Avoiding Toxins

Laser + Holistic Dental avoids the use of many materials used in traditional dentistry due to both the possibility of negative health and environmental impacts. Please use read through this page to review the scientific literature and understand our rationale behind avoiding the following:

Mercury
For at least 150 years dental clinics have used the ‘silver’ amalgam fillings to treat teeth that have become decayed and damaged. Dental amalgam, is made of about 50% of one of the most potent toxins known to man – the heavy metal mercury.1

Dental amalgam, is made of about 50% of one of the most potent toxins known to man – the heavy metal mercury.

Dental amalgam manufacturers provide hazardous warnings to the public about the risk of consumers being exposed to mercury from their product as well as the adverse effects to our environment and dental workers.The following is taken from an official amalgam manufacturers safety data sheet.

“Inhalation of mercury vapours, dusts or organic vapours, or skin absorption or mercury over long periods can cause mercurialism. Symptoms include tremors, inflammation of mouth and gums, excessive salivation, stomatitis, blue lines on gums, pain and numbness in extremities, weight loss, mental depression, and nervousness. Exposure may aggravate kidney disorders, chronic respiratory disease and nervous system disorders. May cause damage to blood, kidneys, liver, brain, peripheral nervous system, central nervous system. Other adverse effects: Very toxic to aquatic organisms, may cause long-term adverse effects in the aquatic environment.”1
Measuring exposure to mercury is difficult, yet it is well documented through autopsy studies that humans with dental amalgams placed have toxic levels of mercury in their brains and/or kidneys.2

it is well documented through autopsy studies that humans with dental amalgams placed have toxic levels of mercury in their brains and/or kidneys.

These studies found that the average mercury levels in the brain for those with more than 12 amalgam fillings was at least eight times above levels considered to be neurotoxic.2
In Germany the neurotoxic action of mercury and associated pathological changes in the brain were found to be typical of Alzheimer’s disease.2
This also poses great risk to children, especially in utero and for new borns, as there is a correlation between the number of maternal amalgam dental fillings and the mercury levels in fetal tissue, infant tissue and breast milk.2
Dental amalgams account for 60-95% of mercury deposits in human tissue, yet there is no correlation between mercury blood and urine levels and actual mercury levels in the body tissue.2
This is due to the fat soluble nature of mercury, which is why it is often found concentrated in neurological tissues. Mercury bioaccumulates, and has been shown to have a half life in the brain of decades.3

Unfortunately dental clinics are the major source of mercury pollution going into waste water.4
This toxic waste ends up into the natural water tables and oceans, where it then enters the food chain and is converted into the more toxic methylmercury, concentrating as it climbs up the food chain back to the fish you might eat for dinner. Dental amalgam also causes environmental harm through incineration of industrial waste, human cremations and burials, and general release of mercury vapour into the air.4
The widely documented environmental dangers of mercury have led to a United Nations initiative to phase out mercury based products world wide. This initiative has been named the Minamata Convention and is currently under negotiation. All of our dentists at Laser + Holistic Dental are members of Australians for Mercury Free Dentistry and believe that all mercury based dental products should be immediately phased out due to health, occupational risk and environmental concerns. At Laser + Holistic Dental we follow strict mercury removal protocols to protect you, our staff and the environment – which you can learn more about here.

Nickel
Dental appliances, including dentures, crowns and orthodontic wires and brackets often contain nickel, cobalt chromium and other transition metal alloys. Nickel sensitivity is an increasing problem with exposure causing auto immune issues and has been found that in high doses nickel is also a known carcinogen.5
Nickel sensitivity is one of the most common causes of contact dermatitis with a large portion of the population being susceptible.6 In extreme cases nickel found in dental oral appliances and wire braces can cause severe lesions to the gums, tongue, inside of the mouth and other mucosa tissue.7Other common metals in dentistry such as chromium, gold and cobalt are also allergenic, but with a far lower prevalence compared to Nickel – hence it being voted 2008 ‘Allergen of the Year’ by the American Contact Dermatitis Society. 7

Research has found that for patients who had orthodontic treatment using nickel based products there was a significantly higher rate of nickel allergy when compared with who had not had this type of treatment, suggesting that consistent exposure to nickel in this way can have considerable health implications.8 For these reasons there is growing scientific concern about dentistry exposing patients to nickel, and recommendations that dentists should be testing patients to assess risk for nickel allergies.9

At Laser + Holistic Dental we avoid this risk all together but not using nickel based products in any of our general dental and orthodontic services.

