Mercury and the Messenger

LATE LAST WINTER, Mary Puff's hands and feet started going numb. She began having trouble concentrating and speaking; parts of her body would shake or twitch. She asked her family dentist whether there might be any connection between the symptoms and the fillings she'd had put in just a few weeks earlier; "silver" dental amalgam, she knew, consists of about 50 percent mercury. The dentist told her not to worry, but the symptoms persisted, and got worse after some more dental work. Eventually she sought out a doctor who she'd heard would remove mercury fillings. Within weeks of the procedure, she says, she got better.

Puff's second dentist was Dr. Gary Jacobson, who has made a name by speaking publicly about what privately worries a growing number of dentists--the dangers of putting a known poison in people's mouths. The American Dental Association and the Minnesota Board of Dentistry don't agree with Jacobson's and other dentists' contention that mercury may leak out of fillings and slowly poison people; the state has taken Jacobson to court for alleged ethics and health violations. Last week, Jacobson's patients and other anti-mercury advocates packed a legislative hearing room demanding new regulations on dental mercury. It was the first installment in what's likely to become a heated political battle.

The controversy isn't over whether mercury is toxic. The metal is known to be more poisonous than arsenic and lead, and at high levels it's been shown to cause birth defects and insanity. What's not clear is what it can do at low doses--especially the tiny amounts thought to escape from dental fillings, mostly in the form of mercury vapor. There's no conclusive research showing that low-level mercury causes any of the myriad diseases it's been implicated in, from depression and fatigue to multiple sclerosis and Alzheimer's disease; by the same token, no one has been able to establish a "safe" dose.

Either way, Jacobson's patients say they've chosen to be safe rather than sorry, while the board of dentistry accuses him of using "misinformation" and failing to tell patients that "it [is] contrary to accepted scientific opinion to replace amalgam on fear of mercury poisoning." The board says Jacobson also committed several other violations, such as pulling teeth that had had root-canal treatments. In some six years' worth of investigation, the board has spent an estimated $130,000 and accumulated at least 3,500 pages of documents on Jacobson; until this fall, says Jacobson, he was not told what the board's complaints were. In September the state filed a notice requiring Jacobson to appear before an administrative law judge in what amounts to a disciplinary proceeding. A hearing in the case is scheduled for January 17, but Jacobson's lawyers are asking for a delay.

January 17, as it happens, is also when the state Legislature convenes--and if an odd-bedfellows group of lawmakers has its way, mercury will be one of the first items on the agenda. Among others, the group includes Sen. Ellen Anderson, a St. Paul DFLer who often takes up consumer-group causes, as well as conservative Rep. Don Frerichs (R-Rochester), whose son is a mercury-free dentist. They've written a bill under which dentists would have to tell patients of "associated risks" when putting in silver fillings; they also want the state board to give specific complaints to dentists being investigated. (At least two more mercury-free dentists say the board has been looking into their patient files) The bill got a pre-session hearing last week in the Senate Health Committee; the dentistry board called witnesses arguing that even to suggest that mercury is not safe would cause patients unnecessary anxiety.

Ironically, if the fight drags out long enough it may become moot. Though dentistry groups have made defending mercury a major part of their platforms as criticism has mounted, mercury-free fillings are available and generally considered comparable to conventional amalgam in cost and performance. And some dentists, who say they're not worried about health risks, are switching to the new materials for entirely different reasons: Silver fillings, it turns out, are considered a hazardous waste both before they go into a person's mouth and after they come out.

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