Analysis of Dr. Oz's Unwarranted Attack on Amalgam Fillings

Stephen Barrett, M.D.

On March 28, 2013, the "Dr. Oz Show" claimed—falsely and irresponsibly—that everyone who has "silver" (amalgam) fillings is at risk for mercury toxicity. The show featured:

  • Gerry Curatola, D.D.S., whose Web sites describe him as co-founder/director of Rejuvenation Dentistry, a multispecialty dental group that "integrates advanced health with cosmetic dentistry." He also founded and chairs C. S. Bioscience, Inc., a dental biotech company which markets a nutritional-homeopathic toothpaste called Revitin.
  • Dave Wentz, the chief executive officer of USANA, a multilevel company that sells dietary supplements and is a major donor to Oz's HealthCorps foundation.
  • Jonathan Levine, D.M.D., who teaches at NYU's dental school and practices aesthetic dentistry.
  • Dana, an unidentified woman who claimed she had suffered from and been treated for mercury toxicity.
 

The wall behind Oz, which was visible during much of the broadcast, displayed the words "TOXIC TEETH" in large letters. Oz made a pretense of balance by mentioning that the American Dental Association says that amalgam is safe—and at times he used subtle phraseology to soften what he was saying. But the program's clear message was that amalgams are sufficiently risky that all people who have them should take immediate steps to protect themself.

Oz's message was way off the mark. Amalgam fillings are safe, inexpensive, and durable, and there is no logical reason to fear them. The best indication of safety is the fact that dentists who are exposed to mercury dust when they drill out old fillings have no higher rate of any disease and have the same death rates as others in the same socioeconomic strata.

Here's a transcript of the show with my comments in brackets.

Dr. Oz: Our show today concerns every one of you watching who's ever had a cavity filled, because if your filling is made with silver, it probably also contains the highly toxic element mercury. How toxic? This thermometer contains mercury. If I were to drop it, we would have to evacuate this entire studio immediately. So why are dentists still putting fillings containing mercury in your mouth? If they're already there, could your fillings be poisoning you and making you sick? [The Environmental Protection Agency recommends that people not involved in cleaning up a spill leave the room in order to avoid any mercury fumes that are given off. However, thermometer spills are easy clean up and pose no risk when properly managed. More important, the liqud mercury in thermometers differs from the mercury in amalgam that is bound to the other ingredients. Contrary to the impression Oz and his guests attempt to create, theamalgam fillings pose zero risk of toxicity.]

They're called amalgam fillings, and more than a hundred million Americans to date have had them in their mouths. They're made of silver and other metals, but it's mercury that binds these fillings together and keeps them sturdy. Dentists have been using mercury in dental filings for more than 150 years. But are they safe? It's a question that first sparked firestorm 30 years ago when major news reports brought to light the potential toxicity of mercury fillings. [During this passage, four headlines showed on the screen. The first one—"Mercury in fillings may have a toxic bite"—was a newspaper article generated in 1990 by an unfounded lawsuit filed by anti-amalgam dentist David Kennedy against the American Dental Association and others. Three months later, the judge granted the ADA's motion to dismiss the suit.]

The concern, that these fillings may cause serious health problems from memory loss to mood swings, anxiety, even autoimmune disorders. [There's no scientific evidence that they do.] The American Dental Association insists your fillings are safe, but now there's mounting new evidence showing mercury is released when you eat and drink and even when you brush your teeth. [The fact that mercury is released from fillings has been known for decades. It is not new. The question is whether the amount is significant. It is not.] According to one report, half of dentists surveyed no longer use them. And, if they're inside your mouth, what should you do? [The correct answer is nothing.]

I want everyone to take and look in the mirror right now and if you see these silver-, gray-, or even black-colored fillings in your teeth, that means you have mercury amalgams. I need you to pay attention to this show. Joining me is integrative dentist, Dr. Gerry Curatola. He has not used silver fillings containing mercury in over 20 years. Also, Dr. Jonathan Levine is an aesthetic dentist and a member of this show's advisory board. He has not used fillings with mercury in over 16 years. The American Dental Association says fillings containing mercury are safe and post no health threat. Dr. Curatola, you argue they have got it all wrong. Why is that?

Dr. Curatola: This one of the most hotly contested conversations going on in dentistry today. [I haven't seen any evidence that amalgam use is hotly contested. Not everyone uses amalgam, but the scientific consensus is that they are safe.] And everyone really deserves to know the facts. There is an ongoing, growing body of research that has shown that mercury from silver fillings can be hazardous. [I don't believe that.] So it's a conversation that really needs to move forward and not to stay in the past.

