VI

3. For the following case studies of amalgam replacement, some clinics primarily replaced amalgam fillings using patient protective measures and supportive supplements, whereas some clinics do something comparable to Hal Huggins total dental revision where in addition to amalgam replacement, patients gold or nickel crowns over amalgam are replaced by biocompatible alternatives, root canals extracted and cavitations checked for and cleaned. There are extensive documented cases (many thousands)where removal of amalgam fillings led to cure or significant improvement of serious health problems such as

periodontal diseases (tissue inflammation, metal mouth, mouth sores, bone loss, burning mouth, etc.) (8,35,40,46,57,60,62,75,78,82,94,95,100,115,133,192bcf,212,222,233abcdefgh,271,313,317,321,322,341,376,525,532,538,551,552,583), oral lichen planus/leukaplakia (56,86,87,90,101,168, 313a) (oral keratosis (pre cancer)(87,251), immune system/ autoimmune problems (8,35,60,62,222,270,271,313,323,322,342,91,212,229,291,452,470,485,523,532,552), epilepsy (5,35,309,229,386e,557), multiple chemical sensitivities (26,35,60,62,95,222,229,232,233,115,313,342,537,583), allergies (8,26,35,40,46,62,94,95,97,165,212,222,228,229,233,271,317,322,349,376,469,525c,532,557,583), asthma (8,75,97,222,228,271,322,552,556,557), chronic headaches/migraines (5,8,34,35,47f,62,95,185,212ab,222,229, 233abdefgh,271, 317,322,349,354,115,376,440,453, 523,525,532,537,538,552,556,583), tachycardia and heart problems (8,35,59,94,115,205,212,222 , 232,233bcdg, 271,306, 310,322,525c,554,556,557), blood conditions (8,212,222,232,233,271,322,523,551,35,95), Chron’s disease (60,222,229,469,485,594), stomach (gastrointestinal) problems (8,35,62,95,212ab,222,228,229, 233bdg,271,317,322, 440,469,525c, 532) , lupus(12,35,60,113,222,233,323,537), dizzyness/vertigo (8,40,95,212,222,229,233bcdgh,271,322,376,453,525c,551,552), joint pain/arthritis (8,35,62,95,103,212ab,222,229,233abcg,271,313, 322,358,386de,469,523,525c,538,551,552,556,557,583), neuropathy/paresthesia(8,35,62,94,163,212,222,322,556,557), ALS(97,246,423,405,469,470,485,535,35), MS(62,94,95,102,163,170,212,222,229,271,291,302,322,369,469,485,34,35,229,523,532), Alzheimer’s(62,204,251c,386e,535,35), Parkinson’s/ muscle tremor (222,248,228a,229,233f, 271,322, 469,535,557,212,62,94,98,35), Chronic Fatigue Syndrome (8,35,47f,60,62,88,185,212,293,229,222,232,233abcdfgh,271,313,317,322,323,342,346,369,375,376,386de,440,469,470,523,532,537, 538, 551,552,556,557,558), memory disorders (8,35,94,212,222,322,440,453,552,557), muscular/jointpain/Fibromyalgia (5,8,35,60,62,185,222,233bcfg,293,317,322,346,369,440,469,470,523,527,532,538,552,556,94), infertility(9,35,38,229,367), endometriosis(229,35,38,9), autism & Asperger’s Syndrome (558,601,602) schizophrenia (294,34,35), depression(62,94,107,163,185,212,222,229,233bcfh,271,294,285e,317,322,376,386de,453,465,485,523,525c,532,538,551,556,557,583, 35, 40), insomnia (35,62,94,212,222,233ag,271,317,322,376,525c,583), nausea(525c),anger(212,233,102,557,35,62), anxiety & mental confusion (62,94,212,222,229,233abcfgh,271,317,322,440,453,525c, 532,551, 557,583, 35,57), susceptibility to infections (35,40,62,222,233cd,251,317,322,349,350,469,470,532), antibiotic resistant infection(251), cancer(breast,etc./leukemia) (35,38,94,180,228a,469,486,530), alopecia/hair loss (40,187,271,317,322,349,583), sinus problems (35,40,47f,94,222,271,322,532,583), tinnitus(8,35,62,94,222,233cdg,271,322,349,376,525c), chronic eye conditions: inflamation/ iritis/ astigmatism/myopia /cataracts/macula degeneration/retinitis pigmentosa, color vision loss,etc. (35,222,233abcg,271,322,440,529), vision disturbances (8,35,62,212,233abcg,271,322,525c), eczema and psoriasis (62,168b,212b,233c,322,323,385, 375, 408, 459,525c,557), autoimmune thyroiditis (369,382,91), skin conditions (8,62,212,222,233bc,322,525c,583), urinary/prostrate problems(212,222), hearing loss(102,322,35), candida(26,35,404,537,etc.), PMS(35,6,322,etc.), diabetes(35,369,598,etc.), HIV/AIDs, (485b,35), etc.