Titanium
Another metal that is gaining widespread use for dental and surgical procedures is titanium. Titanium orthopaedic and dental implants are often the most common option available. As with other transition metals, there are a group of people who are adversely reacting to titanium and titanium oxide – which is commonly used as white pigment. Exposure to titanium can occurs whether it is in surgical implants, toothpaste, processed foods, cosmetics, jewellery, sunscreen and white pigments. The symptoms and signs of an allergic reaction to metals used in dentistry can manifest both in and around the mouth as well as other parts of the body, especially the skin and gastrointestinal tract.
Symptoms of metal allergy can manifest as the following conditions:10

  • a burning feeling in the mouth
  • a tingling feeling in your tongue
  • dry mouth
  • ulcers on the mucous membrane
  • hair loss
  • skin rash
  • gingivitis, gum bleeding
  • inflammation of the skin around the mouth
  • a sour, metallic taste
  • tiredness
  • slightly high body temperature

Immunologists classify metal allergy as a Delayed -Type IV hypersensitivity reaction or cell-mediated immune memory response, antibody-independent or contact allergy and is by far the most frequent type of allergy. It occurs after exposure to allergens for between ten days and several years. Type IV sensitization is induced by repeated contact of an allergen with skin or mucosa. Prolonged exposure to metal allergens has been related to the onset of a host of autoimmune conditions and multiple chemical sensitivities.11,12
Further research studies demonstrate that removal of titanium implants acting as metallic allergens led to the reversal and improvement of the patients health after suffering symptoms such as muscle, joint, and nerve pain, chronic fatigue syndrome, neurological problems, depression, multiple chemical sensitivity, dermatitis, and acne-like facial inflammation.13
Clinical results have shown the metal free alternative material of zirconia implants to be successful even in patients that have previously shown signs of titanium allergies.14 For this reason Laser + Holistic Dental only uses zirconia implants as a durable, natural looking, cost effective alternative which you can learn more about here.

