“There is nothing more frightening than active ignorance.” Goethe

The whole letter in PDF Here


“…compared with non-Hg-exposed individuals, dental personnel reported more often neurobehavioural problems, reduced psychomotor speed, reduced cognitive flexibility, attention deficits, as well as memory loss, fatigue and sleep problems. Of these symptoms, memory loss may be the most important. Dental personnel’s exposure to Hg during their work with dental amalgam may provide a reasonable explanation for these findings.”

Neurotoxic effects of mercury exposure in dental personnel

Mercury is the Third Most Toxic substance after Arsenic and Lead

In 1995 The Australian Dental Association stated:

“Current Scientific opinion shows that there is no causal relationship between dental amalgam and health, other than those rare cases of allergy and local hypersensitivity.” [1]

They have not changed their minds at time of writing in 2022. Almost all other Dental Associations worldwide, have a similar philosophy and continue to deny that there is anything wrong with dentist’s health.

The British Dental Association states that;

“Dentists have far more mercury exposure than the general populations. Health and morbidity studies, however, have indicated that dentists have no unusual diseases and live longer than physician colleagues……” 

I should have joined the British trade organization! They clearly have some type of magical, alchemical connections that protect dentists from the ravages of mercury poisoning. It really is a shame that they could not cite these miraculous ‘health and morbidity studies’.

Also published in the British Dental Journal in 2004 –

“Dentists were found to have, on average, urinary mercury levels over 4 times that of control subjects…Dentists were significantly more likely than control subjects to have suffered from disorders of the kidney…One hundred and twenty two (67.8%) of the 180 surgeries visited had environmental mercury measurements above the Occupational Exposure Standard (OES) set by the Health and Safety Executive.”  [2]  

Any dental association with true concern for their members, would have called for an immediate ban on the use of amalgam years ago, but sadly that’s not how the system works!  The American and Swedish dental Associations were formed by dentists in the 1850s, who advocated the use of mercury amalgam which was invented in 1812. The American Dental Association still holds patents on two of the most popularly used amalgam alloys. Vested Interests? (Patent Number 4018600 (1977) and Number 4078921 (1978)

Contrary to what the British Dental Association is claiming, this study published in 2012, demonstrates a different picture of mercury in the dental environment; [302}

Dentists demonstrated significantly more prescription utilization of specific illness medications than did Controls, for the following disease categories: Neuropsychological, Neurological, Respiratory, and Cardiovascular. The greater majority of paediatric and general practice dentists still use mercury amalgam restorations. This places them at greater risk than the general population for those disorders, as well as threatening the future health of America’s children and adults who continue to receive silver amalgam restorations.

“…for the disease categories examined, the general dentists are less healthy than matched controls.” “…it is well know that the central nervous system is the critical target organ for mercury vapor, it being a strong neurotoxin (Clarkson, 1989) [45].” … “there was a greater prevalence of central nervous system problems in the dentist group compared to control subjects.” …”the prevalence of neurological problems among general practice dentists is 7.6 times higher than in the control group” … “it is, in fact universally recognized that general dentists have an occupationally derived higher body burden of mercury than the general population.” … “the general dentists who do not use amalgam are still exposed to mercury vapor when they remove amalgam fillings. It is estimated that a typical dentist removes between two to ten amalgams per day (CRA, 2001)” …

“It would also stretch credulity to the breaking point to believe that dentists would continue to purchase illness-specific medication, to the extent that it places them in the highest category of medical health pharmacy utilization, if there were no underlying specific illnesses in need of treatment.”

(my emphasis)

International Journal of Statistics in Medical Research, 2012 Vol. 1, No. 1 13

Is your dental association looking after the welfare of its membership?

This paper is mainly about dentists, dental nurses and other dental personnel.  Included in this group are the families of these people.  They are also affected by the mercury.  Many homes of dentists have been found to have high levels of mercury contamination, caused by dentists bringing mercury home on shoes and clothes. [3] I have not seen studies on the homes of dental nurses, but their exposure also brings mercury into the home.

The mercury vapour present in the house, may also be there when there is a pregnancy and newborn child.  The mercury you bring home from work is enough to cause neural defects in the child’s developing brain.  Just a “little bit” every day?  Who’s the first person you pick up and cuddle when you get home from the office?  That white uniform that you wore all day probably gets washed with the other whites, like your bed linen and pillow slips!  Most people in western societies wear their shoes into the house.  Most take them off in the carpeted bedroom and and keep them in a carpeted closet.  The bits of amalgam will end up in the carpet.  The carpet is then vacuumed, and the heat of the vacuum cleaner will vaporize the mercury for all to breath, especially the person doing the cleaning. Your bedroom has just become a toxic fume cupboard.

It’s a really bad idea to wear your shoes into the home and to wash your cloths with that of the rest of the family.  Everyone in your family will be contaminated.  If you don’t wash your hair every night, you will be sleeping in a cloud of mercury vapour from your head and then pillow.  Sadly, your partner will be sharing this poison with you.  Neither of you are aware of it, as the vapour is invisible, and without smell or taste.  This could be an explanation for why the relationship gets a bit rocky and the ability to cope with misunderstandings and other issues, gets more and more difficult.  This could also be an explanation of why your partner (who may be more sensitive than you) is getting sick.  I knew a dentist whose wife was dying of leukemia.  I suggested that there may be this link with mercury and was told that the FDI and WHO said amalgam was safe.  His wife died – that was easier than looking at other options.

These are things that the the criminals in high places forget to teach, and that the dental establishment denies. Instead, they use reassuring language like ‘dentists are healthier than the rest of the population’.  Pieces of amalgam, no matter how small, do NOT just disappear.  In fact, they have a very long shelf life, constantly releasing mercury. 

Although the PTOs claim that amalgam is safe, provided ‘good mercury hygiene practices are employed’, they do not give details of what these good mercury hygiene practices are.  It’s all just double talk gobldy goop!  The reality is that the only good hygiene practice, is to never go near the stuff.  Using amalgam is just plain STUPID! Cutting the stuff with high speed drills, or polishing those corroded old fillings, is also extremely dangerous with massive levels of mercury vapour released during these procedures. The concept that mercury is only released during the actual tooth filling period is total B.S. See Smoking Tooth Video below.

The dramatic video titled Smoking Teeth / Poison Gas has had a tremendous impact on both the public and professional audiences. This full version includes interviews of experts in the fields of mercury toxicology, environmental medicine, politics and dentistry.

Copyright Robert Gammal 2021

Our dental schools and associations, DO NOT TEACH about the dangers of mercury!  There is just a criminal desire to deny! It’s not even a conspiracy – it is blatant.  I would want a better standard of behavior from the organizations that I pay to represent me.  That’s why I stopped being a member! 

“I sent the club a wire stating,

please accept my resignation.

I don’t want to belong to any club

that will accept me as a member.”

Groucho Marx

How many hours are wasted in dental school teaching young students how to use mercury amalgam? How many hours are not spent teaching what follows? There is lots of time wasted in dental schools teaching students how to perform ‘treatments’ that poison themselves and their patients! One of the more unfortunate side effects of being a dentist and exposing yourself to mercury, (because the professor said you should), is that it may be responsible for killing you. [4],[5],[6],[7] 

A study from 2016 showed that dental personnel contained significantly higher levels of mercury in their blood samples (dentists: 29 mcg/L and dental assistants: 22 mcg/L) compared to that of the controls (3  mcg/L). [8] 

The new threshold level for mercury in the blood is now 1mcg/l.  Levels above this are going to have a severe effect on health and 29mcg/L is life threatening. 

