(Sworn testimony of R. Baratz before the Florida Dental Board on amalgam rule, Sept 29, 2001, with review by B. Windham, DAMS technical consultant)
1. "A dental license is a privilege and a licensee has an obligation to present factually correct information to the public. And your duty is to see that happens." (page 6) R.B.
This is an ironic statement, since it is clear that much of the information presented here by Dr. Baratz was not factually correct or supported by Scientific evidence. B.W.
2. "And except for a handful of reports of simple allergies, no patient, anywhere, has ever been harmed by the materials in a properly mixed and placed amalgam restoration". (page 7)
This is not accurate, there are hundreds of peer-reviewed studies and thousands of documented clinical cases of adverse effects from mercury from amalgam. Many of them published in dental journals. And it is well documented in the literature than large numbers of people(many millions) are immune reactive to mercury, and that immune reactivity commonly causes significant adverse health effects.
3. "That is about one milligram. The amount of mercury that might be released from a dental amalgam is a fraction of that, in a day. A fraction of a fraction of that. And that is what all the controversy, if you want to call it that, is about". (page 7)
Dr. Baratz apparently is not familiar with the fact that mercury is extremely toxic so that levels of exposure in milligrams and micrograms are extremely high and dangerous. Mercury is known to be the most toxic substance people commonly come in contact with at significant exposure levels. The EPA drinking water standard for mercury is 2 parts per billion, much lower than the levels he is discussing; and it is well documented that the average daily exposure of someone with several amalgams is more than the ATSDR/EPA guidelines(MRL) for mercury.
Agency for Toxic Substances and Disease Registry, U.S. Public Health Service, Toxicological Profile for Mercury , 1999; & Apr 19,1999 Media Advisory, New MRLs for toxic substances, MRL:elemental mercury vapor/inhalation/chronic & MRL: methyl mercury/ oral/acute; & http://www.atsdr.cdc.gov/mrls.html
4. "Sodium, if I were to take some sodium metal and drop it into this glass of water in front of Mr. Nicol here, all of you would be killed by the explosion." (page 7)
Anyone with a reasonable background in science knows that this statement is not true. This experiment is commonly performed in Chemistry labs.
5. “The point is that dental amalgam does not contain mercury. It has none.” (page 7)
6. "It contains things that were mixed together which formerly were mercury and formerly were a bunch of other metals but once we mixed them together they are no longer that, those separate materials, they are now a new material we call amalgam." (page 7)
7. "If you detect traces of mercury that are released from that material, it is because that material has now been decomposed by heat and by friction to drive it back towards what used to be the ingredient."
5,6,7. This is a very strange statement for Dr. Baratz to make, as anyone with a reasonable science background knows that it is not true. As documented by amalgam manufacturers such as Dentsply, amalgam is about 50% mercury, and the mercury in amalgam is elemental mercury. This is well known. All of the metals in amalgam are divalent cations that do not form chemical compounds with each other. Also since mercury has a negative vapor pressure, the mercury in amalgam is constantly vaporizing- resulting in high levels of mercury in the oral air, saliva, and oral mucosa. The fact that there is oral galvanism between mixed metals in the mouth is also commonly known, including by dentists and dental school staff, which results in additional release of mercury into the body. This is documented in the dental literature and is known to have effects on some patients. Also commonly resulting in buildups of mercury in the oral cavity, called amalgam tattoos. The levels are commonly much higher than Government health guidelines for mercury in office air or drinking water, food,etc.
8. "You often hear people say, Well, mercury is a deadly poison. Amalgam has mercury therefore you are putting poison in people’’s mouths. That is fundamentally false and anyone who says that is not telling the truth. They do not understand what a poison is. If that is true, then eating sodium chloride is equivalent to poisoning yourself, and we do it every day." (page 7)
This is also a very strange statement for a person claiming to have a science background to make. According to U.S. EPA and ATSDR, mercury is extremely toxic and one of the most toxic substances people commonly come in contact with. All forms of mercury are extremely toxic. The drinking water standard is 2 parts per billion, much lower than most poisons like arsenic, pesticides,etc. And it is in the top 3 of all toxic substances causing adverse health effects. All U.S. Government agencies involved with toxics state that mercury is extremely toxic. Amalgam is documented to be the number one source of exposure for most people. Amalgam waste is classified as toxic waste by EPA. The fact that you put it in someone’s mouth does not change the fact that mercury from amalgam is extremely toxic, and an extremely potent poison. And the level of daily exposure is known to be high, relative to Government health guidelines.