Dr. Oz:: So how much dental amalgam is too much? I showed the audience images of what these look like. Is there risk to having one filling that's with this amalgam . . . or ten?

Dr. Curatola: So we really don't know how much is dangerous. And this is where there's not enough controlled studies but more need to be done. The reality is that the more fillings you have, mercury vapor comes out. [Correct, but the amount is trivial and harmless.] When I was in dental school, they used to believe . . . In 1982, the ADA was saying that the mercury is locked in, magically locked in the filling. But we know now that there is mercury vapor. It's acknowledged. [I don't believe the American Dental Association ever said that none comes out.] We just don't know how much really makes you sick.

Dr. Oz:: So walk me through the types of symptoms that folks who believe they have poisoning from mercury in their amalgams might be experiencing. I know there is some research on people who've actually had them removed showing improvement in these areas. [These findings were generated by poorly designed research. Well designed research has found no relationship between amalgams and symptoms.]

Dr. Curatola: That's correct. Mercury is one of the most neurotoxic—that is, damaging to our nervous systems—on the planet. It also suppresses the immune system. So you have autoimmune disorders, fatigue, memory loss, migraines, even skin problems like psoriasis and eczema that have been linked in different studies to toxic exposure to mercury. [These problems are caused by exposure to toxic mercury compounds, but this has nothing to do with amalgam.]

Dr. Oz:: I know in medical school we're talking about classic mercury poisoning. Those are mostly neurologic. Can you walk me through the things that no one can argue could be related to mercury poisoning?

Dr. Curatola: Tremors, memory loss, focus, inability to concentrate, these are the most damaging. It's really extremely toxic to the central nervous system. [Again, these problems are caused by exposure to toxic mercury compounds, but this has nothing to do with amalgam.]

Dr. Oz:: So there are lots of alternatives now to fillings. There are many things dentists could be doing to avoid exposure to themselves. Why is it that so many traditional dentists are still putting in these silver amalgam fillings? [Because they are safe, economical, and long-lasting.]

Dr. Curatola: You know, I'm amazed that 47% of the dentists in the United States are still placing amalgam restorations. . . . They're very inexpensive to do. They're easy, they're cheap, and we know that they've lasted in the mouth for a very long time. There are probably viewers right now who've had silver-mercury fillings for 20 years or more. [I have had some for more than 60 years. Incidentally, it's been shown that the amount of mercury vapor given off decreases as fillings get older.]

Dr. Oz:: I'm one of them. I've got my share. [This is not the first time Oz has provided a forum for an amalgam scaremonger. He had Joseph Mercola, D.O. as a guest last year. If Oz believes that amalgam fillings were dangerous, why hasn't he had his removed?] Let me bring in Dr. Jonathan Levine. So John, you argue there actually is not enough evidence, compelling evidence correlating mercury as a major threat to our health, and yet I reported earlier that even you have stopped using them in your practice. [Notice that Oz doesn't ask Levine to discuss why he might disagree with the scare statements presented so far.] Why is that?

Dr. Levine: That's right. I mean we stopped about 17, 18 years ago. There are just so many better restorative options. You're really looking at these white restorative materials that are tooth-colored that actually help to hold the truth together. But the evidence is conflicting and there are questions about the science behind it.

Dr. Oz:: Let me challenge you. There are some countries in Europe for example that have banned the use of amalgams. I mean they wouldn't do that arbitrarily. It is a very commonly used world-proven technique. [Oz's "challenge" is not much of a challenge. The program as a whole is set up to dramatize alleged danger and to encourage viewers to distrust the American Dental Association and dentists who use amalgam.]

[Commercial break]

Dr. Levine: That's exactly right. In the Scandinavian countries, in 2008 they banned amalgams because of environmental and health purposes. [It was not done for health reasons. It was done to limit thepossible environmental impact of mercury waste getting into the water supply.] Now environmental is when you take out amalgams, and that's when the most amount of mercury is released. It can be into the water supply. There are also were a number of studies that came out of Sweden that really showed some health risk with the mercury coming off the amalgam and offering up all of these problems that Dr. Curatola is talking about. [The problems Curatola mentioned were "autoimmune disorders, fatigue, memory loss, migraines, even skin problems like psoriasis and eczema." Levine says that no toxicity has been proven. So why does Levine endorse what Curatola has said? Regardless, there's no scientific evidence of any such risk.]