Fluoride
Here in Australia, almost 80% of our public water supply has been fluoridated in the hope that this would result in better dental health. 60 years later since broadscale artificial fluoridation of water was introduced, our nation still has an embarrassing oral health crisis across a large portion of the population. The dental benefit that public water fluoridation was supposed to provide has been disappointing. The majority of western countries have never fluoridated their water supply. A World Health Organisation study in 2012 compared the incidence of decay rates in 12 year old children in countries that had never fluoridated their water eg Japan, Belgium, Italy, Iceland and found that these children have similar decay rates to Australians despite our fluoridated water supply.15
Incidence of dental decay30 years ago it was established that the use of fluoridated toothpaste was proven more effective than fluoridating water supplies in reducing the prevalence of dental decay once the mechanism of how fluoride was integrated into the tooth surface was identified. In the July 2000 issue of the Journal of the American Dental Association it was reported that “fluoride incorporated during tooth development is insufficient to play a significant role in caries protection.”16 The Centers for Disease Control affirmed this position in 2001, that “fluoride’s predominant effect is posteruptive and topical. Fluoride prevents dental caries predominately after eruption of the tooth into the mouth, and its actions primarily are topical for both adults and children.”17There has been controversy and concerns raised about the health and environmental impact of fluoridation of water supply because of fluoride’s tendency to bioaccumulate in body tissues over time and it’s repeated implication in brain, thyroid, kidney, reproductive, bone, joint and teeth disorders. In a review of the literature commissioned by the US Environmental Protection Agency (EPA), fluoride has been listed among about 100 chemicals for which there is “substantial evidence of developmental neurotoxicity.”18British scientists published a study in February 2015, showing that fluoridated water in Britain is associated with elevated rates of hypothyroidism.19 The relationship between fluoride and thyroid conditions has been known for a long time. Last century, fluoride was in fact prescribed as an effective medication for hyperthyroidism to reduce thyroid activity. Because all metabolically active cells require thyroid hormone for proper functioning, thyroid disruption can have a wide range of effects on virtually every system of the body. Chemicals that interfere with thyroid function must be treated with great caution – which is one of the reasons we avoid fluoride at Laser + Holistic Dental.Fluoride concentrates in the mineralized hard tissues of the body and also targets the kidneys, bladder and pineal gland. In children with dental fluorosis, caused by excess fluoride exposure, a correlation has been found between dental and skeletal fluorosis and kidney disease.20 By the start of the 1980s dialysis units had installed filtration equipment to remove fluoride as it was identified that the fluoride in the water caused worsening of the patients severe renal disease and the serious complication of osteomalacia (softening of the bones).21dental fluorosis 1
Other bone conditions associated with fluoride exposure are arthritis, fractures, skeletal fluorosis and the cancer osteosarcoma. Several human epidemiological studies have found an association between fluoride in drinking water and the occurrence of osteosarcoma (bone cancer) in young males.22 Research conducted at Harvard found that young boys had a five-to-seven fold increased risk of getting osteosarcoma by the age of 20 if they drank fluoridated water during their mid-childhood growth spurt (age 6 to 8).22Another grave concern about the practice of artificially fluoridating water supplies is that the source of fluoride is a hazardous industrial waste product from the fertilizer industry that is laced with the carcinogenic heavy metal contaminant arsenic.23 Furthermore, there is no monitoring of exposure to fluoride levels in the citizens who are living in fluoridated communities to check on any adverse side effects.It is ironic that the recommendation of using fluoride to reduce dental decay has infact created another serious dental condition specifically known as dental fluorosis which is a permanent and often cosmetically disfiguring state of yellow and white blotches of the mineralization in the adult teeth. Dental fluorosis may also be an indication that fluoride may be impacting on other developing tissues. Chinese and Indian studies confirm that in areas of naturally high levels of fluoride the first indicator of harm is dental fluorosis in children.24 In the same communities many older people develop crippling skeletal fluorosis with fluoride levels below 1ppm which is equivalent to the concentration of artificial fluoridation doses.24Fluoride has a history being used for medical and dental purposes with harmful results. The British Government’s York Review estimated that up to 48% of children in fluoridated areas worldwide have dental fluorosis in all forms, with 12.5% having fluorosis of aesthetic concern.25 Clinical trials were conducted using high doses of fluoride to treat osteoporosis in post menopausal women, which ironically led to an increase in the serious complication spinal and hip fractures.26Today we have a situation that our community is now being overexposed to fluoride as a legacy of decades of fluoridation of our public water supply. Every plant, and animal that grows in fluoridated regions concentrates the fluoride due to its bioaccumulative nature within our food chain. Exposure from other sources has increased as well. Other sources include processed foods made with fluoridated water, fluoride-containing pesticides (eg cryolite), tea leaves, fluorinated pharmaceuticals and teflon pans. The dental industry provides numerous fluoride added products for home use in addition to the spectrum of slow releasing fluoride-added dental filling materials. It is now widely acknowledged that exposure to non-water sources of fluoride has significantly increased since the water fluoridation program first began and overexposure is a real problem.27 It has taken 50 years for the USA Department of Health and Human Services in 2011 to review and recommend that the concentration of water fluoridation programs be reduced to 0.7ppm to compensate for the elevated levels from other sources.28Our current Australian experience is that there is no concession in Dental health policy to adjust fluoridation levels in line with the trend of other nations who have either stopped fluoridation or have at least reduced the concentration of fluoride in their public water supply. The current National Oral Health Plan for Australia 2015-2024: Healthy Mouths, Healthy Lives, recommends that communities with populations of over 1000 people should have access to fluoridated water supplies – a concerning proposition given the evidence against water fluoridation.29At Laser + Holistic Dental, we exercise the precautionary principle and choose not to use fluoride added products such as toothpastes, mouth rinses, dental filling materials and we even have reverse osmosis water filters fitted centre wide so our water is fluoride free.

