Part 2 – The Diagnosis and Treatment of Chronic Mercury Toxicity Due to Dental Amalgam.

Ross Mackay, BDS

In the previous article1 I outlined the scientific research into dental amalgam mercury which has to date led us to the following conclusions:

  • dental amalgam is a major source of mercury pollution;
  • dental amalgam releases mercury into intra-oral air in significant pharmacological levels;
  • dental amalgam mercury is inhaled and swallowed;
  • dental amalgam mercury is distributed to body tissues and amalgam mercury can alter cell function.

Continual low level exposure to mercury from dental amalgam leads to an accumulation of mercury in the body. Once the mercury in the tissues reaches a certain level, the patient starts to exhibit signs and symptoms of a syndrome that has become known as Chronic Mercury Toxicity2. This is different in its clinical presentation from acute mercury poisoning, which usually comes about due to a short duration exposure to a high level of mercury vapour.

The purpose of this article is to outline and explore the methods used in diagnosis and treatment of Chronic Mercury Toxicity. This paper is not intended to be comprehensive in its coverage of this topic, but only to give a succinct presentation relevant to our Australian situation.

 

DIAGNOSIS

It must be realised from the start that there is no definitive diagnostic test yet available to determine if a patient is suffering from prolonged exposure to low levels of mercury. Dr. Murray Vimy3, one of the world’s leading researchers into dental amalgam, said about the effects of chronic mercury toxicity that “whether it is a poison depends on each person’s biological sensitivity and shows in different organs”. He also stated that one of the problems of low dose mercury exposure is that it is almost impossible to diagnose it, because at present we have not developed the technology to be able to do this. Consequently, the myriad effects which are outlined in this article are common to many other ailments in our society and have led chronic mercury exposure to be known as the great masquerader – a possible underlying causal factor in many of the diseases we see today.

The major source of mercury, to those not exposed to mercury in the workplace, is dental amalgam fillings. The World Health Organisation, in its Environmental Health Criteria4 publication, showed that the largest source of exposure to mercury is from dental fillings and this exposure could be up to nine times all the other sources combined. Mercury is the most toxic of the heavy metals, being a potent enzyme poison. The fact that there is no known level of mercury exposure below which symptoms have not been reported, means there is no safe level of mercury exposure. So mercury amalgam fillings should be a suspected causal factor if the following signs and symptoms are reported by our patients.

 

MEDICAL HISTORY

Our best diagnostic tools to date are still a comprehensive medical history and clinical examination. Quite a lot of the data about signs and symptoms related to chronic mercury toxicity came from observing victims of two major mercury poisoning episodes this century at Minimata Bay, Japan, in the 1960s, and Iraq in 1972. There are many signs and symptoms which have been found in patients with low level mercury exposure. Dr. Hal Huggins,5 who has spent the last twenty years researching and treating the mercury toxic patient, divides the manifestation of the chronic mercury toxic patient’s symptoms into seven categories.

1. Neurological

Commonly found signs are paraesthesia in the hands, feet and lips; tremors of the hands and feet; convulsions; ataxia; speech, auditory and visual impairment; tinnitus; poor short term memory; headache and insomnia.

Mercury has been implicated in the cause of Myasthenia Gravis like symptoms, Multiple Sclerosis,7 Alzheimer’s disease,9 Amyotrophic Lateral Sclerosis (ALS)6 with remission of ALS8 following removal of amalgam fillings being reported.

2. Behavioural and Psychological Symptoms

Exposure to mercury leads to changes in personality and behaviour which generally occur subtly over a period of time. The changes seen are anxiety, depression, irritability, fits of anger, indecision, timidity, apathy, poor concentration, lack of self confidence and suicidal tendencies.

3. Cardiovascular

Abnormal ECG results have been reported by researchers.10 Bradycardia, tachycardia, arteriosclerosis, chest pains, abnormally high or low blood pressure and unexplained elevation of cholesterol and serum triglycerides.