The above over 60,000 cases of cure or significant improvements were not isolated cases of cures; the clinical studies indicated a large majority of most such type cases treated showed significant improvement. Details are available and case histories. For example, one of the clinics(95) replacing amalgams in a large number of patients with chronic conditions had full recovery or significant improvement:

in over 90% of cases for: metallic taste, tender teeth, bad breath, and mouth sores;

in over 80% of cases for: depression, irrational fear, head aches/migraines, irritability, dizziness,

insomnia, bleeding gums, throat irritation, nasal congestion or discharge, muscle tremor, and leg cramps;

in over 70% of cases for: bloating or intestinal cramps, skin reactions, sciatic pain, chest pain, poor memory, urinary disorders, fatigue, poor concentration/ADD, watery eyes;

in over 60% of cases for: allergies, constipation, muscle fatigue, cold hands/feet, heart problems.

A Jerome meter was used to measure mercury vapor level in the mouth, and the average was 54.6 micrograms mercury per cubic meter of air, far above the Government health guideline for mercury(217).

Some of the above cases used chemical or natural chelation to reduce accumulated mercury body burden in addition to amalgam replacement. Some clinics using DMPS for chelation reported over 80% with chronic health problems were cured or significantly improved(222,271,359).

Other clinics reported similar success. But the recovery rate of those using dentists with special equipment and training in protecting the patient reported much higher success rates than those with standard training and equipment, 97% versus 37 to 88%(435). The Huggins TDR protocol includes testing teeth with metal for level of galvanic current caused by the mixed metals, and removal of the teeth with highest negative galvanic current first(35,228a). This has been found to improve recovery rate for chronic conditions like epilepsy and autoimmune conditions. Metals are being pushed into the body from negatively charged metal dental work with saliva as electrolyte and the highest charged teeth lose the most metal to the body(35).

Clinical studies have found that patch testing is not a good predictor of success of amalgam removal, as a high percentage of those testing negative also recovered from chronic conditions after replacement of fillings(86,87,168,etc.).

The Huggins Clinic using TDR has successfully treated over a thousand patients with chronic autoimmune conditions like MS, Lupus, ALS, AD, diabetes, etc.(35), including himself with the population of over 600(approx. 85%) who experienced significant improvement in MS. In a large German study of MS patients after amalgam revision, extraction resulted in 85% recovery rate versus only 16% for filling replacement alone (222,302). Other cases have found that recovery from serious autoimmune diseases, dementia, or cancer may require more aggressive mercury removal techniques than simple filling replacement due to body burden. This appears to be due to migration of mercury into roots & gums that is not eliminated by simple filling replacement. That such mercury(and similarly bacteria) in the teeth and gums have direct routes to the brain and CNS has been documented by several medical studies(34,325,etc.).

Among those with chronic immune system problems with related immune antibodies, the types showing the highest level of antibody reductions after amalgam removal include glomerular basal membrane, thyroglobulin, and microsomal thyroid antigens(91). TDR and other measures used in metals detox have been found to increase T-cells and immune function in AIDS patients(35).

Swedish researchers have developed a sophisticated test for immune/autoimmune reactions that has proved successful in diagnosing and treating environmentally caused diseases such as lichen planus, CFS,MS, etc. related to mercury and other immunotoxics(60,313,etc.).

Interviews of a large population of Swedish patients that had amalgams removed due to health problems found that virtually all reported significant health improvements and that the health improvements were permanent(233). (study period 17 years) A compilation of an even larger population found similar results(212,282). For example 89% of those reporting allergies had significant improvements or total elimination; extrapolated to U.S. population this would represent over 17 million people who would benefit regarding allergies alone.