BPA
Human exposure to the chemical Bisphenol A (BPA), should be of concern as it’s a known endocrine disruptor that may contribute to physical and neurological problems during early developmental stages in a person’s life.30 Research has also shown BPA to interfere with proper thyroid function and also possibly be carcinogenic.31BPA was introduced to our culture in the 1950s sparking the “plastics revolution”. This ubiquitious chemical is bioaccumulative and since the 1930s has been classified as a xenoestrogen because of its capability to interrupt the network that regulates the signals which control the reproductive development in humans and animals.32Available data from extensive biomonitoring studies of thousands of people in many different countries clearly indicate that the general population is exposed to BPA and is at risk from internal exposure to BPA. Scientists reviewed 80 published human biomonitoring studies that measured BPA concentrations in human tissues, urine, blood, and other fluids, along with two toxicokinetic studies of human BPA metabolism. These studies overwhelmingly detected BPA in individual adults, adolescents, and children.33The negative impact of BPA on our environment should not be overlooked. BPA levels are detected in waterways, air and animals. BPA is one of the high volume chemicals produced worldwide with greater than 8 billion pounds produced each year and more than 100 tons released into the atmosphere each year by yearly production.33 Animal tests of mammals, fish and birdlife show that BPA is an estrogen-like chemical that causes negative reproductive and developmental effects.33We are directly exposed to BPA mainly through dietary and skin absorption of plastic products such as canned foods with a plastic coating and plastic bottles containing beverages. Touching receipts, even handling our plastic money will rub off some BPA into your skin. Of even greater concern is that maternal stores of BPA pass through the placental barrier and also enter into breastmilk in the developing baby.34, 35, 36During the “plastics revolution” sixty years ago, saw the advent of Mercury free alternatives to amalgam fillings becoming available. The development and use of “white” resin fillings means dental patients, dental workers and the environment are no longer exposed to mercury with the additional bonus of a more natural looking filling for the patient. Dental composites are materials consisting of an organic resin matrix that reinforce inorganic filler and a silane-coupling agent. Originally the white fillings were made from polymers derived from plastic derivatives containing the chemical BPA and were not very strong. Dental sealants used in paediatric dentistry were found to be leaching BPA.37 Today BPA free filling alternatives are available that are durable, cost-effective and natural looking.In 2008, the International Academy of Oral Medicine and Toxicology (IAOMT) undertook a laboratory study of BPA release from a range of commercially available dental composites under human physiological conditions: 37º C, pH 7.0 and pH 5.5. The dental materials used at Laser + Holistic Dental were supplied to be included in the study for independent testing. The results confirmed the biocompatibility and minimal exposure to BPA from the dental filling materials selected for patient use at Laser + Holistic Dental.Laser + Holistic Dental would also like to point out that other dental products are BPA free such as Invisalign aligners and Vivera Retainers do not contain Bisphenol-A or phthalate plasticizers. These aligners and retainers are made with USP Class VI medical grade, high molecular weight, polyurethane resins. Tests have been conducted to determine the biocompatibility of these materials, and show that they are biocompatible and pass all applicable regulatory requirements and thresholds for human wear in the mouthOther measures that Laser + Holistic Dental have undertaken to reduce our direct and environmental exposure to BPA is choosing plastic alternatives such as glass, ceramic containers and paper products from sustainable sources.
Latex
The occurrence of latex allergy within our community is a relatively fairly recent phenomena. There are very few research studies conducted to evaluate the prevalence of this condition. More and more people are becoming affected by latex allergy, especially in the healthcare sector.38 Latex allergy can be a potentially life-threatening reaction so much so that it is now standard procedure for all dentists to screen their patients to identify prior to treatment if their patient has been diagnosed as allergic to latex.Latex or natural rubber is the substance obtained from the sap of the Hevea brasiliensis tree. After the addition of preservatives and stabilisers, it is dipped into a mould, then heated and dried. During manufacturing, chemicals are added to render latex elastic and stable to heat by vulcanisation (heating in the presence of sulfur). Further chemicals are added for strength and durability, including mercaptobenzothiazole, thiurams and carbamates. Sometimes a dry powder lubricant (usually corn-starch, or talcum powder) is added to the surface of the latex to prevent the rubber surfaces from sticking together. Allergic reactions can occur to latex protein as well as the chemicals added to it.39There is a spectrum of adverse reactions from being exposed to latex. The most serious is the immediate anaphylactic reaction which is potentially life-threatening (Type 1 allergic reaction) then the delayed Type IV hypersensitivity immunological reaction manifesting as a contact dermatitis. It is thought that this reaction is caused by the chemicals that are used to manufacture the latex product. Another unpleasant and less serious reaction is known as “irritant” contact dermatitis. What immunologists agree on, is that the more one is exposed to latex either by contact or inhalation, the greater the likelihood of developing some form of latex allergy over time. Avoidance of latex products is the best and only strategy available at this time to manage latex allergy and to be prepared should a health emergency occur.Below is a list of some products that use latex including those used in delivering dental services, especially root canal fillings, oral surgery and orthodontics.