4. Collagen

Evidence from the Minimata Bay poisoning indicate that chronic mercury toxicity can mimic collagen diseases such as lupus erythematosus, scleroderma and arthritis. Poor wound healing, unexplained haemorrhage, particularly from the gingiva, and periodontal disease have all been reported as signs of mercury poisoning. There has even been a case of remission of periodontal disease following removal of amalgam fillings.11

5. Immunological

The placement of amalgam fillings has been shown to have an adverse effect on T cell count.12 Low level exposure to mercury causes a reduction in proliferation of B cells.13 Also related to chronic mercury toxicity is susceptibility to infections, candida, sinusitis, persistent rhinitis, leukaemia, Hodgkin’s disease, lymphadenopathy, cancer14 and auto-immune disorders.15 It has been postulated that mercury may have a role in auto-immune disease by binding to the sulphydryl groups on proteins, thereby changing their structure, so causing the body to mount an immune response against the proteins.

6. Allergy

Between 1% and 5% of the population are allergic to mercury. Hypersensitivity to mercury may be acquired due to continual exposure, whether the source is from the workplace or fillings. Mercury collects in the GIT16 and so may cause digestive problems such as ‘leaky gut’, allowing foreign proteins into the body, which could lead to hypersensitivity and food intolerances. Dermatitis and unexplained skin rashes are signs, and even cases of oral lichen planus17 have been resolved following amalgam removal. Susceptibility to other allergens, such as dust mite, pollen and chemicals, has also been reported.

7. Other

There are many other signs and symptoms, with the most common being fatigue. Also found are headaches, thyroid dysfunction, low body temperature, cold hands and feet, excessive perspiration with ‘night sweats’, decrease in libido, more frequent urination, nocturia, weight and appetite loss. Gastro-intestinal effects such as poor digestion, bloating after eating, constipation and diarrhoea are also seen. There are also oral manifestations like metallic taste, apthous ulcers and excessive salivation.

As can be seen from the above array of signs and symptoms, chronic mercury toxicity can manifest in many ways, depending on the patient’s biological sensitivity and unique biochemistry. Mercury may act by enhancing our genetic susceptibility to disease or by exacerbating our physiological weaknesses.

OTHER SOURCES OF MERCURY EXPOSURE

When taking a history, it is necessary to check for environmental or workplace exposure to mercury. The workplace is by far the most important factor and the patients must be screened closely to determine their employment history, particularly if they have worked with or in the manufacture of batteries, electrical appliances, laboratory measuring equipment, paint, pesticides and insecticides, mercury mining and processing, fluorescent lights, or if they have worked as photographers, printers, crematorium workers or, especially, in dentistry.

There was a case reported this year in the Australian press of a former dental nurse awarded compensation for the damage caused to her health by exposure to mercury in the dental surgery. She “was eventually forced to quit work in 1981 when headaches, numbness in her limbs and dizziness gave way to blackouts. She now has only 5% vision which she attributes to…mercury”.18

Commonly used products such as mercurochrome, waterproof mascara, contact lens solutions containing Thimerasol, nasal sprays and some vaginal gels contain mercury, so alternatives should be found.

Diet is also a possible source of mercury, due to increased mercury pollution in the environment, concentrating up the food chain. Fish and other seafood have long been recognised as sources of mercury, with the highest concentration confined to species that grow to relatively large size and/or have a relatively long lifespan,19 in particular, large predators such as tuna and shark. The government guidelines recommend that any shark over 18 kilo should not be caught, as it would contain mercury above the accepted safe level. Crustacea which feed on the sea-bed, where pollution tends to accumulate, may also have high levels. At present in Australia, the legal maximum limit for mercury content of fish is one half part per million (0.5 mg/kg averaged over a multiple sample of fish). Fish also contain significant amounts of selenium, which is protective against the effects of mercury, so the intake of seafood may not be as important a factor as once thought. However, the main point here is that patients who exhibit chronic mercury toxicity should avoid old fish, large predators and crustacea.