Dr. Oz:: Walk me through exactly how the mercury gets out of the amalgams. I mean we talked about this vaporization that was not known that it existed a few decades ago.

Dr. Levine: That's exactly right. So whenever the amalgam starts to wear—any type of contact—so imagine chewing, people who grind their teeth, people who have other factors that increase the amount of mercury vapor coming off, the amount of amalgams in your mouth, how old are they. You know, when they get older they corrode and the breakdown of that mercury vapor comes out much greater. Do you grind your teeth for a long period of time? Do you have carbonated sodas, which lowers the pH in the mouth and increases the amount of mercury? So there are number of factors that actually can accelerate that amount of mercury but they just haven't tested it enough to correlate it with these medical issues.

Dr. Oz:: So I was doing my own homework on this, and mercury vapors rising out of the teeth, they're invisible to the eye. No one has ever seen them. But for the first time on television, for the first time ever, I'm going to show you what happens when you brush your teeth with mercury fillings. I'm going to get some help from a friend, Dave Wentz. I worked with Dave and his Ph.D. dad a long time. Their company are big sponsors of HealthCorps, which is the Children's Health Foundation. We were doing a program together, and I witnessed you do this demonstration with your father, it just blew me away. I want you to bring it alive on stage today. So if you could, show us how this monitor and this little contraption you built can reveal to us what happens when we brush our teeth. [Wentz's company, USANA, is a major donor to Oz's HealthCorps (a nonprofit foundation). Oz is referring to a demonstration that Wentz did at a conference Oz sponsored in 2012.]

Mr. Wentz:: Okay. Well what we have is a set of teeth with typical silver fillings in them, and we've contained in this glove box with a special air filter to protect everyone in the room so we don't have any mercury toxic element, we don't want it out.

Dr. Oz:: So what's the amount of mercury right now that's in this box?

Wentz: We've ventilated it. We've used the filter to clear it out, so we're at zero now.

Dr. Oz:: Okay. So I'm going to put my hands in the glove. You can run the device.

Wentz: Okay.

Dr. Oz:: Here just to point out, you've built us a mouth here.

Wentz:: Yup.

Dr. Oz:: Can we all see the mouth there? What do you have in there? Those are amalgam fillings?

Wentz:: Yup. We've been told that when you mix mercury with silver, tin, copper, it becomes completely stable. No mercury vapor supposed to be released and we're going to do a little demonstration to show how much is released. [Wentz repeats Oz's "straw man" ploy. It is well known that amalgam releases mercury vapor, but the amount of decomposition is trivial. That's why amalgam fillings usually last for decades.]

Dr. Oz:: So if I brushed for example part of the teeth that don't have any mercury like here, that shouldn't be a problem?

Wentz:: Yeah.

Dr. Oz:: But you're arguing that if I brush down here—

Wentz:: Yup.

Dr. Oz:: Okay, go ahead I'll start brushing now. Now at what point should I be concerned? At what level is it, you know, more than we're supposed to have?

Wentz:: Anything over zero is toxic, so . . . We're at 61. [The statement that anything over sero is toxic is preposetrous]

Dr. Oz:: Oh my goodness, 61?

Wentz:: 61 micrograms.

Dr. Oz:: Now how can anyone dispute that mercury is coming off amalgams? I just . . .

Wentz:: You really can't. You can't. It's happening, and we have the devices. We have the technology to measure that mercury vapor, and we are well above the limits that you would want to be exposed to. That mercury is coming off the fillings in your mouth, going across the blood brain barrier into your brain. [There's no dispute abut the fact that amalgam gives off mercury vapor. However, the amount is trivial and poses no health threat whatsoever.]

Dr. Oz:: Thank you very much. And I saw this the first time and I could not believe that it actually was revealing something that we've been disputing. You know, this is a science experiment, but it does conclusively to me anyway demonstrate that we do shed gas off.

Wentz:: Absolutely.

Dr. Oz:: Mercury in ways that we don't want to brush our teeth. Of course normally, we don't measure in the air in your mouth, although it's concerning that numbers you're not supposed to have in the air are found in your mouth in high doses.

Wentz:: Yeah, close space in your mouth.

Dr. Oz:: . . . . Urine oftentimes is how you would measure the amount of mercury. So I've got a guest here who actually believed that she had mercury toxicity from her amalgam filling. Dana, thank you for joining us. How are you?

Dana: Hi. Nice to meet you.