  • Gloves
  • Gutta Percha/Gutta Balota (used to seal root canals)
  • Dental dams
  • Orthodontic elastics
  • Blood pressure cuffs
  • Stethoscope tubing
  • Bandages
  • Dishwashing gloves
  • Balloons
  • Erasers
  • Rubber bands
  • Condoms
  • Baby bottle nipples

Interestingly, people may not be aware that their ‘allergic” symptoms and food intolerances to may actually be the presentation of symptoms triggered from exposure to latex. Common symptoms include: hives, swelling, runny nose, sneezing, headache, itchy and red eyes, sore throat, abdominal cramps and asthmatic symptoms.

People who have latex allergy may also have or develop an allergic response to some plants and/or products of these plants such as fruits. This is known as the latex-fruit syndrome. Fruits (and seeds) involved in this syndrome include banana, pineapple, avocado, chestnut, kiwi fruit, mango, passionfruit, fig, strawberry and soy.40 There can also be “hidden latex” in foods. This occurs when food items are prepared by people wearing latex gloves and the residue of latex contaminates the food. Lactiferous plants are another group of substances that can trigger a latex reaction. These are plants that produce a white, milky sap (often poisonous). Many are common household and landscaping plants such as peace lily, anthuriums, caladiums, chrysanthemum, caladium, oleander, allamanda, croton, philodendrum, bergamot, limes, figs, mangos, cashew, and some palms and cacti.41

The dental profession uses many latex based products such as rubber surgical gloves, rubber dam, orthodontic elastics and ties and gutta percha for root canal (endondontically) treated abscessed teeth.42 Fortunately latex alternatives now exist for all of these products and Laser + Holistic Dental has introduced all of these into the clinic as a universal precautionary measure. Natural rubber based dams and gloves have been proven to be less effective at preventing mercury vapour generated from replacing amalgam fillings from passing through, thereby offering less protection for the patient and dental workers from mercury exposure.43 Nitrile ‘rubber’ dam and gloves are not only latex free but provide better protection against mercury exposure and these are used exclusively at Laser + Holistic Dental.