 

CLINICAL and RADIOGRAPHIC EXAMINATION

A clinical examination will reveal the number of restorations, types of materials used and the effects of any bruxing habit. Radiographs will show any pins or posts, retrograde amalgam20 and any amalgam fragments contained in the gingiva and bone.

Dissimilar metals in an electrolytic solution, such as saliva, will create a galvanic cell, leading to electrolytic corrosion of the less noble metal. Amalgam is comprised of at least five metals and so will self corrode. However, if there is a combination of gold, titanium, palladium and amalgam restorations, then the former three will cause more rapid corrosion of the amalgam, so leading to a greater release of mercury. If the patient’s oral hygiene is poor, then the accumulated plaque on the amalgam fillings create oxygen depleted regions which will more rapidly corrode.

 

ADJUNCT DIAGNOSTIC TESTS

Mercury vapour analysis can be done of the intra-oral air at rest and following chewing, to demonstrate that mercury is released from fillings in significant quantities21 and increases in quantity following oral function. The ‘Jerome Mercury Vapour Analyser’ is an expensive instrument manufactured in the USA, which is able to monitor the intra-oral mercury levels. There are a few practitioners using this machine in Australia, as it really only tells us what has been shown repeatedly in controlled experiments.

Hair analysis can be helpful in analysing a range of deficiencies, excesses and imbalances in the body’s minerals and also can give some indication of exposure to toxic elements. There is some debate over the interpretation of the mercury levels. A higher than average level would indicate an increased exposure to mercury and a low level an average or minimal exposure. Any concentration above 5 parts per million is indicative of mercury intoxication.22 Huggins23 feels now that a low level of mercury in a patient with exposure to mercury and symptoms of chronic mercury toxicity, indicates ‘retention toxicity’. That is, the patient is not excreting mercury effectively, so it is accumulating in the body. Lead levels are of interest, as mercury and lead work synergistically, combining to be more toxic than either singly. Selenium is known to be protective against mercury toxicity, so low Se hair levels would indicate the need for supplementation.

A mercury patch can be worn by the patient for a period of 24 hours to see if any sensitivity reactions or systemic symptoms can be stimulated. Care should be taken and the patch removed if the patient experiences excessive symptoms.

Porphyrin profile test, commonly done for lead poisoning, has now been developed for mercury, utilising technology called High Performance Liquid Chromatography.24 This test is based on the synthesis of heme, which is necessary for normal metabolism by all animal cells. It is a cascade reaction in which a total of six porphyrins are required, with a different enzyme at each step. Heavy metals interrupt this cascade reaction by oxidising one or more of the enzymes. Each heavy metal effects different enzyme combinations, leading to a particular ‘fingerprint’ for mercury. This test is an improvement on dimple urine mercury, because it is based on a biological response to mercury and is specific for mercury. Also, the test response will occur before the onset of symptoms of mercury toxicity and persist for a time after the cessation of mercury exposure which is consistent with the depletion of the body’s mercury stores. This test is unavailable in Australia at present, because of the large capital costs to set up the test equipment.

The urine challenge test for mercury is probably the most informative of the adjunctive tests we have. A chelating drug such as Penicillamine which is used orally, or DMPS used intravenously, bind mercury and other heavy metals and increase their excretion. The patient is asked to give a urine sample prior to taking the chelation drug and another sample whilst the chelator is in the body. This usually shows around a ten-fold increase in urine mercury levels in patients with amalgam fillings, but much less in control patients without fillings. The test can be repeated a period of months after removal of amalgam fillings, which will show a decrease in the challenged mercury level. There has been research which related the decrease in the body burden of mercury with a cessation or improvement in symptoms.25

Galvanic currents between the dissimilar metals in the mouth can be measured using a micro amp meter.26 The significance of this is that the larger the currents, the more mercury will be released. It is known that the average current produced is around 80 times the current levels found in the brain. It is also felt that the currents in the mouth could cause blockages in the acupuncture channels. These latter two could be explanations of why we sometimes see ‘miraculous’ cures, where a patient’s symptoms quickly resolve, following removal of amalgam fillings. The half life of mercury ion the body varies from 70 to 10,000 days, depending on the organ, so very quick resolution of symptoms could be readily explained by mercury sensitivity or toxicity. However, the removal of electric currents from the mouth would immediately remove deleterious effects of these currents on the brain and acupuncture meridian system so enhancing a rapid resolution of symptoms.

