Is Mercury in Fillings Really a Problem?
"There have been a number of studies looking at the potential effects of mercury from amalgam in the general population, and the preponderance of evidence is that there is no relationship between the presence of amalgam fillings and any disease condition," says ADA spokesman J. Rodway Mackert, PhD.
"Therefore there's no reason for a patient to avoid placement of amalgam fillings, and there's no reason to have amalgam fillings removed for the purpose of trying to alleviate any disease condition," says Mackert, who is a professor at the Medical College of Georgia in Augusta.
But DeLong says by the standards of the Environmental Protection Agency, the amount of mercury in one filling is enough to contaminate a 10-acre pond, making the fish that live in the pond over the mercury limit for human consumption.
"It's hazardous waste," DeLong says of a filling that has been removed. "You have to dispose of it properly, you have to send it to an EPA-licensed facility that handles mercury waste -- this is the very material that just came out of a person's mouth."
There are numerous options to silver fillings, including tooth-colored resin, porcelain, and gold fillings -- all of which are considerably more expensive. Some dentists say colleagues who encourage patients to have silver fillings removed and replaced with the more expensive fillings are just making money off the controversy.
Charles G. Brown, the Washington attorney who represents DeLong, four other dentists, and seven patients in the lawsuit, says American dentists are dropping the ball on an important health issue.
"They know it is going to harm some people. They know, but they discourage warnings," says Brown. "They're keeping people in the dark ... they're incredibly biased on this issue."
The ADA, which is not named in the lawsuit, denies they ever discourage dentists from talking to patients about the issue.
"What we discourage is dentists misrepresenting to patients the value of any therapeutic treatment," says Kathleen Todd, ADA associate general counsel.
A New York City dentist who uses silver fillings agrees with the ADA that the amount of mercury in the fillings is not harmful and that the controversy over their safety is unwarranted.
"With the fillings of today, it's not a problem at all," says Nikolaos Laoutaris, DDS.
He says many people prefer the tooth-colored fillings to the silver fillings for cosmetic reasons anyway, so it may be becoming less of an issue.
But Laoutaris, director of the General Dentistry Program at New York Weill Cornell Medical Center, says he advises patients with fillings that are more than 25 years old to have them removed because the amount of mercury released increases with the age of the filling. Still, he says he doesn't discourage replacing them with silver fillings because the evidence does not support any harm associated with them.