental provider for yourself and your family.
Now that about half of American dentists are mercury-free, Consumers for Dental Choice has shifted its focus from supply to demand, and consumer demand for mercury-free dentistry is primarily held back by insurance companies and other third-party payers who mandate continued amalgam use. It’s time to drive home the message that consumers will no longer tolerate the use of mercury amalgams and will not settle for insurance plans and programs that mandate amalgam use. To participate:
1. Check the details of your dental insurance policy. If it fully pays for amalgam while limiting or denying coverage for mercury-free fillings, register your objections with this easy-to-fill-out online form, which you can then email to your insurance company. Please visit the Consumer for Dental Choice Demand Your Choice page to find additional details and tools to help you take a stand against your insurance company’s pro-mercury policies.
2. Next, find another insurance company or plan that pays for mercury-free fillings in all teeth, without exceptions or LEAT clauses.
3. If your current dentist is still using mercury in his or her practice — even if they also offer mercury-free options — seek out a dentist that offers only mercury-free fillings for all patients. And, be sure to inform your dentist about the reason you’re transferring.
The reason for this is because dentists who still use amalgam end up using it on people who rarely have any other choice, either because they cannot afford to pay the difference, or their state or government program dictates they can only receive mercury.
This unfair practice needs to end, and the quicker we can get all dentists to go 100 percent mercury-free, the sooner these programs will be forced to change. So, selecting a 100 percent mercury-free dentist is an altruistic choice on your part, which will help those whose voices are so often ignored. It will also lead to a safer office environment for the patients and staff.
4. If you have mercury fillings, be sure to consult with a biological dentist who is trained in the safe removal of amalgam.
5. Last but not least, spread the word, and urge your family and friends to challenge their insurance companies’ toxic policies and make the switch to a mercury-free dentist as well.