TREATMENT

As with treatment of all poisonings, the patient must be removed from exposure to the poisoning agent, so replacement of the mercury-based fillings is integral to the success of treatment. The residual poison must be excreted from the body and this can be enhanced by a variety of means through diet, vitamin and mineral supplementation, homoeopathy, herbs and drug therapy. To describe the sequencing and protocol for successful detoxification of the patient suffering from chronic mercury toxicity, I will explain the procedure before, during and after the removal of amalgam fillings.

Pre-amalgam Removal

The aim prior to dental treatment is to use diet and nutritional supplementation along with other modalities, to enhance the excretion of mercury and to optimise the body’s detoxification mechanisms, so protecting the body from the deleterious effects of mercury exposure during the dental procedures. Many patients suffer from chronic and degenerative disorders which require more evaluation, treatment and monitoring at the pre-amalgam removal phase. This is generally undertaken by a doctor or naturopath and consequently any discussion is beyond the scope of this paper. It must be stressed here that healthy GIT function for adequate nutrient absorption and a properly functioning liver for detoxification and excretion of mercury are essential for success in the treatment of the chronic mercury toxic patient.

Nutritional supplements often need to be tailored for patients, to compensate for deficiencies and sensitivity to any of the following products. However, there is a basic regime of five elements that I use for chronic mercury toxicity and recommend that patients begin this two weeks before treatment.

Vitamin C is prescribed for its antioxidant and heavy metal detoxification qualities. It is a weak chelator of mercury, forming mercury ascorbate which can be excreted. Vitamin C can be titrated to bowel tolerance or, alternatively, use 4 g to 6 g per day in divided doses.

Selenium is an essential trace element which has a special relationship with mercury. Selenium works by breaking the carbon-mercury bond, so there needs to be excess of selenium to set up a process of competitive equilibrium, in which mercury is displaced from its binding sites.27 If this happens in the gut, then mercury is excreted. If it occurs in the body, then the mercury is redistributed to other tissue, organs or to recently ingested sulphur-bearing proteins.27 The displaced mercury can then be transported to the liver by lipoproteins and excreted in the bile. The dosage used here is 200 µg per day to be continued though treatment and for the following three months.

Amino acids containing sulphydryl groups, such as L-cysteine and glutathione, are able to promote the excretion of mercury because of mercury’s affinity for the sulphydryl molecule. N-acetylcysteine has been shown to be protective against mercury toxic symptoms in experimental animals.28 The daily dosage of glutathione is 100 mg/day and of N-acetylcysteine is 1000 mg/day.

Garlic also contains sulphydryl group amino acids, particularly in allicin which is comprised of cysteine. Along with other ingredients such as allyl disulphide and methyl trisulphide, garlic offers an excellent source of sulphydryl chelation agents for escorting mercury out of the intestinal tract.27

Other anti-oxidants, such as vitamins A and E and zinc, are used because of the strong free radical action of the divalent heavy metals such as mercury. Also recommended is a multi-vitamin and mineral formula to address any possible deficiencies.

Dietary advice given to patients will depend on whether they are under concurrent treatment by another practitioner who is monitoring their diet. Any mercury-containing foods, like fish and seafood, should be greatly reduced or removed from the diet, especially the large predator fish and crustaceans, but allowing for fish which are good sources of essential fatty acids, if required by the patient. It is recommended to remove or reduce from the diet, foods which may stress the patient’s biological systems, such as coffee, tea, alcohol, sugar and refined carbohydrates plus any foods to which they are intolerant or sensitive. Foods which are high in the supplements recommended above, should be added to the diet. Selenium is contained in butter, Brazil and cashew nuts, whole wheat bread, garlic, brown rice and cheddar cheese.