If you, as a dental assistant, work for a recalcitrant dentist who ‘knows’ that amalgam is ‘safe and fantastic’, then you might want to wake them up a bit.  Otherwise it may be worth finding a new job! If you are the recalcitrant dentist, it may be worth your health to read the rest of this page. 

We went to university and learnt all about amalgam from our insane professors, and what they told us, is all that we needed to learn – right?  Especially because they tell the same lie over and over again. It is a choice to believe them or to educate ourselves.

I possibly sound a little bit arrogant, but there is a reason that I have included myself in the above paragraph.  I was one of those who knew that amalgam was safe, because my professor taught me thoroughly.  When I started to wake up, it felt like I was coming out of some kind of mind control program.  We dentists need to learn to take responsibility for what we do and what we implant into other humans.  We need to take responsibility for what we throw into the environment. We need to have truthful information so that we can start to take this responsibility.   As dentists we need to be held accountable for the exposure we subject our staff and our patients too.  As well we need to take responsibility for what we expose ourselves too.

Believing the lies of the professors, dental boards and PTOs may cost you your health and perhaps your life.  Am I angry about it?  You bet! I was lied to from the day I started university and they are still lying about it.   There is no such thing as a safe level of mercury.  There is no such thing as a ‘little bit’ of mercury vapour. If you work with amalgam, either putting it in or taking it out, then there is no such thing as proper mercury hygiene. At some stage we really do have to choose who to believe.  You need to read the research and work it out for yourselves. 

The levels of mercury in the dental surgery can be 200,000 times higher than the level that the Agency for Toxic Substances and Disease Registry, says causes immediate observable physiologic changes, at transient exposures

These same levels are eighty times higher than is permitted by law, by Occupational Safety and Health, in both the USA and Australia. 

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The Dental Environment

let’s talk figures!

Maximum Allowable Levels of Mercury Vapour

  OSHA   Occupational Safety & Health Authority   Time Weighted Average 40hr/week   USA & Australia (Occupational Exposure)  50 mcg/m3   Includes dentistry  
  EPA   Environmental Protection Agency   USA & Australia for non-occupationally exposed people  0.3 mcg/m3   All other humans  
  ATSDR   Agency for Toxic Substances   & Disease Registry USA      transient exposure to this level produces observable physiological change.  0.02 mcg/m3   Transient Exposure  
dentistry is classified as ‘occupational exposure’ – we are not included as other people!

Actual Measured Levels

The results published by the International Association of Oral Medicine and Toxicology show that;

  • When cutting amalgam with a high speed drill, the levels of mercury vapour, 18 inches from the mouth, can exceed 4,000mcg/m3
  • When the nurse opens a freshly mixed capsule of amalgam, the level of mercury vapour she (and the rest of the surgery) will be exposed to is 1,000 mcg/m3. (This is 200 times above OSHA standards and 50,000 above the ATSDR levels.)

These figures are beyond comprehension, especially when our very own trade associations claim that they are safe.  Is this what they call good mercury hygiene?  A reminder to all dentists and PTOs:

in 1991 the World Health Organization stated clearly (Criteria 118) that the

No Observable Effects Level (NOEL) for mercury vapour is ZERO.

Zero is the only SAFE level!

Copyright Robert Gammal 2021

Dental students are particularly vulnerable, as most are still young enough when being subjected to their first load of mercury, to still be developing neurologically.  In particular the females, who are usually still of childbearing age.  All they have for protection is a paper mask and blind trust in what they are taught! Mercury vapour passes through such masks as easily as if they were not there!   Students are not supplied with mercury vapour masks and neither they nor their patients are supplied with separate air supplies.  In fact, they are merely told to wash their hands and not spill mercury.  Considering this information, the thought of twenty dental students, all placing or cutting amalgam in the same clinic at the same time, makes for a great horror movie. 

Every time a dental student opens a capsule of mixed amalgam, a mercury vapour cloud is released.  Concentrations up to 1,000mcg/m have been measured. [9]   This is 3,000 times greater than what the EPA standards allow and 50,000 times greater than what is known to cause observable physiological change.

A cloud of mercury vapour is also created when an amalgam filling is cut with a high speed bur.  Levels as high as 4,000mcg/m3 have been measured 18 inches from the mouth.  This is well within the breathing zone of the dental student and dental nurse, let alone the patient.  This is 200,000 times greater than what is known to cause observable physiological change, as a transient exposure!

The mercury vapour will travel through the whole building – all the way to the reception at the front desk and the royal chambers of the deans and professors on the penthouse floor. The higher places where they can scream their prayers closer to god. Did the deans get permission to poison everyone so totally, or do they claim that they just don’t know?  

Exceeding the maximum allowable levels by HOW MUCH?

Maximum Allowable Hg Vapour mcg/m36 amalgam fillings – Oral Vapour concentration 30-120 mcg/m3Opening a mixed amalgam capsule 1000 mcg/m3Drilling amalgam fillings 4000 mcg/m3
 OSHA    502x20x80x
 EPA       0.3400x3,333x13,333x
 ATSDR  0.026,000x50,000200,000

OSHA surveys found 16% of U.S. dental offices exceed the OSHA standard of 50 mcg/M3. Most office mercury levels were found to far exceed the U.S. guidelines for chronic mercury exposure.39  

And now you can redo the math, because at present the OSHA TWA for mercury vapour in Alberta USA, has been dropped from 50mcg/m3 to 25mcg/m3That’s right – they halved the maximum allowable for a work situation

Proper mercury vapour masks should be a ‘minimum requirement’ for all people who must breathe, in a mercury vapour environment.  Why are dental students and other dental personnel being denied this basic protection?  Perhaps the patients may get a bit nervous about having amalgam implanted into their bodies, if proper mercury hygiene were observed and students were really given protective clothing and masks.  Personally, I think that anyone going into a dental hospital should wear full hazmat gear!   Why are the EPA & OSHA standards so shamelessly ignored?  Why is it that the EPA and OSHA don’t have the balls to do anything about it?  I asked this question years ago when addressing an OSHA conference.  I was answered by lots of blank looks. Why does every dental teaching facility actively poison everyone in it – this is not new information!

image taken from the www
WHAT A JOKE!
image taken from the www
image taken from the www

Cutting amalgam will create a cloud of mercury vapour as well as a cloud of microscopic particles.  This will also cause a marked elevation in body burden of mercury.[10] 

These particles are fully respirable right down into the alveoli of the lungs.10  Clearly the cumulative surface area of these micro particles is vast.  This huge surface area coats the lungs and continues to release mercury vapour at the elevated levels caused by body temperature, a degree or two higher than is found in the mouth.  This then constitutes a very long-term and extremely high exposure.  Damage to lungs is well documented.[11]

Dentists wear paper facemasks in the belief that they are protected from anything that sprays out of the patient’s mouth.  Many find these masks so expensive (about 5 cents each) that they give themselves and their staff only ONE mask per day.  (No, I am not exaggerating.) I have seen many dentists walking around – mainly to the toilets, but sometimes even to go out and by food, with their masks still around their throats. It’s like the doctors that wear their stethoscope around their necks for effect, accept that the stethoscope is not poisoning them. These paper masks are not only useless but are in fact positively dangerous.

Most (not all) microscopic particles of amalgam are trapped on the mask and remain there. After about a minute, the temperature of the breath will heat these amalgam particles, and then the mercury vapour levels inside the mask can easily exceed vapour levels in the rest of the room. 

