The question of the compatibility or incompatibility of the dental filling material amalgam still divides opinions - worldwide. In some countries, the use of amalgam is prohibited for ecological or health reasons, while in other countries (such as the USA), the amalgam separators prescribed in Germany are not even mandatory. In any case, the amalgam discussion is not a "typically German" discussion (alleged "German angst"), as the extensive English-language Wikipedia article on the subject proves:
The amalgam debate is by no means a "fad": amalgam has been fiercely contested ever since it was first disseminated by the Crawcourt brothers, whose move from France to America in the 1930s - and the establishment of an extremely flourishing dental practice in New York - triggered the first professional political disputes within the American dental profession, the so-called "first amalgam war". The arguments - on a differently developed level - are essentially the same today as they were then: on the one side are the opponents of amalgam, who postulate a health hazard from this material, and on the other side amalgam advocates, who do not want to let this very durable material out of the provision of tooth-preserving filling therapy to broad sections of the population because of its comparatively low cost.
As caries today has again increasingly become a problem in its worldwide spread, which preferably affects poorer population strata or countries, the considerations on this are just as complex as the connection with the question of a worldwide outlawing of the metal mercury in all industrial and application processes: for the long-term elimination of this source of poison from the environment.
The WHO estimates the contribution of dental amalgam to the total emission of mercury into the environment at about one third. In this respect, the question arises whether - as in so many environmental issues - the costs of amalgam therapy are not far higher if the environmental consequences (practice effluents, cremation of amalgam carriers) are included.
http://www.who.int/water_sanitation_health/medicalwaste/mercurypolpaper.pdf
8% of all amalgam filling wearers reported health problems related to amalgam fillings or had the fillings removed in surveys conducted independently in Norway (2006)1 and Sweden (1993)2. Eight percent is not the majority of the population. But neither is it a negligible minority, as often seems to be the case in the German discussion between amalgam opponents and proponents, in which, depending on the point of view, either "everyone is poisoned" - or just a case for the psychotherapist, as the controversial amalgam study also wanted to suggest, which was triggered by a German court case against the amalgam manufacturer Degussa, and which, depending on the viewpoint of the reporters, either signaled "all-clear for amalgam" - or, despite twelve years of research (1996-2008! ), still no clear results3.
At the very least, the discussion about amalgam may now enter the post-ideological era due to the well-studied data situation: The GZM (International Society for Holistic Dentistry) investigators involved in the study also found no patients poisoned in the clinical sense of mercury intoxication. None of the diagnostic methods investigated could reliably distinguish between subjectively healthy and subjectively contaminated subjects. Nevertheless, the results of the controlled, clinical study showed that the removal of amalgam fillings improved the patients' chief complaints, quality of life, and psychological distress.
The question must be allowed: Does it make sense to treat people psychotherapeutically when their complaints could just as easily be remedied by replacing a dental filling? Is the assertion of "psychosomatic" effects not led ad absurdum by the consideration that one can also assume somato-psychic effects just as well and with some evidence? (Investigations of the same study prove low-dose effects of mercury on immune and functional cells: Lymphocytes respond in vitro to low doses of mercury with suppression. Functional cells (liver, kidneys, nerve cells) show a reduced adaptability of the cellular stress response in vitro).
An approach that makes sense from the point of view of environmental medicine and is less discriminating for those affected would then be to treat people who may have been exposed to multiple stresses first at the manageable, comparatively easily accessible physical level (relieving the organism of heavy metal stresses) before even postulating (or treating) further, possibly mental stresses.
A restriction for this arises with patients who, in the sense of a negative focusing (possibly also after traumatic experiences at the dentist), require special attention before they become accessible at all to a treatment approach that is target-oriented for them.
In the search for an individual truth, one will first try to identify those people who, in the classical sense, have an allergy to one of the contained metals mercury, silver , copper or tin. In the past, there have already been problems here, because the epicutaneous test, which has been most commonly used up to now, only identifies contact allergies of the skin, but not systemic late-type allergies (type IV allergies). Also, the epicutaneous test is critically discussed by environmental physicians because of the unavoidable confrontation of the patient with the potentially toxic metals. In the lymphocyte transformation test (LTT) metal sensitizations are detectable today without patient exposure and with higher sensitivity.
Not always clearly distinguished from allergic phenomena are intolerances that are associated, for example, with a lack of detoxification capacity in the patient's body system. The low dose effects proven in vitro will not be proven in individual cases.
In summary, it can be said that amalgam is a filling material which, like all other materials, can be incompatible in the sense of a classic allergy, but which also has toxic components which can inhibit important vital functions in the body. A "blind" exchange for another material is not recommended, since in principle any substance foreign to the body can interact with the organism in an undesirable way and thus be a trigger for chronic diseases.4
- Norheim, AJ, Ramstad, S.: Opplevde sammenhenger mellom amalgam og helse i den norske befolkning. NAFKAMs skriftserie, nr. 2., 2006
- Hamre, Harald: Amalgam. Probleme und Lösungen in der naturheilkundlichen Praxis. Hippokrates, 1997, S. 77-80
- Melchart, Dieter et al.:Treatment of Health Complaints attributed to Amalgam – The German Amalgam Trial. J Dent Research 2008, 97: 349-353
- Reichl, Franz-Xaver: Zur Toxikologie dentaler Restaurationsmaterialien. Vortrag zum 7. Norddeutschen Umweltsymposium Kiel, 18.-19.04.2008
