The American judicial system abounds with scare stories and strike suits. Leave it to the trial lawyers to blame almost every human ailment on someone with a deep pocket. The latest cause celebre is tooth fillings.
For more than 150 years dentists have used a combination of metals, including mercury, to fill cavities. Millions of Americans and perhaps billions of human beings have had not just one or two, but up to a dozen, or even more, fillings. People with money typically prefer gold or porcelain. But mere mortals usually choose amalgams. Now a group of fervent but unscientific crusaders, with trial attorneys in tow, has targeted amalgams. Bills have been introduced in Congress and in several state legislatures to ban the use of mercury.
Moreover, the lawsuit tide is rising. Suits in California and Georgia blame autism on amalgams. A Maryland class action charges dentists with fraud in terming amalgams "silver." The fount of amalgam litigation is Shawn Khorrami, a Los Angeles attorney. He has targeted just about everyone: American Dental Association, state dental chapters and a mix of other firms and groups.
Khorrami explains: "We are trying to get rid of mercury," which he proclaims to be "dangerous before it goes into the mouth" and "a hazardous material when it comes out." He has targeted the American Dental Association for being "out of the medical mainstream." In response to his "campaign of lies and distortions" the association has filed a defamation suit. Contends association chief counsel Peter Sfikas, "The statements that Khorrami makes are completely false in that he is aware of the scientific evidence."
The association deserves credit for directly confronting the problem of junk science. Were amalgams harmful, one would expect to find thousands, or even millions, of injured or even dead dental patients. As Steven Milloy, publisher of JunkScience.com.com, puts it, "There are enough people out there who have amalgam fillings that if there was something going on, I think we would have noticed by now."
Critics rely on anecdotes. Some people with amalgam fillings have also suffered from autism and child development disorders, as well as Alzheimer's and autoimmune disease. And everyone who has ever received a filling of any kind will eventually die.
However, when millions or billions of people receive a particular procedure, it should come as no surprise when some of them suffer from a range of maladies. If correlation equals causation, one could argue that driving a car, being touched by a stethoscope, licking a stamp and drinking water caused autism, autoimmune diseases, Alzheimer's and, ultimately, death. The American Dental Association calls amalgam fillings "safe and effective," and it is not alone in endorsing amalgams.
In February, the Food and Drug Administration affirmed that "no valid scientific evidence has ever shown that amalgams cause harm to patients." Last year Consumers Union observed: "your silver amalgam fillings are doing you no harm."
In 1997, the World Health Organization and World Dental Federation reported "no controlled studies have been published demonstrating systematic adverse effects from amalgam restorations." Six years before, the National Institutes of Health concluded that there was "no scientific evidence that currently used restorations cause significant side effects. Available data do not justify discontinuing the use of any currently available dental restorative materials or recommending their replacement."
True, at high levels of exposure, mercury can be toxic. However, it is a common element, found in fish and other seafood, for instance, and is impossible to avoid. Estimates as to safe daily absorption of mercury range up to 40 micrograms a day, according to the World Health Organization.
In contrast, the absorption rates of mercury from amalgams are estimated at between 1 to 3 micrograms per day. Observes Dr. Stephen Barrett of QuackWatch: "the miniscule amount of mercury the body absorbs from amalgams is far below the level that exerts any adverse health effect."
Thus, in the publication FDA Consumer, Laura Bradbard observed that other than allergic reactions - fewer than 100 reported cases over the last century - "research has not shown that low levels of mercury-containing amalgam are harmful." She added: "In a literature review of amalgam research, the U.S. Public Health Service found no sound scientific evidence linking amalgam to multiple sclerosis, arthritis, mental disorders or other diseases."
If people still believe that amalgam fillings are dangerous, they should be able to choose an alternative. And to have all of their old fillings removed, if they desire. But the issue should not be decided by emotional anecdotes and abusive lawsuits. Litigation was once an important means of holding people responsible for their actions. Unfortunately, as the issue of tooth fillings too well illustrates, litigation has become an even more important means of enriching creative trial attorneys.