Dentists and dental nurses should NEVER wear a paper mask for more than one patient. In fact, if you are cutting amalgam, you should wear proper mercury vapour masks. Paper masks are useless and dangerous. This is just basic hygiene.  If you cannot afford five cents per patient, then you really need to revisit your business model.  If you are using paper masks, they need to be disposed of immediately after cutting the amalgam.  Remember, this paper mask is now loaded with amalgam particles.  It must also be regarded as toxic waste and must not be disposed of in the garbage or down the toilet.  It must be stored in a glass jar under photographic fixer and disposed of as toxic waste by toxic waste experts. 

Copyright Robert Gammal 2021

Paper masks are useless and dangerous as a protection from mercury.  All procedures, from mixing and placing amalgam to the recommended 6 monthly polish, and all the way through to drilling out the old amalgam filling, create massive levels of mercury vapour, which will pass without hindrance, through a paper mask.  It is criminal neglect to only supply paper masks for dental students and dental personnel.

Copyright Robert Gammal 2021

Special respiratory masks need to be used by the dentist, nurses and patients when removing amalgams.  Sterile compressed air can then be directed across the faces at a comfortable volume, but windy enough to blow mercury vapour and amalgam particles away from your faces.  These masks and gasses do cost extra but really, they are also not that expensive.  Compared to the cost of the diseases, this is an absolute bargain method to protect everyone.  Proper mercury vapour masks are better. Don’t take the mask off as soon as the drilling is finished. The particles and vapour remain in the air for several minutes after amalgam is cut. Let the dust settle.

A Good Suck

Dental exhausts suck air, water, particles and mercury vapour out of the patient’s mouths.  This mix is then passed through a system which separates out the particulate matter (such as bits off filling and tooth and other objects) and allows the water and air to pass through.  The water is then dumped into the drain and the ‘outer’ environment. 

The suction air continues to pass all the way back to the suction motor to be expelled into the surrounding atmosphere.  Air filters which are attached to these suction motors do NOT stop mercury vapour

Many dental practices use small suction motors which are often placed under a bench in the laboratory.  These motors therefore pump their exhaust, including the mercury vapour, back into the surgery.  Suddenly the whole premises are contaminated – a fume cupboard is thus created, and you are sitting in it.  This vapour will constitute a serious hazard to everyone in those premises including the patients who are only there for a short time! The dental nurses and reception staff will be sitting in this cloud from morning till night. This is the reason for asking your dentist if the suction air is vented out of the building

This is a critical situation for all dentists to recognize and remedy. 

A friend who worked in an office building, told me about the dentist who moved in next door on the same floor. When presented with this information, he simply claimed that he was working within the accepted guidelines and the expense of ducting to the outside of the building was not essential.  My friend had the mercury levels in the air-conditioning ducts analyzed, as the air con was shared by everyone on the floor.  She did this for two years, every six months, and the result was an ever increasing level of mercury in the dust in the ducts. The dentist was only on the premises one day a week and did not use amalgam as a filling material.  This measurable amount of mercury was caused by occasionally drilling out old amalgams.  If you share air conditioning with other people in the building than you will be poisoning them.

If your residence is above or connected to a dental surgery, then seriously consider changing where you live.  By the way this is the same advice regarding dry cleaning establishments.

Studies show levels of mercury vapour which far exceed the OSHA standard of 50mcg/m3, on a time-weighted average over a 40-hour workweek. At least 10% of all surgeries had a mercury vapour level greater than 50mcg/m3.  Some went as high as 100mcg/m3[12],[13],[14],[15],[16]

“…the cutting of amalgam fillings caused highly fluctuating mercury vapor levels, which were 2-15 times higher than the threshold limit value.”[17]  (threshold limit value at the time of this study, in 1995 was 30mcg/m3)

A deeply disturbing study of dentists’ amalgam habits was published in 2005.  The study was conducted in Senegal and I assure readers that this type of behaviour happens in many parts of the world including Sydney.

“Our results showed that among the dentists:

44% used 250g to 500g of mercury per year,

14% used their hands for insertion of amalgam in the cavities,

10% used their hands for condensation of amalgam into cavities,

87% throw their amalgam on the trash.” [18]

I once worked in a large clinic in Sydney that treated many nuns and priests from third world countries.  Most had fingerprints in their fillings.  Mercury will be absorbed through the skin in toxicologically relevant amounts.

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Mercury Levels in Dental Personnel

Generally, dental personnel who use amalgam have twice the body burden of mercury compared to controls.  Autopsy studies have shown levels of mercury in pituitary and thyroid to be 10 times that of controls and in the kidneys to be 7 times higher.  Mercury levels were astronomical in the pituitary 4,040 ppb, kidney 2,110 ppb, thyroid 28,000 ppb. 39,

From 1975 to 1983 the American Dental Association carried out a survey of the dentists who participated in the Health Assessment Programs they conducted.  This study looked at urinary mercury levels of 4,272 Dentists in the USA.  They measured straight urine/mercury levels.  (Most mercury is retained in the body. Most that is excreted is faecal. Very LITTLE mercury is excreted through the urine.) We could expect that if a DMPS Challenge test had been employed, the figures would be at least five times higher.  These dentists had a mean mercury urine level of 14.2mcg/l. The maximum normal level as stated by the American Dental Association was at time considered to be 20mcg/l.  The observed ranges of urine mercury levels were from 0 to 556 mcg/l. 

The study showed that;

19 % are over the maximum normal measurement of 20 mcg Hg/L

10% are over the C.D.C. maximum acceptable level of 30 mcg Hg/L

5% are over 50 mcg Hg/L, the level found to cause induced tremors

1.3% are over 100 mcg Hg/L, the level found to cause tremors

Believe it or not, this study was used for many years to show how ‘healthy’ the dentists were! 

Note that the reference levels used were 20 micrograms of mercury per litre of urine.  The new German guidelines for urine mercury levels since 2006 is now 0.7 mcg/l.  This would suggest that dentists with a level of 20 mcg/L would show significant physical and psychological disturbances.  I can’t imagine what 500 mcg/L would be like.

These figures suggest that virtually ALL of the dentists tested are headed for serious disease and/or disability or death. Heart attack rates for dentists are very high.  Mercury damages the linings of the arteries and causes atherosclerosis.  Nearly one fifth of all dentists in the USA, and presumably everywhere else, are above 20 mcg/l. I do not have figures for the number of dentists above the level of 0.7 mcg/l but we may safely assume that it is very much higher.  Perhaps very few are likely to be below this level.

One of the few countries that is not scared of its dentists is Canada.  The Canadian government fully supported the Richardson Report of 1995. Dr Mark Richardson’s report for Health Canada (1995) showed dental mercury released from the fillings absorbed by the body, is the most significant source of mercury, compared with food, indoor and outdoor air, drinking water and soil.  Richardson recommended restricting the number of mercury fillings to one in children, three in teenagers, and four in adults and seniors, to limit lifelong exposure to mercury. The Canadian Dental Association continues to oppose the Richardson report as being scientifically unsound.

In 1996, Richard Tobin, director of Health Canada’s Medical Devices Bureau wrote to Dr. James Brookfield, President of the Canadian Dental Association, urging the Canadian Dental Association to correct the misinformation they were distributing about dental amalgam.  Read the letter here

Tobin pointed out that, contrary to the association’s information, dental amalgam has never been approved by Health Canada.  In some people, the mercury exposure from their fillings may be as great as from all natural sources.  Several reliable studies show higher levels of mercury in the blood and urine of people with amalgam fillings than those without.

