ARE YOUR TEETH TOXIC?

By Christine Gorman

MOST PEOPLE TAKE THE SILVER FILLings in their mouth for granted. As long as their dental work doesn't crack or fall out, they are happy to leave well enough alone. But over the past couple of decades, it has become popular among some followers of alternative medicine to have the old fillings removed--a process that is not only expensive but also often painful. The theory is that the fillings slowly poison the body by leaching out mercury that was mixed with silver to make the amalgam. Hundreds of dentists in the U.S. offer amalgam extractions as a profitable adjunct to their regular practice. In their view, the old fillings, which can be up to 50% mercury, are responsible for a host of modern ills including Alzheimer's disease, chronic fatigue and multiple sclerosis.

No one has preached against the evils of silver amalgam more successfully than a Colorado Springs dentist named Hal Huggins. A prolific writer of antiamalgam articles, pamphlets and books, Huggins, 58, is the maestro of mercury removal. About 2,000 Americans, many desperately ill, have visited the Huggins Diagnostic Center, where a team of five dentists pulled out fillings in two custom-made "bubble operatories" designed to minimize exposure to toxins. At its peak, in the early 1990s, the center treated 32 patients a month, subjecting them to intensive two-week therapies and charging as much as $8,500 a mouth.

Today, however, Huggins' drill is silent. He closed his clinic in September to devote his energy to writing another book, he says. But there may have been other, more pressing reasons. Three weeks ago, a civil jury found Huggins and an associate liable in a negligence suit brought by a woman who came in to have her fillings removed and ended up having five teeth extracted. Another lawsuit alleges that the Huggins Center hastened the death of an elderly couple; the wife stopped going to her oncologist for cancer treatments after going to the center. At a hearing that began last week, the Colorado attorney general's office charged that Huggins used fraud and "pseudo science" to frighten patients into undergoing treatment. If the judge finds against Huggins, he might lose his license.

Huggins got into trouble, according to state dental examiners, when, in pursuit of mercury, he went beyond the bounds of dentistry. In some cases he prescribed lithium tablets and ordered potentially dangerous injections of insulin "without clinical justification." One man, who had no amalgam fillings, was allegedly told that his lab reports showed he had "retention toxicity." Huggins denies any wrongdoing and claims that "dentistry is trying to embarrass me for getting this message out."

Many of Huggins' patients continue to swear by his treatments. Kenneth Lay, chairman of Enron Corp. in Houston, and his wife Linda had their amalgam fillings removed at the Huggins Center in 1991. Her chronic fatigue disappeared, as did an unexplained numbness he was experiencing. "I know what his critics say," comments Lay, "but I'm convinced that he does a lot of good for a lot of people."

At the heart of the controversy, and at the center of Huggins' practice, is the tricky question of how much mercury is too much. No one denies that mercury is toxic in small doses. Nor is there any doubt that some mercury leaches out of fillings. In fact most people, with or without fillings, show trace amounts in their urine samples, measured in 1 or 2 parts per billion. Yet no adverse effects from mercury have been shown at levels below 25 ppb.

Despite the broad safety margin, there are reputable dentists who worry about amalgam. When their patients need new dental work, they offer fillings made of gold or plastic and ceramic composites. Gold, of course, is much more expensive than silver, and ceramic fillings don't hold up as well for molars, which must grind against one another. Yet most dentists stop short of encouraging their patients to have sound fillings removed. Healthy teeth have to be drilled out to accommodate new fillings, which rarely hold as well as the originals. And in removing the old fillings, dentists risk exposing patients to more mercury than if their teeth had been left alone.

Even in Sweden, where mainstream dentistry has been much more open to the possibility that mercury fillings might be poisonous, public health officials have been slow to endorse wholesale extractions. As a precaution, many Swedish women won't have their teeth filled during pregnancy. But in 1994, after an exhaustive review of the available literature, the Swedish National Board of Health and Welfare concluded that "there are at present no medical indications for recommending amalgam removal in order to relieve symptoms of general ill health."

Who is right about silver fillings? The American Dental Association, the World Health Organization and the Multiple Sclerosis Society have all declared them to be safe. Dentists have been filling teeth with amalgam since the early 1800s, and more than half of all Americans have them in their mouth without apparent ill effect. But as J. Rodway Mackert, an expert on dental materials at the Medical College of Georgia, points out, "it's impossible to prove something is entirely safe." And as long as there are people who believe their fillings are making them sick, there will be dentists happy to pull them out.

--Reported by Richard Woodbury/Colorado Springs

With reporting by RICHARD WOODBURY/COLORADO SPRINGS