Dr. Oz:: You can come on down. . . . So I'd love to hear your story. I'm intrigued by this because so many of us have amalgam fillings. So what made you believe . . . Actually what were your problems to begin and then what made you believe that mercury fillings were the cause of them?

Dana: . . . . When I was younger, I had about 15 mercury amalgam fillings placed in my mouth. And as I got older, I started to have terrible tremors, hand tremors. I couldn't concentrate, and I thought I was losing my memory. I know it sounds crazy.

Dr. Oz:: By the way I hear these complaints from a lot of people, but they just don't know why they're happening, which is why I'm so curious about this as a potential cause. [If Oz is really curious, why doesn't he conduct a proper investigation? He could begin by asking some of the "lots of people" to send him their medical records, which he (or another physician) could examine for evidence that they their urine mercury levels reflected toxicity.]

Dana: Right.

Dr. Oz:: So how did you actually identify that you had mercury in your body? Did you do any of the tests that are available for that?

Dana: Yes, I did some urine testing.

Dr. Oz:: And you had high levels of mercury?

Dana: Yes. [Did Oz look at Dana's medical records? If so, did a test report from a trustworthy laboratory state that her urine levels reflected mercury toxicity?]

Dr. Oz:: Did you have amalgams removed?

Dana: I had them removed, yes.

Dr. Oz:: So then what happened?

Dana: Some of my symptoms went away immediately. Other symptoms have taken awhile to dissipate. I'm still working on them.

Dr. Oz:: Are you happy that you had the amalgams taken out?

Dana: Oh, yes. I would do it again in a heartbeat.

Dr. Oz:: You would do it again?

Dana: Yeah.

Dr. Oz:: All right. So despite the growing controversy about mercury and amalgam fillings [There is no "growing controversy.] , the official position of the American Dental Association is still that they are harmless. Again this is a very strong group, they've done many wonderful things, so I wanted to hear from and here's what they said. [What a faker! If he really wanted to hear from them, he would have invited a spokesperson to appear on his program. All he really wanted was to get a statement from them so that he could pretend that he was covering "both sides" of the "controversy."] They said dental amalgam is considered a safe, affordable and durable material that has been used to restore the teeth in more than a hundred million Americans and has established a record of safety and effectiveness. So coming up, if you're concerned about what you've heard so far, maybe asking should I have my mercury fillings removed, the answer will truly surprise you. That's next.

{Commercial break]

Dr. Oz:: We made the case that mercury in your fillings could be toxic and harmful for your health, which leads to the question that everyone watching should be asking: Should you have your mercury fillings taken out? Dr. Jonathan Levine and Dr. Gerry Curatola are back with us. So Dr. Levine, what's your view? Should everyone go out there and start getting their amalgams taken out?

Dr. Levine: Absolutely not. I mean it's all about the conversation that you're going to have with your dentist. If your restorations are old, there is potential decay underneath, the dentist has found out that there's decay under a radiograph, there's a space or a gap between the silver and the tooth and there's structurally something wrong with the filling, well then there's a rationale to change that filling. But when you're putting the material back in to restore, we really have better alternatives than amalgam that are safe.

Dr. Oz:: Dr. Curatola, do you agree?

Dr. Curatola: I totally agree. What everyone should know is that taking the fillings out also exposes you to the highest level of mercury vapor. So there are specific conditions that you should talk to your dentist about. Obviously number one is decay, leaking margins, corrosion on old fillings. [What a strange suggestion. If fillings are failing, dentists will detect this during their periodic examinations and advise patients accordingly. They do not need prodding.] And then there are the others. If they have eight or more fillings, they maybe want to have that conversation. [Levine said nothing about extra concern or removal if a person has eight or more fillings.] They grind, they grind their teeth, they eat acidic foods, sodas, things like that, can increase the amount of vapor that's being emitted from the amalgam fillings. [But they don't raise the levels high enough to justify the slightest concern.]

Dr. Oz:: All right. Dr. Levine, what are the best alternatives when you get that mercury amalgam removed, or if you have a cavity instead of using a mercury amalgam?

Dr. Levine: So if you're taking out the silver filling, the direct restoratives composite, which are, tooth-colored restorative materials is using adhesive dentistry and you're actually bonding the tooth together so the tooth is actually stronger. With silver, it's wedge technique, and you're actually putting stresses on the tooth. So using composites doesn't have any potential health risk. It's actually a better material. There's also laboratory fabricated restorations that can be done in porcelain and this new ceramic that allow us to do a very conservative tooth preparation but also to restore the tooth and to structurally improve the tooth, so that again is a big advantage.