H. L. Queen27 recommends the ingestion of one eighth pound (50 g) to one quarter pound (100 g) of butter to supply adequate fat for the lipoproteins which transport the mercury to the liver from where it can be excreted. Also, fat will increase the flow of bile, which is the major pathway for mercury excretion and, finally, butter will stimulate the enzyme LCAT which is necessary to transport mercury out of the body. However, if the patient is dairy allergic, then the butter should be avoided.

Homoeopathics is a modality often used and in the hands of skilled homoeopaths, who may prescribe homoeopathic amalgam, can help ameliorate the signs and symptoms of chronic mercury toxicity.

Herbal medicine also has treatments to offer the mercury toxic patient, by prescribing herbs which give protection to the liver, kidney and neural tissue during the mercury detoxification programme when stress is placed on these organs. For liver protection use one or more of the following: St. Mary’s thistle, 2-3 tablets per day, Tumeric, 2-3 teaspoons three times daily, and dandelion tea at 3 cups per day. To support the kidneys, use cornsilk as tea, 2 cups a day, or as tablets, 2 twice daily and dandelion tea at 3 cups per day. For neural protection use 3 ml to 5 ml of St. John’s wort standard fluid extract.29

Drug therapy is the treatment of choice for acute mercury poisoning and appears to have some value in chronic mercury toxicity. The traditional heavy metal chelators such as Dimercaprol (BAL) and Penicillamine have toxic side effects if used over an extended time, so are neither safe nor effective for chronic mercury toxicity.30 However, Russell Jaffe in the USA proposes the use of Penicillamine as a chelator or mercury on alternate days, along with vitamin and mineral supplementation, thus avoiding the toxic side effects of longer term use. 2,3-Dimercaptosuccinic acid, known as DMSA, is an orally administered chelator which has been reported31 to be effective in reducing the body stores of mercury and, with more research, may prove to be safe and effective therapy for the chronic mercury patient. DMSA may be particularly useful for those patients with a large body store of mercury, who exhibit neurological signs, as it crosses the blood-brain barrier. 2,3-Dimercapto-1-Propanesulfonic acid, or DMPS, is another mercury chelator which can be given orally or I.V. DMPS reported a reduction or resolution in symptoms in patients whose chronic mercury toxic symptoms persisted following amalgam removal. DMPS and DMSA both have fewer side effects than BAL or Penicillamine, with DMSA the drug of choice from the present research. However, neither of these are registered drugs in Australia at present.

Dental Treatment

The aim here is to remove the amalgam fillings, releasing as little mercury vapour as possible, to protect the patient from any vapour and particulate matter that is released and also place a filling material that is compatible with the patient.

The pre-amalgam removal recommendations for supplements and diet are continued throughout treatment. To enhance the anti-oxidant and chelating effect of vitamin C, it is advised to give it in an intravenous infusion just before or during the dental procedures when amalgam is removed. The dosages vary between different practitioners, but we usually administer 30 g.

To minimise the risk of replacing one toxic or sensitising material with another, a biocompatibility test is carried out. In Australia at present this can be done using electro-acupuncture, an antibody/antigen precipitation test (Oucterlony immunodiffusion) and Bryan Cytotoxic test, in which the amount of white cell destruction by the dental materials is observed.33 Although these tests are not completely reliable, they do give at least some indication of which materials may be compatible with the patient at the time of treatment.

Measurement of the current and polarity of individual fillings has been strongly advocated by Dr. H. Huggins. He found from observing his patients, that his success rate for symptomatic improvement increased from 10% to 80% if the fillings with the highest negative currents were removed first. This is a simple procedure to carry out, using a micro amp meter which will register the highest current as the filling is discharged by the meter.