VII. Tests for Mercury Level or Toxicity and Treatment

1. Feces is the major path of excretion of mercury from the body, having a higher correlation to systemic body burden than urine or blood, which tend to correlate with recent exposure level (6b,21abd,35,36,79,80,183,278). For this reason many researchers consider feces to be the most reliable indicator of daily exposure level to mercury or other toxics. The average level of mercury in feces of populations with amalgam fillings is as much as 1 ppm and approx. 10 times that of a similar group without fillings (79,80,83,335,386,528,25), with significant numbers of those with several filings having over 10 ppm and 170 times those without fillings(80). For those with several fillings daily fecal mercury excretion levels range between 20 to 200 ug/day. The saliva test is another good test for daily mercury exposure, done commonly in Europe and representing one of the largest sources of mercury exposure. There is only a weak correlation between blood or urine mercury levels and body burden or level in a target organ(36,157,183,258,278,11,21abd,6b). Mercury vapor passes through the blood rapidly(half-life in blood is 10 seconds(370)) and accumulates in other parts of the body such as the brain, kidneys, liver, thyroid gland, pituitary gland, etc. Thus blood test measures mostly recent exposure. Kidneys have a lot of hydroxyl(SH) groups which mercury binds to causing accumulation in the kidneys, and inhibiting excretion(503). As damage occurs to kidneys over time, mercury is less efficiently eliminated (11,36,57,183,216,258,260,503), so urine tests are not reliable for body burden after long term exposure. Some researchers suggest hair offers a better indicator of mercury body burden than blood or urine(279,21ab), though still not totally reliable and may be a better indicator for organic mercury than inorganic. In the early stages of mercury exposure before major systemic damage other than slight fatigue results you usually see high hemoglobin, hemocrit, alkaline phosphatase, and lactic dehydroganese; in later states you usually see marginal hemoglobin, hemocrit, plus low oxyhemoglobin(35). Hair was found to be significantly correlated with fish consumption, as well as with occupational dental exposure and to be a good medium for monitoring internal mercury exposure, except that external occupational exposure can also affect hair levels. Mercury hair level in a population sampled in Madrid Spain ranged from 1.3 to 92.5 ppm. This study found a significant positive correlation between maternal hair mercury and mercury level in nursing infants. Hair mercury levels did not have a significant correlation with urine mercury in one study(340) and did not have a significant correlation to number of fillings(350). One researcher suggests that mercury levels in hair of greater than 5 ppm are indicative of mercury intoxication.

A new test approved by the FDA for diagnosing damage that has been caused by toxic metals like mercury is the fractionated porphyrin test(260,35), that measures amount of damage as well as likely source. Mercury blocks enzymes needed to convert some types of porphyrins to hemoglobin and adenosine tri phosphate(ATP). The pattern of which porphyrins are high gives an indication of likely toxic exposure, with high precoproporphyrin almost always high with mercury toxicity and often coproporphyrin.

Provocation challenge tests after use of chemical chelators such as DMPS or DMSA also are effective at measuring body burden(57,58), but high levels of DMPS can be dangerous to some people- especially those still having amalgam fillings or those allergic to sulfur drugs or sulfites. Many studies using chemical chelators such as DMPS or DMSA have found post chelation levels to be poorly correlated with prechelation blood or urine levels(57,115,303), but one study (340) found a significant correlation between pre and post chelation values when using DMPS. Challenge tests using DMPS or DMSA appear to have a better correlation with body burden and toxicity symptoms such as concentration , memory, and motor deficits(290)- with many studies finding a significant correlation between post chelation mercury level and the number of amalgam surfaces(57,172,173,222,290,292,273,303). On average those with 29 amalgam surfaces excreted over 3 times more mercury in urine after DMPS challenge than those with 3 amalgam surfaces, and those with 45 amalgam surfaces more than 6 times as much mercury(12b). Several doctors use 16 ug/L as the upper bound for mercury after DMPS challenge, and consider anyone with higher levels to have excess body burden(222,352). However one study(290) found significant effects at lower levels. Some researchers believe DMSA has less adverse side effects than DMPS and prefer to use DMSA for chelation for this reason. Some studies have also found DMSA as more effective at removing mercury from the brain(58). A common protocol for DMSA(developed to avoid redistribution effects) is 50 mg orally every 4 hours for 3 days and then off 11 days.