Dr. Oz:: . . . . For everybody who doesn't know what these are, like this is a porcelain-restored tooth compared to a silver filing. You can see how the silver filling is pushing the tooth part and the porcelain pulls it back together again. I would gather that part of this debate is about money and the fact that these amalgams are a lot less expensive. So walk me through the cost differences for the average consumer.

Dr. Levine: So for the composite resins, they're about 20, 25 percent more expensive than the silver fillings. For the laboratory process type restorations where you take an impression of the tooth and you're fabricating that in the lab and at a second appointment to cement and to bond them in, it usually can be anywhere from $1,500 to even greater depending on where you live.

Dr. Oz:: So money is an issue. So let me leave you all with my bottom line. I believe based on what we know about the toxicity of mercury and the risks for mercury vapors from the fillings that contain it that we should avoid using dental amalgams whenever possible. There are safer alternatives that work just as well and last just as long. [It has not been established that the alternatives are safer.]

[Commercial break]

Dr. Oz:: We're back with integrative dentist Dr. Gerry Curatola. He says there are three simple things you could do starting today to protect yourself if you have silver dental fillings. I want to remind everybody, talk to your dentist about having amalgams removed if you have eight or more fillings, corrosion or decay, or some of the symptoms of mercury toxicity that we've been talking about in this show. [What rubbish. People with the symptoms discussed during the show should not discuss them with a dentist. They should consult competent physician.] Dr. Curatola, how about for the rest of us? If you feel fine, if you don't have eight fillings, what do you do to reduce the risk of having even a little bit of mercury in your body?

Dr. Curatola: You know, Dr. Oz, there's a hundred million Americans out there with silver fillings that may be stable, but there are some simple things you can do to reduce the amount of exposure from the vapor that's coming off of these fillings.

Dr. Oz:: So like step number 1, which is to not brush your teeth anymore. No.

Dr. Curatola: [Laughs]

Dr. Oz:: We have to brush our teeth

[Crosstalk]
But first you offer that we can avoid acidic foods.

Dr. Curatola: Right.

Dr. Oz:: Which are interestingly more effective at leaching out the mercury.

Dr. Curatola: Now these are tomatoes, grapefruits, wonderful, but the acidic content of these has been shown to increase the amount of mercury vapor coming off the fillings. Same thing with vinegars and America's favorite beverage, coffee, which is not only acidic but it's hot. And so my advice is use a straw. [So is Curatola—with Oz's blessing—advising viewers to stop eating tomatoes? Has Oz stopped eating tomatoes?]

Dr. Oz:: Straw?

Dr. Curatola: Simple straw. Sodas, coffees, a straw.

Dr. Oz:: Will you all use a straw from now on? I mean just in case. Plus it helps with the color of the teeth anyway. [If Oz drinks soda or coffee, do you think he will use a straw?]

Dr. Curatola: Absolutely.

Dr. Oz:: All right. And next up you've got a one-two punch, and this is something you love garlic and cilantro. I can think of a lot of recipes with these.

Dr. Curatola: This is my favorite area. These are such great nutritionals for the body for many different reasons. Garlic purifies the blood. [What a dumb statement. "Purification" is not a medical term or body process. Why doesn't Oz challenge its use?] It actually helps eliminate mercury through the kidneys. Cilantro is a wonderful herb. It also purifies, it binds to heavy metals in the body. Cilantro is great salad. I love to make a pesto out of both of these. [I'd sure like to know what studies show that garlic and cilantro can cause mercury to be excreted.]

Dr. Oz:: It has a little bit of soapy taste to it. That's what my kids tell me but I actually like the taste, and it is probably the best natural product we can use to detoxify ourselves. [Detoxification is done by the liver. The idea that people need to take substances to detoxify themselves is quack nonsense.] But there's something else that is probably the best detoxifier of all. It's called a chlorella supplement. We don't normally eat this in its raw form but you can take it in a supplement. Walk us through It.

Dr. Curatola: I love chlorella. It's a fresh water algae. . . . It's one of the richest sources of chlorophyll, and chlorella eliminates mercury through the intestines.

Dr. Oz:: Right.

Dr. Curatola: So chlorella supplements, I would recommend them. I think this is one of the best nutritional supplements for people with mercury fillings.

Dr. Oz:: And where do you find them?

Dr. Curatola: Any health food store.

Dr. Oz:: Easy to find.

This article was revised on April 9, 2013.