Agency for Toxic Substances and Disease Registry, U.S. Public Health Service, Toxicological Profile for Mercury , 1999; & Apr 19,1999 Media Advisory, New MRLs for toxic substances, MRL: elemental mercury vapor/ inhalation/chronic & MRL: methyl mercury/ oral/acute; & http://www.atsdr.cdc.gov/mrls.html &
ATSDR/EPA Priority List for 1999: Top 20 Hazardous Substances, Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services, http://www.atsdr.cdc.gov/99list.html
9. "So to say that dental amalgam has mercury in it is false. It has what used to be mercury." (page 8)
Dr. Baratz doesn’t seem to understand that mercury is an element and that approximately 50% of amalgam is mercury. The mercury in amalgam is “mercury”, but even if it were a chemical compound of mercury, all such are extremely toxic. Amalgam manufacturers and the material data safety sheets that all dentists see indicate this. Most of the exposure to people from amalgam is from elemental mercury, though it is rapidly converted in the body to both inorganic and organic(methyl) mercury. Mercury vapor has an extremely short half life in the blood, before entering cells and being converted to other forms. It is documented that amalgam is the number one source of both inorganic and organic mercury in most people with amalgam fillings.
10. "I don’’t have one here but I could take a thermometer that had mercury in it, snap it into this glass and drink it in front of you and not be harmed. I could sniff it and not be harmed." (page 8)
Again this is very strange for someone claiming a science background to say.
It is well known that if a thermometer breaks in a school or building, Government agencies require that the room be evacuated because of the extreme danger of adverse effects. It is well known that drinking mercury as described would cause extremely serious effects. The drinking water standard is 2 parts per billion because of mercury’s well documented extreme toxicity. To say one could drink a large amount and not be affected is absurd. And the negative vapor pressure of mercury which results in mercury exposed to air vaporizing constantly is the reason that sniffing it would be dangerous and cause adverse effects, and the reason rooms where a thermometer breaks are evacuated. Very low exposures to mercury are documented to cause serious effects. Cases where people were acutely exposed to mercury, such as this suggestion, have documented serious effects.
11. "The quantities that would be in there would be equivalent to about the amount of mercury that would go into one amalgam restoration. That would be about 250 milligrams. To say that is a harmful substance is false." (page 8)
The average amalgam filling has about 0.5 grams of mercury(500 milligrams).
And it is well documented in the literature that this amount of mercury is sufficient to
make all of the bass in a 10 acre lake dangerously toxic to eat and would require a warning to limit fish consumption. 250 milligrams or 500 milligrams is a hugely toxic and dangerous amount of mercury. Dr. Baratz does not appear to be aware of basic toxicology facts and appears to have not done much research or reading on these issues.
[Electric Power Research Institute, EPRI Technical Brief:"Mercury in the Environment", 1993; & EPRI Journal, April 1990.; and www.flcv.com/damspr2f.html]
12. "There are case reports where people have tried to commit suicide by drinking not just the amount that was in the thermometer, but a pint of liquid mercury. Guess what happened. Diarrhea. It is not absorbed from the gut. Even in pure form. " (page 8)
This is a folk tale that is not true. If Dr. Baratz is going to make such claims, he should back it up by documentation. It is well known that mercury is extremely toxic, and this amount of mercury would have significant adverse health effects. There are cases in the literature of such instances, and they resulted in significant effects.
Dr. Baratz appears to consider only acute effects to be important, but mercury’s chronic long term effects are significant. But this would also result in acute effects, as well as chronic. And its also well documented that inorganic mercury is methylated to methyl mercury in the body which is highly absorbable.