In this letter Canada Health made some interesting and revealing comments to the Canadian Dental Association about their ‘Questions and Answers’ that the CANADIAN DENTAL ASSOCIATION was making in their public policy statements on amalgam. The points made are applicable to all other PTOs peddling the same misinformation to this day.

Canadian Dental Association

Q. Is dental amalgam approved for use in Canada?

A. Yes, dental amalgam is approved for use in Canada by Health Protection Branch.

Canada Health;

This statement is categorically false. Dental amalgam has never undergone pre‑market review in Canada because it was in use before the Medical Devices Regulations were established. The CANADIAN DENTAL ASSOCIATION previously published this misinformation in a paper in the CANADIAN DENTAL ASSOCIATION Journal in May 1995. At that time, we informed the CANADIAN DENTAL ASSOCIATION of this error, but CANADIAN DENTAL ASSOCIATION has repeated it here.

(In Australia amalgam has never been approved for use by the TGA and nor the FDA in America.  The TGA only regulate for the amalgam alloy but step out of the room when it is mixed with mercury.)

Canadian Dental Association

A. Scientific literature on the topic, as a whole, supports the position that amounts released are generally less than mercury picked up from natural sources.

Canada Health;

This may be a misleading over‑simplification. The World Health Organization states that dental amalgam is the largest single source of mercury exposure for persons not occupationally exposed (reference World Health Organization. 1991. Inorganic Mercury. Environmental Health Criteria 118. International Program on Chemical Safety. (Geneva).)

Canadian Dental Association

Q. Is the mercury which is released from fillings absorbed into the body?

A. Yes, but in extremely small amounts, i.e. in MILLIONTHS of a gram (this is a very small amount, 0.000001 grams.)

Canada Health;

This answer is rather condescending and insulting to the intelligence of readers. By emphasizing only how small a microgram is it implies that a microgram of toxic material could not be harmful. What is significant is not how many zeroes there are in a microgram, but how many micrograms of mercury are released by and compared to the number of micrograms required to cause illness. The fact is that a level of only one hundred millionths of a gram of mercury per gram of Creatinine in urine is considered to indicate clinical mercury poisoning.

Canadian Dental Association

A. Some researchers claim to detect higher mercury in the blood of people with amalgams than in those without amalgams but other researchers could not detect mercury in the blood of patients even with new amalgam restorations.

Canada Health;

Although I am not familiar with studies that could not detect mercury in the blood of patients even with new amalgam restorations, there are several reliable studies (one of them by Dr Anders Berglund) which show higher levels of mercury in blood and urine of people with amalgam fillings than in these without. There are also studies which show a strong correlation between the number of amalgam surfaces and mercury levels in the brain and kidney.

Canadian Dental Association

Q. Is the dental profession suppressing information on the dangers of amalgams?

A. No, the dental profession believes in informed patient consent and recognises the patient interest above any other considerations.

Canada Health;

You are in a better position than we are to determine the degree to which this statement is correct. The CDA’s policy states that “Dentists want patients to be aware of conclusions from the range of scientific studies on dental amalgam so that the appropriate choice can be made.” This statement is difficult to reconcile with the CDA’s sweeping dismissal of research such as that discussed above, linking mercury levels with the number of amalgam fillings.”

~~~~~~~~~~~~~~~~~~~~~~~~~~

We have been misled and lied to for years. It is time to wake up and demand the truth from the people who espouse ethical behaviour with one hand and take your health and money with the other! Dental amalgam has never been approved for use by either the FDA in America or the TGA in Australia!  To all of you dentists who have attacked my stance on amalgam, you might have a think about who you are protecting and who you are damaging.  Is it more important to belong to a corrupt organization or enjoy good health for yourself, your staff and your patients?

Why does dentistry have the highest suicide rate of all professions?  Since when does this not count as serious enough to warrant a full and frank investigation?  We have been led to believe that dentistry is a high stress profession.  I don’t believe that this is so.  Certainly it is stressful for the patient.  I would not compare this sort of work stress as anything like the stress involved in being an ambulance or fire person.  I think the police would have just a bit more stress than playing with teeth.  These guys put their lives on the line every day!

The stress in dentistry is simply a heavy metal called mercury.  There is no other stress.  The high rate of suicide is the result of mercury poisoning?  

~~~~~~~~~~~~~~~~~~~~~~~~~~

A study from 2001 explored the mercury levels in dental students and dental teachers in clinics, and office staff who were in areas of the dental hospital, remote from the clinics, over a one year period.  This study is published in the British Dental Journal!

“There were statistically significant increases in plasma mercury concentration between measurements in all groups at the end of the academic year… Although the highest levels of mercury were recorded in persons working with amalgam, increased levels were also found in subjects working in the teaching classrooms but not with amalgam (controls and first year students).” [19]

Copyright Robert Gammal 2021

The mercury vapour clearly travels to all parts of the building and even the clerical staff showed increased mercury levels.  This was only measured over a one year period.  Do the staff at the dental hospitals have their mercury levels measured every year?  If not, then why not?  I noted earlier about never going into a dental surgery where amalgam is used.  This also applies to dental hospitals.

Another study of dental students measured the urine mercury at the beginning of their course and at the end. The average urine mercury increased by 500% during the 5 year course.[20]

Other studies on dental students demonstrated that 44% of them were allergic to mercury. [21],[22],[23],[24]   Whose guinea pigs are the dental students? The dental associations claim that less than 1% of the population are allergic to mercury!

Urine and blood measurements of mercury are consistently higher in dental personnel than the rest of the population.  So much so that it is clear that there is little understanding of ‘Mercury Hygiene Principles’ espoused by the associations. [25],[26],[27],[28],[29],   These levels were consistently higher than the old threshold levels of 20mcg/l prior to Germany dropping it to 0.7mcg/l. [30],[31]

Another study from 1991 concluded;  “In the group of dental personnel, the effect of their own amalgam fillings on Hg concentrations….was as important as their occupational exposure to Hg”. [32]

Health of Dental Personnel

The publication in 1985, of a huge study of 9,241 people, has hardly raised an eyebrow.   A study of this size has great statistical significance, yet has not made it into the dental association information in over 33 years.  You would think that the statistical significance in the incidence of brain cancer, should make front page news in all countries. This group was comprised of 3,454 male dentists, 1,125 female dentists and 4,662 female dental nurses.  It showed that the rate of a particular type of brain cancer called a Glioblastoma was twice as high in this group of dental personnel compared to the rest of the population. [33]  Mercury is highly absorbed by glial cells.

Polyneuropathy is damage or disease affecting peripheral nerves in roughly the same areas on both sides of the body, featuring weakness, numbness, and burning pain.  A study of 298 dentists revealed that 30% of the high mercury group had polyneuropathies. No polyneuropathies were detected in the control group.  The high mercury group also had mild visuographic dysfunction; (disturbance of visual and motor task combinations – just the type of problem you would want your dentist to have while fixing your back molar) and also had more symptom-distress than did the control group.  “These findings suggest that the use of mercury as a restorative material is a health risk for dentists”. [34]

Copyright Robert Gammal 2021

Another study of 66 dental personnel; 22 dentists and 15 female dental assistants showed the most frequent symptoms referred by dentists and their nurses were: irritability, tension headaches and arthritic joint pains.[35]

Dentists were found to score significantly worse than a comparable control group on neurobehavioral tests of motor speed, visual scanning, and visuomotor coordination, concentration, verbal memory, visual memory, and emotional/mood tests.  Test performance was found to be proportional to exposure/body levels of mercury.     Significant adverse neurobehavioral effects were found even for dental personnel receiving low exposure levels (less than 4 mcg/l Hg in urine).  Those with higher levels of mercury had deficits in memory, mood, and motor function compared to those with lower exposure levels. 46  (the reference level is now .7mcg/L)

A survey of over 60,000 U.S. dentists and dental assistants with chronic exposure to mercury vapour and anaesthetics found increased health problems compared to controls, including significantly higher liver, kidney, and neurological diseases.  Other studies reviewed, found increased rates of brain cancers and allergies. [36],[37],[38]  Swedish male dentists were found to have an elevated standardized mortality ratio compared to other male academic groups.194,39   Inability to concentrate for any length of time, chronic muscular pain, burnout and hating dental work are all symptoms that are common in dentistry.