The debate about whether conventional root canal fillings may contribute to the onset of latex allergy is currently inconclusive. When reviewing the scientific research on this topic, there is justifiable concern. It seems that commercial grade gutta percha is regarded as being “inert” but sometimes the form of gutta-balata may be added which can sensitize the latex allergic patient. The dentist or Endodontist would not be aware of this as the source of gutta percha is never defined on the label.44

As with so many issues in healthcare, more research is needed. In the meantime, heeding caution, it is best to choose products and services that are least likely to cause any adverse reactions maintaining a standard of duty of care.

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References
1. Manufacturer Amalgam Filling Safety Data Sheet
2. Is Dental Amalgam Safe For Humans?
3. Persistent Mercury In Nerve Cells
4. The Real Cost of Dental Mercury
5. Nickel Compounds and Metallic Nickel
6. A Study of Nickel Allergy
7. Allergic Reaction to orthodontic wire
8. Nickel Allergy and orthodontic treatment
9. The Nickel Problem
10. Titanium: A Metal Allergen Of Growing Significance
11. Allergological and Toxicological Aspects in a Multiple Chemical Sensitivity Cohort
12. The role of metals in autoimmunity
13. Hypersensitivity to titanium: Clinical and laboratory evidence
14. Full-mouth oral rehabilitation in a titanium allergy patient using zirconium oxide dental implants and zirconium oxide restorations
15. Country Oral Health Profiles
16. The Science and Practice of Caries Prevention
17. Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States
18. Developmental fluoride neurotoxicity: a systematic review and meta-analysis
19. Are fluoride levels in drinking water associated with hypothyroidism prevalence in England?
20. Enamel Hypoplasia in Children with Renal Disease in a Fluoridated Area
21. Exposure to excessive fluoride during hemodialysis
22. Association Between Fluoride in Drinking Water During Growth and Development and the Incidence of Osteosarcoma for Children and Adolescents
23. Treatment Chemicals Contribute to Arsenic Levels
24. Skeletal fluorosis mimicking seronegative arthritis
25. Systematic review of water fluoridation
26. A Randomized Trial of Sodium Fluoride (60 mg) Estrogen in Postmenopausal Osteoporotic Vertebral Fractures: Increased Vertebral Fractures and Peripheral Bone Loss with Sodium Fluoride
27. Fluoride in Drinking Water: A Scientific Review of EPA’s Standards
28. Proposed HHS Recommendation for Fluoride Concentration in Drinking Water
29. Australia’s National Oral Health Plan 2015-2024
30. Bisphenol A in relation to behavior and learning of school-age children
31. Bisphenol A Induces Both Transient and Permanent Histofunctional Alterations of the Hypothalamic- Pituitary-Gonadal Axis in Prenatally Exposed Male Rats
32. Urinary, Circulating, and Tissue Biomonitoring Studies Indicate Widespread Exposure to Bisphenol A
33. Environmental Chemicals Impacting the Thyroid: Targets and Consequences
34. Biotransformations of Bisphenol A in a Mammalian Model: Answers and New Questions Raised by Low-Dose Metabolic Fate Studies in Pregnant CD1 Mice
35. Measuring environmental phenols and chlorinated organic chemicals in breast milk using automated on-line column-switching–high performance liquid chromatography–isotope dilution tandem mass spectrometry
36. Determination of bisphenol A in human breast milk by HPLC with column-switching and fluorescence detection
37. Exposure to Bisphenol A (BPA) from Dental Sealants is Detectable in Saliva and Urine, and Varies Significantly Between Sealant Formulations
38. Latex allergy: prevalence, risk factors, and cross-reactivity
39. Latex allergy
40. ”Latex-fruit syndrome”: frequency of cross-reacting IgE antibodies
41. A word or two about gardening
42. Latex Hypersensitivity: A Closer Look at Considerations for Dentistry
43. Safe Removal of Amalgam Fillings
44. Cross-Reactivity Studies of Gutta-Percha, Gutta-Balata, and Natural Rubber Latex