Heintze et al,“Methylation of Mercury from dental amalgam and mercuric chloride by oral Streptococci”.,Scan. J. Dent. Res. 1983, 91:150‑152: & Rowland, Grasso, Davies “The Methylation of Mercuric Chloride by Human Intestinal Bacteria”. Experientia. Basel 1975 ,31: 1064‑1065
13. "And it is even less well absorbed in the gut as powered amalgam once amalgam is made." (page 8)
It is well documented in the scientific and medical literature that the primary mercury exposure from amalgam both during placement and once in the mouth is to mercury vapor, from vaporization and oral galvanism in the mouth. But much of the mercury is rapidly methylated to methyl mercury by bacteria and yeast, etc. in the body so there is also significant exposure from methyl mercury. This is well documented in the medical literature.
14. "There are allegations that vapor comes off the surface of a dental restoration, and indeed a tiny bit does. The amount that comes off is equivalent to the amount you get every day by breathing the air in this city, by drinking the water in this city, by eating the food in this city." (page 8)
If Dr. Baratz wants to make extreme claims in his testimony, he should provide some documentation. There is a lot of documentation in the medical literature that
amalgam is the number one source of mercury exposure in most people with several amalgam fillings, and U.S. government agencies have officially confirmed this fact.
[U.S. Dept. of Health, ATSDR, Mercury Profile, 1999; which is the official government source for such information, along with the World Health Organization, etc.] The level of exposure is commonly above the ATSDR health guideline level.
See: www.flcv.com/damspr1.html &
15. "Whether you have amalgam or not, you body has mercury in it. Even the most ardent anti-amalgamist have virtually the same amount of mercury in their bodies as you do, because there has not been one patient who has ever been harmed by it." (page 8)
It is well documented in the medical literature and by hundreds of thousands of tests by medical labs that the daily mercury exposure of those with amalgam is on average about 10 times that of people without amalgam.
Also it is well documented by hundreds of peer-reviewed medical studies and many thousands of clinical cases that mercury commonly causes significant adverse health effects. www.flcv.com/indexa.html
16. "Is this material safe and effective? Yes it is." (page 8)
Mercury is extremely toxic, and it is well documented that people get significant exposures to mercury from amalgam. There is no scientific evidence in the medical literature that the level of exposure that is common from amalgam is safe, and there is a huge amount of documentation that there are common adverse health effects. Dr. Baratz should provide some documentation for his extreme claims that are contrary to common sense since it is well known that mercury is extremely toxic.
There is also no documentation that I am aware of that amalgam is more effective than other current options, unless by effective he means cheaper than other options. The Governments of other countries such as Sweden and Norway recommended not using amalgm after major scientific panel studies, and many other countries and states have warnings.
17. “So I am bringing you the same simple message that I brought to the FDA in 1991, and to legislative boards in other states, there is no evidence that amalgam is harmful, and suggesting it is, or telling people it is, while practicing under a dental license or other professional license, is wrong. It is unprofessional conduct.” (page 9)
See previous documentation, there is a huge amount of documentation in the medical and dental literature and from clinical cases that amalgam commonly causes significant adverse health effects. www.flcv.com/indexa.html
18. “In other words, these quantities are so small that we didn’’t have the instrumentation to measure them. They are down in the parts per billion or less, range. This is a drop of water in a huge swimming pool. That’’s how small they are.” (page 10)
There are studies in the medical literature of 20 years ago that include measurement and documentation that people get significant mercury exposure from amalgam. There were measurements in oral air, saliva, stool, etc. that are documented in the literature. And he seems to forget that mercury is known to be extremely toxic,
the U.S. Government drinking water standard is 2 parts per billion. The exposures have long been documented to be much more than this level. There were peer-reviewed studies documenting adverse health effects from the 1800s and any period thereafter.
19. “There are no toxic substances in amalgam although there are people who advocate that there are, but there are not” (page 10)
All of the metals in amalgam are significantly toxic. Several of them(mercury, copper, tin, silver, etc.) are documented in the medical literature to be toxic and cause adverse health effects. EPA and ATSDR have toxic profiles for them that are readily available that document their toxicity. And it is well documented that people get exposures to all of them from amalgam due to oral galvanism. Organo-tin compounds are even more toxic than organic(methyl) mercury.