Psychological Effects on Dentists

How would you like your dentist to be a short tempered psychopath, with shaky hands, who is also suicidally depressed and hates his work?  How about a dentist who slaps a child or holds the child down to ‘fix’ a tooth?  How about a dentist who really does put his knee on your chest to take out a tooth? Perhaps you would prefer the top oral surgeon in Sydney’s Macquarie St., who rests his hand on your breast rather than your shoulder? What about a dentist who gets angry because the injection doesn’t work, and it is therefore your fault? Or how about the dentist who just says, “you can trust me because I am a dentist”?  These are the ones that advertise toothpaste on television.  As a dentist, how would you like to fit any of these categories?  Is it always the nurse’s fault when things get rocky?  Are ALL of your patients a problem, or just most of them? 

Copyright Robert Gammal 2021

No, I am not making any of this up.  These are all dentists I have known in my 40 year career.  I stopped referring to the oral surgeon after finding out what he liked to do!  Do you as a dentist recognise this in the person reflected in your mirror?  Take a serious look, as it is not too late to make changes.  Understand that this is the end product of what we were taught and are still being taught at university! 

Most practicing dentists ignore the law and subject their employees to conditions which should make every Occupational Safety and Health person swing into action. It can only be a matter of time before litigation in this arena hits home in the dentists’ pockets.  Surprisingly the OSHA and EPA both in America and Australia seem to have been subjugated by the will of the dental associations.

Dentists and dental personnel experience significantly higher levels of neurological, memory, musculoskeletal, visiomotor, mood, and behavioral problems, which increase with years of exposure.[39]  Even those with a low exposure were found to have significant neurological effects with increased levels of irritability,[40]  high rates of drug dependency and disabling psychological problems.[41]

If you are a dental student, how do you feel about your instruction in using mercury amalgam, with the knowledge that even very low levels of exposure to mercury, will directly cause a severe reduction in your academic ability? [42],[43] , [44]    In reality you are going to get a massive mercury exposure over your student years!  You might want to have a talk to your lecturers before suing their asses off.  Then they might get the message that they are acting illegally!

Waste amalgam (that which is left over after the tooth is filled) should by law be stored under photographic fixer (as it has a high Sulphur content which binds the mercury) in a sealed glass jar.  Running a mercury vapour meter around such a glass jar, will demonstrate the ineffectiveness of this containment.  It is better though, than keeping it in a spare drawer.  This was a common practice even in the dental hospitals in Sydney.

The waste amalgam is usually picked up and taken away irregularly by toxic waste experts.  They separate out the metals and salvage anything of value like bits of silver.  For this privilege they give the mad hatter a little money.  The amount of money depends on the weight of the collection and usually goes toward the Christmas party.  I once worked in a massive practice and happened to walk in on the boss and the head dental nurse laughingly huddled over a workbench in the lab.  They were using a Bunsen burner to melt pieces of lead, from x-ray film envelopes, to make little lead pellets.  (Lead is the second most toxic material after arsenic. Mercury is the third most toxic.)  These little lead pellets were then added to the amalgam waste in the glass jar to make it heavier.  They could have earned much more money by doing one filling, than by indulging in this madness.  Do you still think that the term Mad Hatter should not be applied to dentists?

Psychological studies of dentists show some really scary results that are reflected in the real world.   One such entitled “Neuropsychological Dysfunctioning Associated with the Dental Office Environment” 40  examined fifty-one dentists and dental personnel, who were studied on standardised tests. It revealed that there were a significant number who measured in the abnormal ranges:

  • Some motor tremor – 90%
  • Some psychomotor dysfunction – 41% 
  • Severe psychomotor dysfunction – 16%
  • Impaired immediate recall – 58%
  • Impaired auditory memory – 84%
  • Visual memory reduced – 52%
  • Vigilance, attention, concentration and cognitive comprehension – 52%
  • Work and lives felt to be pointless -36%
  • Tactile sensory dysfunction/inability to locate finger position – 52%
  • Logical thinking and story recall impaired – 79%
  • Spatial and visual memory impaired – 68%
  • History of unsatisfying interpersonal relationships – 27%
  • Out of normal range on emotional stability scale – 72%
  • Suicidal depression / disgust with life /despondency & despair – 27%
  • Increased state of agitation – 30%
  • Increased scores on psychopathic scale – 42%

This study concludes that as a group, dentists are, after a number of years, at least one standard deviation below the rest of the population in IQ levels.  Considering that a dentist must be at least one standard deviation above the rest of the population to have passed dental school, this represents an enormous and significant drop!

Clearly a very large number – almost half – of dentists are psychopathic.  Perhaps this is a good explanation for the position taken by the PTOs.

Another study from 1995 showed that the higher the urine mercury levels were, there was an accompanying decrease in complex attention tasks and perceptual motor tasks and increase in mood swings.[45]  This is the person who does complex and fine restorative work in your mouth!

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In the same year other research by Echeverria et al came up with a similar conclusion. “Significant urinary mercury dose-effects were found for poor mental concentration, emotional lability, somatosensory irritation, and mood   scores.”  There was evidence of subtle pre-clinical changes in behaviour associated with mercury exposure. Urine mercury levels directly related to “reduced concentration and emotional instability and fine motor function was seriously effected”.  [46]  Fine motor function is the ability to do complex fine mechanical tasks, like filling a tooth or giving an injection painlessly.

These studies present convincing new evidence of “adverse behavioral effects associated with low mercury exposures within the range of that received by the general population”. [47]

“In neurobehavioral tests measuring motor speed (finger tapping), visual scanning (trail making), visuomotor coordination and concentration (digit symbol), verbal memory (digit span, logical   memory delayed recall), visual memory (visual reproduction, immediate   and delayed recall), and visuomotor coordination speed (bender-gestalt time), the performance of the dentists was significantly worse than that of the controls.

… scores were more than 10% poorer. … the performance decreased as the exposed dose increased. These results raise the question as to whether the current threshold limit value of 0.05 mg/m3 (TWA) provides adequate protection against adverse effects of mercury”. [48]

Another study was performed “to find out if the first “professional” contact of dental students with amalgam resulted in an increased mercury excretion.”  The study was conclusive.  The longer the students were exposed to mercury in the clinic, the greater was their body burden of mercury.  [49]  Combine this with a decreased ability to think and perform academically and there just might be a few students wanting to take their professors to task.  It is illegal to expose anyone to these levels of mercury!