Another chelator used for clogged arteries, EDTA, forms toxic compounds with mercury and can damage brain function(307). Use of EDTA may need to be restricted in those with high Hg levels. N-acetylcysteine(NAC) has been found to be effective at increasing cellular glutathione levels and chelating mercury(54). Experienced doctors have also found additional zinc to be useful when chelating mercury(222) as well as counteracting mercury’s oxidative damage(43). Zinc induces metallothionein which protects against oxidative damage and increases protective enzyme activities and glutathione which tend to inhibit lipid peroxidation and suppress mercury toxicity(430,464). Also lipoic acid,LA, has been found to dramatically increase excretion of inorganic mercury(over 12 fold), but to cause decreased excretion of organic mercury(572d) and copper. Lipoic acid has a protective effect regarding lead or inorganic mercury toxicity through its antioxidant properties(572), but should not be used with high copper. Lipoic acid and N-acetylcysteine(NAC) also increase glutathione levels and protect against superoxide radical/peroxynitrite damage, so thus have an additional neuroprotective effect(494a,521,524,572c,54,56). Zinc is a mercury and copper antagonist and can be used to lower copper levels and protect against mercury damage. Lipoic acid has been found to have protective effects against cerebral ischemic-reperfusion, excitotoxic amino acid(glutamate) brain injury, mitochondrial dysfunction, diabetic neuropathy(572). Other antioxidants such as carnosine(495a), Coenzyme Q10,Vitamins C & E, gingko biloba, pycnogenol and selenium have also been found protective against degenerative neurological conditions(494,495e, 444,237).

2. Tests suggested by Huggins/Levy(35) for evaluation and treatment of mercury toxicity:

(a) hair element test(386) (low hair mercury level does not indicate low body level)(more than 3 essential minerals out of normal range indicates likely metals toxicity)

(b) CBC blood test with differential and platelet count

(d) urinary mercury (for person with average exposure with amalgam fillings, average mercury level is 3 to 4 ppm;

lower test level than this likely means person is poor excreter and accumulating mercury, often mercury toxic(35)

(e) fractionated porphyrin(note test results sensitive to light, temperature, shaking)

(f) individual tooth electric currents(replace high negative current teeth first)

(g) patient questionnaire on exposure and symptom history

(h) specific gravity of urine(test for pituitary function, s.g>1.022 normal; s.g.< 1.008 consistent with depression and suicidal tendencies(35)}

3. Note: during initial exposure to mercury the body marshals immune system and other measures to try to deal with the challenge, so many test indicators will be high; after prolonged exposure the body and immune system inevitably lose the battle and measures to combat the challenge decrease- so some test indicator scores decline. Chronic conditions are common during this phase. Also high mercury exposures with low hair mercury or urine mercury level usually indicates body is retaining mercury and likely toxicity problem(35). In such cases where (calcium> 1100 or < 300 ppm) and low test mercury,manganese,zinc,potassium; mercury toxicity likely and hard to treat since retaining mercury.

Test results indicating mercury/metals toxicity(35):

(a) white blood cell count >7500 or < 4500

(b) hemocrit > 50% or < 40%

(d) blood protein level > 7.5 gm/100 ml

(e) triglycerides > 150 mg %ml

(f) BUN > 18 or < 12

(g) hair mercury > 1.5 ppm or < .4 ppm

(h) oxyhemoglobin level < 55% saturated

(I) carboxyhemoglubin > 2.5% saturated

(j) T lymphocyte count < 2000

(k) DNA damage/cancer

(l) TSH > 1 ug

(m) hair aluminum > 10 ppm

(n) hair nickel > 1.5 ppm

(o) hair manganese > 0.3 ppm

(p) immune reactive to mercury, nickel, aluminum, etc.

(q) high hemoglobin and hemocrit and high alkaline phosphatase(alk phos) and lactic dehydrogenese(LDA) during initial phases of exposure; with low/marginal hemoglobin and hemocrit plus low oxyhemoglobin during long term chronic fatigue phase.

4. Huggins Total Dental Revision Protocol(35):

(a) history questionnaire and panel of tests.

(b) replace amalgam fillings starting with filling with highest negative current or highest negative quadrant, with supportive vitamin/mineral supplements.

(d) test and treat cavitations and amalgam tattoos where relevant

(e) supportive supplementation, periodic monitoring tests, evaluate need for further treatment(not usually needed).

(f) avoid acute exposures/challenge to the immune system on a weekly 7/14/21 day pattern.

note: after treatment of many cases of chronic autoimmune conditions such as MS, ALS, Parkinson’s, Alzheimer’s, CFS, Lupus, Rheumatoid Arthritis, etc., it has been observed that often mercury along with root canal toxicity or cavitation toxicity are major factors in these conditions, and most with these conditions improve after TDR if protocol is followed carefully(35). Also, it is documented that the process is inflammatory involving free radical/reactive oxygen species effects, and antioxidants have been found to have benefits in treatment(514). Other measures in addition to TDR that have been found to help in treatment of MS in clinical experience are avoidance of milk products, get lots of sunlight, supplementation of calcium AEP(448) and alpha lipoic acid(572). Progesterone creme has been found to promote regrowth of myelin sheaths in animals(448c).

