Posted by mattdds on May 5, 2003, at 14:10:04
In reply to Re: Dental mercury is a real threat (long), posted by Larry Hoover on May 3, 2003, at 12:36:56
Larry,
You certainly seem to have done your homework on this, and I am overwhelmed by the amount of citations you have provided.
I briefly looked through them, and although the recurrent theme is that mercury is that mercury is indeed a neurotoxin, and definitely an environmental problem as far as disposal, I still am not convinced that there is any correlation between dental amalgams and actual disease. Do you know of any such convincing evidence? I am not aware of any. I don't mean evidence showing how much mercury is liberated during mastication, I mean actual epidemiological evidence linking, e.g. depression to the amount of restored tooth surfaces in amalgam.
Don't you think this would simplify things a bit? Because until we have real epidemiological evidence linking amalgam fillings to real diagnosable diseases, we are making rather large inductive leaps that cannot be considered good science. So all the discussion about mercury levels liberated during mastication, etc. seems like somewhat of a waste of time, when we could just cut to the chase and ask "does mercury used in a dental setting cause an increase in systemic diseases, or psychiatric problems?". As of now I think the answer is an unequivocal "NO, it does not".
Meanwhile, we have a real, tangible disease to be dealt with: dental caries. And we have to make decisions about how to treat it. Dental amalgam, for many years was THE only option in the armamentarium to treat dental caries, and it remains one of the best for it's strength and affordability. I mean, we can't just go extracting everyone's teeth, just because of what dental amalgam MIGHT do. So we have to make decisions, and to most dentists and people, this was the best one! There is no perfect restorative material, otherwise we would be using it, and avoiding amalgam altogether.
I was a bit put off by something you said:
>> Think about the brilliance of the first dentist who used it: "Duh! I know! Let's store mercury in people's mouths, and we'll tell them it's safe."
Do you really believe this was some evil plot by a dentist to get rid of mercury in the environment? Strange, I figured it was probably just some dentist trying to fix a tooth, rather than some elaborate evil scheme to poison everyone. Occams Razor comes to mind here. Which would be the simpler explanation? I was a bit surprised that you would say this, being the scientifically minded and intelligent person you seem to be. (Most) dentists are just doing their job of trying to restore function in peoples mouths and prevent further disease (with which dental amalgam has unquestionably helped). Saying this seems somewhat irresponsible to me, because people here value your opinions, and they might draw conclusions based on what you say (perhaps making them want to avoid the dentist altogether).
I am not married to any of the ideas promoted by the ADA, WHO or AMA, but I do feel that whoever makes the claim that dental amalgam is causing depression, multiple sclerosis, etc. bears a tremendous amount of burden to provide evidence for this. The ADA had nothing to gain from their numerous studies on amalgam (all of which failed to show associations between systemic disease and amalgam fillings).
I see using dental amalgam in dentistry somewhat akin to using Lithium or SSRI's in psychiatry. Although we whine that there is no perfect "silver" bullet in psychiatry, we use the best tools that we have, and we make calculated risk to benefit analyses. There are very tangible risks of using some psychiatric drugs, like the MAOI's, TCA's, benzos, and mood stabilizers. But we feel the benefits outweigh the risks. This is the same thing with dental amalgam, but I feel the risks are even smaller and the benefits are great.
Am I making sense here?
Respectfully,
Matt
poster:mattdds
thread:223248
URL: http://www.dr-bob.org/babble/20030505/msgs/224494.html