The levels of mercury in the urine samples of the dentists, was about three times higher than the control subjects.[50]  Dentists were significantly more likely than control subjects to have had disorders of the kidney and also memory disturbance. [51]  The older dentists showed significantly better performance on the simple reaction time test and significantly poorer performance in the immediate word recall and delayed word recall tests. [52] 

In light of new research, which shows that over time there is a reduction in kidney filtration and a reduction in urine mercury levels due to the inability to excrete, these statements become even more terrifying. [53]

An abbreviated list of some of the common effects that mercury has on dental personnel include:

Very rarely are any of these symptoms and diseases seen in isolation.  They are almost always clustered as groups of symptoms.

This is NOT a complete list.  There are thousands of studies!

How can the dental associations deny this information to their own members?  If you are a dentist, would you not expect more from the people you pay thousands of dollars every year to look after your welfare?

A court case involving the American Dental Association had a very interesting outcome with quite a sting at the end.   With the type of support given in the following case, it is remarkable that the PTOs have any members at all.

In 1992 the AmDA made its position on potential liability for dental amalgam perfectly clear and, in doing so, left amalgam-using dentists on their own. The AmDA had been named as one of the defendants in a lawsuit against amalgam use.[277]

Attorneys for the AmDA pleaded in Court:

The Superior Court of the State of California Case No. 718228, Demurrer (October 22, 1992).

The American Dental Association (ADA) owes no legal duty of care to protect the public form allegedly dangerous products used by dentists. The ADA did not manufacture, design, supply or install the mercury-containing amalgams. The ADA does not control those who do. The ADA’s only alleged involvement in the product was to provide information regarding its use. Dissemination of information relating to the practice of dentistry does not create a duty of care to protect the public from potential injury. [278]

(My Emphasis)

In other words, the dentist was left high and dry to fend for himself, while the association, which likes to enforce its code of ethics and is the main group giving advice to dentists, was let off the hook. 

The American Dental Association’s (ADA) code of ethics makes the removal of serviceable mercury amalgam restorations an issue of ethical conduct. In the ADA’s point of view, it is ethical for a dentist to place mercury amalgam restorations in a patient and claim their safety. However, according to the ADA’s code of ethics a dentist who acknowledges that mercury amalgam restorations are toxic and recommends their removal has acted unethically (“…the removal of amalgam restorations from the non-allergic patient for the alleged purpose of removing toxic substances from the body when such treatment is performed solely at the recommendation of the dentist is improper and unethical….” ADA Resolution 42H-1986. Transaction 1986:536) On the basis of the ADA’s code of ethics, state dental boards have taken disciplinary action against mercury free dentists who have practiced their profession in accordance with current scientific knowledge and their conscience. The disciplinary action has ranged from restrictions placed on their practice to the loss of license.

What an abysmal show of irresponsibility which sadly is not an uncommon scenario.  Ask your association for that one reference that says mercury from amalgam is safe. If you are a dentist, consider how you are going to defend yourself when the prosecution quotes the contraindications from the manufacturer and Here.  Ask them if the PTOs and dental boards will be ready to defend you.  The best you will get is likely to be a write up in their news bulletins on how bad you are. 

I wrote to the Australian Dental Association at that time asking if their position would be similar to the Americans.  They did not respond.  I wrote again and again and they did not respond.  Clearly, as a dentist, if you are going to be taken to court for poisoning a patient with mercury, it would be wise to seek legal advice independent of your dental associations. They do not seem likely to be taking responsibility nor are they interested in supporting their members.  You really are on your own. 

We can choose not to get caught up in this no win situation.  As pointed out in Bioprobe 14-2;

“… the ADA (American) has added to its Principles of Ethics and Code of

Professional Conduct a provision declaring it unethical for a dentist to recommend the removal of clinically serviceable amalgam fillings to eliminate exposure to mercury, a provision widely utilized by state dental boards. At the same time, the ADA Code contains a provision providing an “obligation” for dentists to inform on the results of their investigations when they are useful in safeguarding or promoting the health of the public. This is clearly a dilemma for dentists in regard to dental amalgam; dentists are unethical if they do inform and unethical if they do not inform patients of potential adverse effects to amalgam mercury!”

Female Dental Personnel

All females working in a dental environment.

Dentists, nurses, receptionists, cleaners, office staff etc!

The effect of mercury on women’s health has been known for many years –

1907    “In women, there will be inflammations of the outer genitals, vaginal catarrhs and disturbances of menstruation.  That there is a tendency to miscarriage during chronic mercurialism is well known from the toxicology of mercury”. [279] 

Copyright Robert Gammal 2021

“ Female dentists and dental assistants are especially at risk. AII types of mercury cause genetic damage (Verschaeve et al., 1976),are strongly immunotoxic (Koller 1980) and induce antibiotic resistance in bacteria (Williams, 1971). Hg vapour which enters the nose (from amalgam during exhalation) passes rapidly to the brain and can be found in the olfactory lobe and tract, the pituitary gland and adjacent areas and has strong effects (Stock, 1935).  

Also, the reverse process, methylation by human intestinal bacteria has been found (Rowlandet al., 1975) and persons exposed to only Inorganic Hg also obtain elevated levels of methyl Hg.”  [280]

The female dentists, nurses, receptionists and even the cleaners are all exposed to the mercury that the mad hatter wants to use.  (both male and female mad hatters) It is a long call for the American Dental Association to claim ignorance, when a study published in their own journal from 1991 states, that for female dental personnel;

“… rates of spontaneous abortion or non-congenital abnormalities  in children during this period, were higher in respondents exposed to high levels of mercury in the dental environment than those exposed to low levels.” [281]

Copyright Robert Gammal 2021

This paper was written by Irwin Mandel DDS.,  Assoc. Dean for Research School of Dental and Oral Surgery Colombia University New York.  Clearly the female dental personnel have not been told about this research!

In fact, the rate of infertility, miscarriage, stillbirths and congenital deformities is up to twice that of the rest of the population.  The incidence of menstrual problems increases with length of exposure. [282],[283],[284],283,[285],[286],[287],[288],[289],[290]

The US Environmental Protection Agency has stated way back in 1984 that:

“Women chronically exposed to mercury vapour experienced increased frequencies of menstrual disturbances and spontaneous abortions.”

“A high mortality rate was observed among infants born to women who displayed symptoms of mercury poisoning.” [291] 

Working in a dental surgery and being exposed to mercury on a daily basis, is an occupational hazard with respect to reproductive processes. [292]  In fact, it has been shown that as a dental nurse, preparing 30 or more amalgam fillings per week, your probability of falling pregnant is 63% less than unexposed women. [293]

A study from 1981, demonstrated that female dentists had a higher rate of spontaneous abortions than a control of female medical personnel or the rest of the population.  The Peri-Natal Mortality Rate for the female dentists was more than twice the rate of the female medical personnel. [294] 

Copyright Robert Gammal 2021

Female dental personnel are perhaps the most sensitive of the dental fraternity exposed to mercury.  Remember that they have NO representation by any form of trade organisation.  Many girls start a career in dental nursing in their teens and early twenties.  They continue often into their 30’s, and some longer.  This is the prime reproductive age.  Understanding that Europe has now banned the use of amalgam for children under 15 and for pregnant women and those of childbearing age, should we not also ban the use of this material in the workplace for the same group of people?

In the ‘earlier days’, dental nurses used to mix amalgam with a mortar and pestle.  The mixed amalgam then had to be squeezed through cheesecloth to squish out the excess mercury, which should have been caught in an open dish – that is if it didn’t fall on the floor.  Those were the days before latex gloves were standard.  In the 1970’s as a dental student, I was taught to do everything, including surgery, without gloves.  Gloves did not become standard in dentistry (in Australia) till HIV /AIDS became a phenomenon in the mid 1980’s!  Mercury is transported with ease through the skin.  Many nurses were seriously poisoned in that period.  By the way mercury also passes through latex gloves with ease!