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Monica Kauppi and Dr Britt Ahlrot-Westerlund, Heavy Metal Bulletin 2(3):11-12 December 1995. (Vit B12)

(165) G.Anneroth et al, “Comprehensive Medical Examination of patients with alleged adverse effects from dental amalgams”, Acta Odontal Scand, 1992,50(2):101-11.

(167)R.Brehler et al,”Mercury sensitization in amalgam fillings”, Dtsch med Wochenschr,1993,118(13):451-6.

(168) J.Laine et al, “Resolution of oral lichenoid lesions after replacement of amalgam restorations”, Br J Dermatol, 1992,126(1):10-15; & S.H.Ibbotson et al, “The relevance of amalgam replacement on oral lichenoid reactions”, British Journal of Dermatology, 134(3):420-3, Mar, 1996..

(170) Birgitta Brunes, Adima Bergli, From MS diagnosis to better health ,1996. www.melisa.org; & DAMS, Recoveries from MS after amalgam replacement, www.whale.to/d/ms1.html; & Maile Pouls, Townsend Letter, 1999, www.heall.com/healingnews/may/heavy_metals.html

(180) O.F.Pinto et al, J Intl Acad Prev Med, Vol 3, No.2, 1976.

(182) J Pleva, J Orthomol Psych, Vol 12, No.3, 1983; & J. Of Orthomol. Medicine 1989, 4:141- 148. &

“Mercury-A Public Health Hazard”,Reviews on Environmental Health,1994,10:1-27

(187)Klobusch J, Rabe T, Gerhard I, Runnebaum B, "Alopecia and environmental pollution" Klinisches Labor 1992, 38:469‑ 476

(192) L.J. Calsakis et al, "Alergy to Silver Amalgams",Oral Surg,46:371-5,1978

(199)Dr. P.Kraub & M.Deyhle, Universitat Tubingen- Institut fur Organische Chemie, “Field Study on the

Mercury Content of Saliva”, 1997 http://www.uni‑tuebingen.de/KRAUSS/amalgam.html;

(200) S.Langworth et al, “A case of high mercury exposurte from dental amalgam”, Eur J Oral Sci 104:320- 321,1996.

(204) Tom Warren, Beating Alzheimer’s, Avery Publishing Group, 1991; & www.whale.to/m/alzheimer.html

(205) M.F. Ziff et al, A Persuasive New Look at Heart Disease As It Relates to Mercury, Bio-Probe, Inc.,ISBN 0-941011-08-9; & J. of American College ofCardiology V33,#6, pp1578‑1583, 1999.

(212)(a) Ziff, M.F., “Documented clinical side effects to dental amalgams”, ADV. Dent. Res.,1992; 1(6):131-134; & Ziff, S.,Dentistry without Mercury, 8th Edition, 1996, Bio-Probe, Inc. , ISBN 0-941011-04-6; & Dental Mercury Detox, Bio-Probe, Inc. http://www.bioprobe.com. (Cases: FDA Patient Adverse Reaction Reports-762, Dr.M.Hanson-Swedish patients-519, Dr. H. Lichtenberg-100 Danish patients , Siblerud, RL. Health effects after dental amalgam removal. J. Orthomol. Med. 5, 1990, 95-106(86 patients); & P. Larose. The effect of amalgam removal on 37 health symptoms in humans. Updated 1992 from study reported in Dental Health & Facts 2(1) 1989. Foundation for Toxic-free Dentistry/Bio-Probe, Orlando(80 patients); & Zamm, AV. Removal of dental mercury: often an effective treatment for the very sensitive patient. J Orthomol. Med. 5, 1990, 138-142(22 patients)

(b)Hovmand, O. Oral galvanisme - erfaringer fra praxis. Tandlaegebladet 91, 1987, 473-476.

(& (c)over 1000 additional cases of significant improvement reported directly to FDA)

(222) M. Daunderer, “Improvement of Nerve and Immunological Damages after Amalgam Removal”, Amer. J. Of Probiotic Dentistry and Medicine, Jan 1991. (800 cases, replacement & DMPS); & Max Daunderer, Handbuch der Amalgamvergiftung, Ecomed Verlag, Landsberg 1998, ISBN 3‑609‑71750‑5 (in German) (1100 cases)

(228) Dr. T. Rau, Paracelsus Alergy Clinic, Lustmuhle, Switzerland, 1996(www)

& E. Cutler,Winning the War against Asthma & Allergies, DAMS(800-311-6265)