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10 Things Your Dentist By WILLIAM MAULDIN AOL: 2. "Those old metal fillings of yours may be leaking toxic waste."When Rep. Diane Watson (D., Calif.) learned the mercury in her fillings could end up in her blood, she decided to have them removed. But she met with resistance from local dentists who thought it was unnecessary or worried about health risks from dislodging the fillings. Watson ignored their advice and had the work done in Mexico; she's now sponsoring a bill to phase out mercury in fillings by 2009. Dr. JPM: Wow, she REALLY wanted those fillings removed! "She met with resistence from local dentists who thought it unnecessary or worried about health risks from dislodging the fillings...[she] ignored their advice." No more of a point here, I just wanted to repeat that sentence. I hope she gets her bill passed, and I hope similar legislation passes here in New York. I'm going to be rich, as will all other dentists, all because some politician decided that silver fillings were bad, despite decades of positive results with silver fillings, and over the objections of local dentists. The word "politics" is derived from the Greek: "poly", meaning "many", and "tics", meaning "blood sucking insects." Read on. AOL: Most fillings dentists use today are amalgams, a mixture of mercury, silver and tin once thought completely stable. But amalgams have been found to leak mercury vapor that can pass into the bloodstream at the rate of 10 micrograms a day -- four times what the average person consumes daily in her diet. "There's no question that it's harming people," says Richard D. Fischer, a Virginia dentist, who cites studies where sheep and monkeys given amalgam fillings showed decreased kidney function and traces of mercury in other organs. Dr. JPM: Correct! Mercury is a poison. So is everything in a Diet Coke (except the water) and in a Big Mac. Don't even get me started on cigarettes. By the way, where is that other 2.5 micrograms of mercury coming from? ("amalgams...leak mercury...at the rate of 10 micrograms a day -- four times what the average person consumes daily in her diet.") Of course the President of the American Dental Association gives completely different statistics in his response at http://ada.org/prof/resources/topics/amalgam_smartmoney_brandjord.pdf. The point is that we don't live in a perfect world, and we have all made choices based on time constraints and economic constraints. Silver fillings are safe and effective, but not perfect. Some day you will leave a strand of hair at your dentist's office, s/he'll culture your DNA, and place some of your own fresh new enamel back into your cavity. Then we'll have it perfect. Until then, all restorative materials are a compromise. Look at this from another point of view. Dentists were children once, and we ate chocolate and didn't brush, and had cavities. Silver fillings were placed in the teeth of children who would grow up and become dentists. I would bet that, on the whole, the dentist population has about as many fillings as most other people. You would think that if there were a problem with silver fillings, we would be the first ones clamoring to have them removed from our mouths. But we don't. There is a huge economic incentive for dentists to say "Let's swap out those silver fillings." But we don't. Silver fillings are not perfect, but they are not that bad, especially in the context of all the other harmful chemicals we put into our bodies. I have placed silver fillings in my own children's teeth because it was the proper material to use at the time. There are material considerations of each restorative, to be explored in the next paragraph. AOL: To avoid amalgams, you can request pricier resin fillings. But following Watson's lead isn't the best idea: Removal of amalgams can release a surge of mercury if the dentist isn't extremely careful, Fischer says. Dr. JPM: True again! Pricier resin fillings are not the only answer, nor are they the "one size fits all" solution that is implied. Resin is a fancy way of saying "plastic", which is also not an ideal restorative solution. Resin restorations are very finicky about moisture control while they are being placed. Your mouth is very wet, and if the cavity gets below the gumline, it can get a bit bloody. Resin is not the restorative material of choice in wet or bloody situations. Porcelain and gold are other restorative options, and they are even more expensive. But go ahead, request pricier resins, porcelain and gold restorations! Pass a law making it so! You'll help create a renaissance in restorative dentistry, the likes of which have never been seen before. Every dentist will be so busy that the law of supply and demand will inevitably push the fees even higher: too many fillings to replace, too many porcelain crowns to do, not enough dentists to perform the services. The price point inevitably increases. Or maybe that silver filling isn't looking so bad after all, especially since your insurance won't cover anything BUT that silver filling, under current law. If silver fillings are outlawed, insurance company actuaries will be the first to factor in the increased price point when calculating your premium. Letting politicians decide policies on things they supposedly do know about has proven to have mixed results, at best. This is a no-brainer: keep politics out of your mouth. Keep insurance companies out of your body as well. It's called "The Doctor-Patient relationship" for a reason. The occasional overly aggressive dentist will be shut down by lack of patients in the long run. What's to stop politicians and insurance companies from running amock?
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