Fortunately, the good old days are long gone and nowadays we wear gloves and masks.  The amalgam comes in a pre-capsulated form – the alloy and liquid mercury are supposedly ‘sealed’ into a capsule which you buy from the distributor.  It is always the dental nurse that sits in the cloud of mercury vapour when opening that ‘safe’ amalgam capsule. (1,000mcg/m3) She still needs to be squeezing the mixed amalgam in cheesecloth to get rid of the excess mercury.  Vapour, vapour, vapour!

Copyright Robert Gammal 2021
excess mercury in foetus

It’s the dental nurse who packs the amalgam into the little gun which deposits the dose of deadly mercury into the tooth, and it is the dental nurse who is responsible for cleaning the instruments.  The instrument used to pack amalgam into the tooth has a serrated surface to give it more grip.  (You know, the one that makes that distinct squeaky sound when used).  There is always a little amalgam left stuck to the surface of this instrument.  The conscientious nurse will spend quite some time in the sterilizing area, cleaning off these particles.  A good scrub under hot water does the trick.  The friction and water temperature will subject her to yet another hit of the vapour.

The less conscientious nurse may just bag and sterilize the instrument without removing the amalgam.  Autoclave temperatures are high enough to force massive mercury vapour clouds throughout the whole premises.  Air-conditioning filters do not clear the mercury vapour. Generally, the sterilizing area will be a room toward the back of the premises with little ventilation.  The dental nurse could spend hours here.

How many times must we reinvent the wheel?

The Agency for Toxic Substances and Disease Registry in the USA, stated in 1990:  

“Long-term exposure to either organic or inorganic mercury can permanently damage the brain, kidneys, and developing fetuses….”[295]

A critical study from 1994 [296] (supported in ‘95 [297]) shows that the level of mercury in the body of a foetus or newborn infant is directly proportional to the number of amalgam fillings in the mother’s mouth.  These studies prompted the German Government to immediately issue warnings against the use of amalgam in pregnant women, children and women of childbearing age!  The PTOs in Australia, America, Canada and Great Britain merely commented that these studies “were seriously flawed”.  Never once have these flaws been named or discussed.  The levels of mercury in this study come from the mother’s amalgam fillings.  They are way lower than what is produced in a dental surgery where amalgam is used.

The earliest symptoms associated with long term, low level mercury exposure (micromercurialism) are usually sub-clinical and neurological, namely fatigue, headaches, forgetfulness, reduced short term memory, poor concentration, shyness and timidity, confusion, rapid mood swings, unprovoked anger, depression and suicidal tendencies. [298],[299],[300]

For a dental association to state categorically that “dentists have no unusual diseases and live longer than physician colleagues”, means at best, that they are incapable of reading the published literature.  This makes them as dumb as a mad hatter.  At worst they are intentionally condemning their own membership and that membership’s future generations, but that sounds conspiratorial I suppose!  A case study of a female dentist and the disastrous effects that mercury had on her new born child was published in 1989. Her baby was under weight and had severe brain damage, but clearly the PTOs have problems reading the literature.[301]

An Anecdotal Thought

I graduated from Sydney University in 1975 with about 80 other people who became dentists in my year.  My current age is 70 at this time of writing and about one third of the students who graduated with me are now dead.  Some are disabled and can no longer work.  Some died long ago and some this year!  I accept that mercury may not be the only cause but …

Copyright Robert Gammal 2021
Goanna Ethics
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Studies demonstrating increased mercury levels & serious health effects in Dentists.

Just to give you an idea that there is more than one study out there demonstrating serious health effects on dentists and dental personnel, I offer the following.  Perhaps they may fill the gaps in PTO knowledge.  Perhaps they may convince you as a dentist, that there is something serious going on here and it is your life that’s on the line.

