Wednesday 15 May 2013

Dental Amalgams (silver fillings) and the Kidney

Dental amalgams, more commonly known as “silver fillings”, a mixture of the organo-metallic toxin mercury and several metals, have been used in dentistry for about 150 years.  A cheaper alternative to the more commonly used gold-based fillings used at that time, they became widely embraced by the dental profession because of it’s cheap cost as a filling material after decay had been removed from a tooth.  There is no question that it’s implementation has been successful.

 However, there has been controversy in its use since its beginning. Many have warned of the potential side effects over the years.  Many of the earlier studies were anecdotal or used disputed scientific methods.  However, the body of evidence was growing, both for the use of amalgam and against it’s use.  Though there was no overwhelming evidence one way or the other, panels testifying in front of the Food and Drug Administration were able to make their arguments be heard.  Several years ago the FDA downgraded its classification from universal to general use, with restrictions (Class one to Class two). It is no longer regarded as safe for young children and pregnant women.

In recent years the level of scientific research has improved dramatically as we are now able to do detailed studies at the cellular and molecular levels.  The amalgam issues have not gone away and now they are looking at the controversy  with “new eyes”.  Last year a peer-reviewed paper was published that stated that inflammatory markers were found in the immune-systems of people with dental amalgams that was significantly higher than in those without. 

This month, in the journal of Human and Experimental Toxicology, a peer-reviewed paper was published that states that kidney damage is found in people with dental amalgams that is significant compared to those people without dental amalgams. 

Inside your kidney is a series of tubes lined by cells that help to filter wastes out of the blood to be eliminated by the urine.  Damage was found in the part of the tube called the proximal tubule.  The damage was dose-dependent, meaning the more dental amalgams that a person had, the more damage was found.

This author is  not jumping on the band wagon stating that “ if you don’t get your silver fillings replaced you’re going to die”.  What we are doing is giving you the information, that’s readily available, for you to make a decision about your health.

There is always some risk in replacing dental amalgams since mercury release is highest at placement and removal, and tooth damage during removal is always a possibility. No man-made material is as safe as that you were born with.  However, the chronic issues may be of far more importance to your well-being.

The use of dental amalgams will remain controversial for some time.  Insurance companies tie their benefits to the use of dental amalgam and will be slow to raise the benefits to the more expensive options available today.

If you have more questions that you can contact our office.  We have not placed dental amalgams since 1987.

Daniel F. Babiec, DMD,MAGD


Dentist Alexandria VA
Bradlee Dental Care  
3690 King Street, Suite KL
Alexandria, VA 22302
(703) 820-0809



 
Geier et al, 2013- mercury exposure from dental amaglams and kidney integrity biomarkers

A significant dose-dependent relationship between mercury exposure from dental amalgams and kidney integrity biomarkers: A further assessment of the Casa Pia children’s dental amalgam trial

DA Geier, T Carmody, JK Kern, PG King and MR Geier
Human and Experimental Toxicology 32(4) 434-440. 2013.

Abstract
Dental amalgams are a commonly used dental restorative material. Amalgams are about 50% mercury (Hg), and Hg is known to significantly accumulate in the kidney. It was hypothesized that because Hg accumulates in the proximal tubules (PTs), glutathione-S-transferases (GST)-a (suggestive of kidney damage at the level of PT) would be expected to be more related to Hg exposure than GST-p (suggestive of kidney damage at the level of the distal tubules). Urinary biomarkers of kidney integrity were examined in children of 8-18 years old, with and without dental amalgam fillings, from a completed clinical trial (parent study).

Our study determined whether there was a significant dose-dependent correlation between increasing Hg exposure from dental amalgams and GST-a and GST-p as biomarkers of kidney integrity. Overall, the present study, using a different and more sensitive statistical model than the parent study, revealed a statistically significant dose-dependent correlation between cumulative exposure to Hg from dental amalgams and urinary levels of GST-a, after covariate adjustment; where as, a nonsignificant relationship was observed with urinary levels of GST-p. Furthermore, it was observed that urinary GST-a levels increased by about 10% over the 8-year course of the study among individuals with an average exposure to amalgams among the study subjects from the amalgam group, in comparison with study subjects with no exposure to dental amalgams.

The results of our study suggest that dental amalgams contribute to ongoing kidney damage at the level of the PTs in a dose-dependent fashion.


 

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