The actual dental treatment carried out should minimise mercury exposure to the patient. A rubber dam, which isolates the teeth being worked on from the rest of the mouth, is to be used wherever possible. There are alternatives to a dam, such as an aspirator tip developed in Sweden, called ‘Clean Up’, which encircles each tooth, but clinically does not seem as effective as a dam, although research has shown a reduction in mercury vapour reading compared with conventional aspirator tips. ‘Clean Up’ was developed because of the build up of mercury vapour behind the dam whilst fillings are being removed, but this vapour build up can be overcome by placing a low velocity aspirator in the mouth behind the dam. The patient should wear a nose piece supplying an external source of nitrous oxide/oxygen mixture, so they will not inhale the ambient air which may contain mercury vapour. Eye covers in the form of damp gauze or protective glasses should also be used. The amalgam is cut into small pieces and these removed to minimise the amount of particulate matter in the form of amalgam dust. The high speed hand piece should be adequately water cooled and a high velocity aspirator tip kept close to the area being treated whilst the amalgam is being drilled. The surgery is to be well ventilated with a fan or air conditioner circulating air.

Following Treatment

The nutritional and dietary advice prescribed should be continued for at least three months following completion of treatment, with the large doses of oral vitamin C being reduced to a maintenance dose of 1 g to 2 g per day if so desired. In most organs, excluding the central nervous system, the half life for mercury in the body is 70 days. Therefore, a maintenance dose of chelating supplements would ideally be continued for around one year, as it takes about five half life periods to clear the body of an accumulated toxin.

If possible, a follow up urine challenge test is done 3 to 6 months after treatment, along with a revised history of recent symptoms, to see if there is a correlation between a reduction in the body burden of mercury and an amelioration of symptoms.

 

CONCLUSION

As there is no definitive diagnostic test yet available for chronic mercury toxicity, the diagnosis of this symptom is built up by a thorough history and clinical examination, complemented by other tests which give an indication as to the amount of mercury to which the patient has been exposed and, more importantly, the amount retained in the body. Treatment must involve both physical and systemic protection to keep the exposure and the effects of this exposure to an absolute minimum. If the protocols in this article are observed before, during and after dental treatment, then many patients will experience improvement or cure in the signs and symptoms related to chronic long term exposure to the most toxic of the heavy metals, mercury.