  • Molin M  Marklund SL  Bergman B  Nilsson B   Mercury, selenium, and glutathione peroxidase in dental personnel.  Acta Odontol Scand (1989 Dec) 47(6):383-90
  • Morton J  Mason HJ  Ritchie KA  White M   Comparison of hair, nails and urine for biological monitoring of low   level inorganic mercury exposure in dental workers. Biomarkers (2004 Jan-Feb) 9(1):47-55
  • Ritchie KA  Burke FJ  Gilmour WH  Macdonald EB  Dale IM  Hamilton RM     McGowan DA  Binnie V  Collington D  Hammersley R   Mercury vapour levels in dental practices and body mercury levels of   dentists and controls. Br Dent J (2004 Nov 27) 197(10):625-32;
  • Brown D   A study of the mercury levels in Scottish dentists. Br Dent J (2004 Nov 27) 197(10):621
  • Tezel H  Ertas OS  Erakin C  Kayali A   Blood mercury levels of dental students and dentists at a dental   school. Br Dent J (2001 Oct 27) 191(8):449-52
  • Ngim CH  Foo SC  Boey KW  Jeyaratnam J   Chronic neurobehavioural effects of elemental mercury in dentists. Br J Ind Med (1992 Nov) 49(11):782-90
  • Verschoor MA  Herber RF  Zielhuis RL   Urinary mercury levels and early changes in kidney function in   dentists and dental assistants.
  • Community Dent Oral Epidemiol (1988 Jun)
  • Moszczynski P  Moszczynski P   [Health damage due to exposure to mercury vapour (Hg)] Szkody zdrowotne wywolane narazeniem na pary rteci (Hg). Czas Stomatol (1989 Apr) 42(4):233-8
  • Visser H  Pieper K  Isemann M  Stalder K   [A prospective study on the incidence of mercury levels in dental   students. 2. Correlation analysis] Eine prospektive Untersuchung uber die Quecksilberbelastung von   Zahnmedizinstudenten. 2. Korrelationsanalysen. Dtsch Zahnarztl Z (1991 Aug) 46(8):555-7
  • Ott KH  Grimmeisen J  Alt F  Messerschmidt J  Tolg G   [Mercury in the hair of dentists and dental personnel]Quecksilber im Haar von zahnarztlichem Personal.  Dtsch Zahnarztl Z (1991 Feb) 46(2):154-8
  • Pieper K  Visser H  Isemann M  Stalder K   [Prospective study on the mercury uptake of dental students. Part 1:   Increase in mercury excretion during simulated training]  Eine prospektive Untersuchungen uber die
  • Quecksilberbelastung von   Zahnmedizinstudenten. Teil 1: Anstieg der Hg-Ausscheidung im Verlauf   des Phantomkurses.  Dtsch Zahnarztl Z (1989 Sep) 44(9):714-6
  • Kroncke A  Ott K  Petschelt A  Schaller KH  Szecsi M  Valentin H   [Mercury concentrations in blood and urine in persons with and   without amalgam fillings]  Uber die Quecksilberkonzentrationen in Blut und Urin von Personen mit   und ohne Amalgamfullungen.  Dtsch Zahnarztl Z (1980 Aug) 35(8):803-8
  • Kessel R  Bencze K  Hamm M  Sonnabend E   [Mercury concentrations in the air, in the blood and urine of   dentists in dental clinics and free practice]  Untersuchungen uber die Quecksilber-Konzentrationen in der Raumluft,   im Blut und im Urin bei zahnarztlicher Tatigkeit in Klinik und freier   Praxis.  Dtsch Zahnarztl Z (1980 Apr) 35(4):457-61
  • Mayer R   [Work-hygienic studies connected with the manipulation of silver-tin-   mercury alloys at the dentists working place]  Arbeitshygienische Untersuchungen bei der Verarbeitung von Silber-   Zinn-Quecksilberlegierungen am zahnarztlichen Arbeitsplatz Dtsch Zahnarztl Z (1975 Mar) 30(3):181-8
  • Urban P  Lukas E  Nerudova J  Cabelkova Z  Cikrt M   Neurological and electrophysiological examinations on three groups of   workers with different levels of exposure to mercury vapors. Eur J Neurol (1999 Sep) 6(5):571-7
  • Arenholt-Bindslev D   Environmental aspects of dental filling materials.  Eur J Oral Sci (1998 Apr) 106(2 Pt 2):713-20
  • Echeverria D  Aposhian HV  Woods JS  Heyer NJ  Aposhian MM  Bittner AC     Mahurin RK  Cianciola M  Bittner AC Jr   Neurobehavioral effects from exposure to dental amalgam Hg(o): new   distinctions between recent exposure and Hg body burden.  FASEB J (1998 Aug) 12(11):971-80
  • Nadorfy-Lopez E  Torres SH  Finol H  Mendez M  Bello B   Skeletal muscle abnormalities associated with occupational exposure   to mercury vapours. Histol Histopathol (2000 Jul) 15(3):673-82
  • Karahalil B  Rahravi H  Ertas N   Examination of urinary mercury levels in dentists in Turkey. Hum Exp Toxicol (2005 Aug) 24(8):383-8
  • Sikorski R  Juszkiewicz T  Paszkowski T  Szprengier-Juszkiewicz T   Women in dental surgeries: reproductive hazards in occupational   exposure to metallic mercury.  Int Arch Occup Environ Health (1987)
  • Fan PL  Arenholt-Bindslev D  Schmalz G  Halbach S  Berendsen H   Environmental issues in dentistry–mercury. FDI Commission.  Int Dent J (1997 Apr) 47(2):105-9
  • Newman SM   The relationship of metals to the general health of the patient, the   dentist and office staff.  Int Dent J (1986 Mar) 36(1):35-40
  • Steinberg D  Grauer F  Niv Y  Perlyte M  Kopolovic K   Mercury levels among dental personnel in Israel: a preliminary study.  Isr J Med Sci (1995 Jul) 31(7):428-32
  • Vandenberge J  Moodie AS  Keller RE  Keller RE Jr   Blood serum mercury test report.  J Am Dent Assoc (1977 Jun) 94(6):1155-7
  • White RR  Brandt RL   Development of mercury hypersensitivity among dental students.  J Am Dent Assoc (1976 Jun) 92(6):1204-7
  • Chang SB  Siew C  Gruninger SE   Examination of blood levels of mercurials in practicing dentists   using cold-vapor atomic absorption spectrometry.  J Anal Toxicol (1987 Jul-Aug) 11(4):149-53
  • Saengsirinavin C  Pringsulaka P   [Mercury levels in urine and head hair of dental personnel]  J Dent Assoc Thai (1988 Jul-Aug) 38(4):170-9
  • Langworth S  Sallsten G  Barregard L  Cynkier I  Lind ML  Soderman E   Exposure to mercury vapor and impact on health in the dental   profession in Sweden.  J Dent Res (1997 Jul) 76(7):1397-404
  • Chang SB  Siew C  Gruninger SE   Factors affecting blood mercury concentrations in practicing   dentists.  J Dent Res (1992 Jan) 71(1):66-74
  • Sutow EJ  Hall GC  MacLean CA   Effectiveness of wet and dry mercury vapour suppressant systems in a   faculty of dentistry clinic. J Oral Rehabil (2004 Aug) 31(8):822-6
  • Gonzalez-Ramirez D  Maiorino RM  Zuniga-Charles M  Xu Z  Hurlbut KM     Junco-Munoz P  Aposhian MM  Dart RC  Diaz Gama JH  Echeverria D     et al   Sodium 2,3-dimercaptopropane-1-sulfonate challenge test for mercury   in humans: II. Urinary mercury, porphyrins and neurobehavioral   changes of dental workers in Monterrey, Mexico. J Pharmacol Exp Ther (1995 Jan) 272(1):264-74
  • Eedy DJ  Burrows D  Clifford T  Fay A   Elevated T cell subpopulations in dental students.  J Prosthet Dent (1990 May) 63(5):593-6
  • Nimmo A  Werley MS  Martin JS  Tansy MF   Particulate inhalation during the removal of amalgam restorations.  J Prosthet Dent (1990 Feb) 63(2):228-33
  • Sinclair PM  Turner PR  Johns RB   Mercury levels in dental students and faculty measured by neutron   activation analysis.  J Prosthet Dent (1980 May) 43(5):581-5
  • Joshi A  Douglass CW  Kim HD  Joshipura KJ  Park MC  Rimm EB  Carino MJ     Garcia RI  Morris JS  Willett WC   The relationship between amalgam restorations and mercury levels in   male dentists and nondental health professionals.  J Public Health Dent (2003 Winter) 63(1):
  • Naleway C  Chou HN  Muller T  Dabney J  Roxe D  Siddiqui F   On-site screening for urinary Hg concentrations and correlation with   glomerular and renal tubular function.  J Public Health Dent (1991 Winter) 51(1):12-7
  • Cianciola ME  Echeverria D  Martin MD  Aposian HV  Woods JS   Epidemiologic assessment of measures used to indicate low-level   exposure to mercury vapor (Hg).  J Toxicol Environ Health (1997 Sep) 52(1):19-33
  • Woods JS  Martin MD  Naleway CA  Echeverria D   Urinary porphyrin profiles as a biomarker of mercury exposure:   studies on dentists with occupational exposure to mercury vapor.  J Toxicol Environ Health (1993 Oct-Nov) 40(2-3):235-46
  • Scarlett JM  Gutenmann WH  Lisk DJ   A study of mercury in the hair of dentists and dental-related   professionals in 1985 and subcohort comparison of 1972 and 1985   mercury hair levels.  J Toxicol Environ Health (1988) 25(3):373-81
  • Francis PC  Birge WJ  Roberts BL  Black JA   Mercury content of human hair: a survey of dental personnel.  J Toxicol Environ Health (1982 Oct-Nov) 10(4-5):667-72
  • Nylander M   Mercury in pituitary glands of dentists.  Lancet (1986 Feb 22) 1(8478):442
  • Shapiro IM  Cornblath DR  Sumner AJ  Uzzell B  Spitz LK  Ship II     Bloch P   Neurophysiological and neuropsychological function in mercury-exposed   dentists.  Lancet (1982 May 22) 1(8282):1147-50
  • Bloch P  Shapiro IM   An x-ray fluorescence technique to measure the mercury burden of   dentists in vivo.  Med Phys (1981 May-Jun) 8(3):308-11
  • Echeverria D  Heyer NJ  Martin MD  Naleway CA  Woods JS  Bittner AC     Bittner AC Jr   Behavioral effects of low-level exposure to elemental Hg among   dentists.  Neurotoxicol Teratol (1995 Mar-Apr)
  • Finkelstein Y  Vardi J  Kesten MM  Hod I   The enigma of parkinsonism in chronic borderline mercury   intoxication, resolved by challenge with penicillamine.  Neurotoxicology (1996 Spring) 17(1):291-5
  • Martin MD  Naleway C   The inhibition of mercury absorption by dietary ethanol in humans:   cross-sectional and case-control studies.  Occup Environ Med (2004 Feb) 61(2):e8
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