REFERENCES

  1. Mackay R. “Is Dental Malagam Safe? Scientifically, There is More thn Reasonable Doubt.” Journal of Nut & Enviro. Med Dec 1993; 5-12
  2. Queen H. Chronic Mercury Toxicity Published by Queen & Co. Health Communications, Colorado Springs USA. p 6. 1988
  3. Vimy M. From a presentation given at IAOMT conference in Chicago, USA. Oct 1993
  4. WHO “International Programme on Chemical Safety.” Environmental Health Criteria 118: Inorganic Mercury. p 36, 1991
  5. Huggins H. It’s all in Your Head. Life Science POress, 3rd ed. 1989
  6. Khhare S et al. “Trace Element Imbalances in Amyotrophic Lateral Sclerosis” Neurotoxicology 1; 521-32. 1990
  7. Ingalls T.”Epidemiology, Etiology and Prevention of Multiple Sclerosis.” J Forensic Med & Path. 4:155-61. 1983
  8. Redhe O & Pleva J. “Recovery from Amyotrophic Lateral Sclerosis and From Allergy After Removal of Dental Amalgam.” Int J Risk Safety Med 1994:4 229-236
  9. Wenstrup D et al. “Trace Elements in Isolated Subcellular Fractions of Alzheimer’s Disease Brains.” Brain Research 553: 125-31. 1990
  10. Damluji S. “The Clinical Committee on Mercury Poisoning: Intoxication Due to Alkylmercury Treated Seed, the Clinical Aspects of the 1971-1972 Outbreak in Iraq.” Bull. WHO, 52: 65, 1976
  11. Catsakis I & Sulica V. “Allergy to Silver Amalgams.” Oral Surgery 46: 3 371-375, 1978
  12. Eggleston D. “Effect of Dental Amalgam and Nickel Alloys on T Lymphocytes.” J Pros Dent 51: 617-623. 1984
  13. Shenker B et al. “Immunotoxic Effects of Mercuric Compounds on Human Lymphocytes and Monocytes. 111. Alterations in B Cell Function and Viability. Immunopharmacol Immunotoxicol 15 1:87-112. Jan 1993
  14. Bofetta P et al. “Carcinogenicity of Mercury and Mercury Compounds.” Scand J Work Enviro Health 19 1:1-7. Feb 1993
  15. Kubicka-Muranyi M et al. “Murine Systemic Autoimmune Disease Induced by Mercuric Chloride: Hg-Specific Helper T Cells React to Antigen Stored in Macropahges.” Int J Immunopharmacol 15 2:151-161. Feb 1993
  16. Goodman & Gilman. The Pharmacalogical Basis of Therapeutics. 7th ed. Chpt. 69, p1612
  17. Finne K et al. “Oral Lichen Planus and Contact Allergy to Mercury.” Int J Oral Surg 48: 319-323. 1982
  18. Harris, Sarah (journalist) Sunday Telegraph Sydney. May 1994
  19. Hamdorf I. From a submission compiled for the National Fishing Industry Council on mercury in fish. Dept. of Prim Ind and Res. 1993
  20. Retrograde amalgam fillings are placed into the apical tip of the root within the alveolar bone via a surgical approach.
  21. Vimy M & Lorsheider F. “Intra-Oral Mercury Released from Dental Amalgams.” J Dent Res 64:1069-1071. 1985
  22. Katz S & Katz R. “Use of Hair Analysis for Evaluating Mercury Intoxication of the Human Body: a Review.” J App Toxicol 12(2): 79-84. 1992
  23. Huggins H. It’s All in Your Head op cit
  24. Woods J et al. “Quantitative Determination of Perphyrins in Rat and Human Urine and Evaluation of Urinary Porphyrin Profilkes During Mercury and Lead Exposures.” J Lab Clin Med 129(2): 272-281. Aug 1992
  25. Godfrey M & Campbell N. “Investigation of Sodium-2,3-Dimercaptopropane-1-Sulphonate (DMPS) as a Diagnostic Test to Confirm Chronic Accumulation of Mercury in Humans.” J Adv Med 7(1) 19-30. Spring 1994
  26. A German company, Pittering Electronic Gmbh in Munich (089 7466 2413) make an instrument specifically for dentistry called ‘µ Potential’ which gives micro amps, millivolts and polarity.
  27. Queen, H. Chronic Mercury Toxicity op cit p 48-51.
  28. Giardi G & Elias M. “Effectiveness of N-acetylcysteine in Protecting Against Mercuric Chloride Induced Nephrotoxicity.” Toxicology 67:155-164. 1991
  29. Herbal recommendations and dosages supplied by Ruth Kendon, ND. “The Haven”, 183 Edinburgh Road, Castlecrag, NSW. 02 958 6155.
  30. Queen H. Chronic Mercury Toxicity op cit p 92.
  31. Hibberd A. “DMSA as an Oral Chelating Agent for Mercury.” Informed Consent Issue 2, 1992 & Issue 5, 1993
  32. Aposhian H. “DMSA and DMPS – Water Soluble Antidotes for Heavy Metal Poisoning.” Ann Rev Pharmacol Toxicol 23:193-215. 1983
  33. Daunder M. “Mobilisation Test for Environmental Metal Poisoning.” Forum des Praktischen und Allgemnd-Arztes 28(3):88. 1989
  34. Electro-acupuncture can be done with commercially available machines such as Interro, Listen and Vega.

The Oucterlony immunodiffusion and Bryan cytotoxic dental materials compatibility tests are available from Australian Biologics, 135 Macquarie St., Sydney, NSW. 02 247 5322.


The above article first appeared in Journal of the Australasian College of Nutritional & Environmental Medicine, Vol. 13, No. 2, December 1994, pages 15-19.