Seven
out of ten patients with long-lasting illness and a multitude
of symptoms experienced less and reduced symptoms as well
as improved quality of life after removal of mercury amalgam
dental fillings and other metal alloys. The method of treatment
called the "Uppsala Model" also includes antioxidant
supplementation. It was developed by dentists and medical
doctors at the Department of Clinical Metal Biology, Uppsala
University Hospital. Results from a study of 463 patients
is presented in Neuroendocrinology Letters.
Data
indicate that it was not coincidental which patients recovered
and which did not. Those who improved had greater differences
in plasma mercury before and after treatment than the others
and there were also other differences related to the outcome.
These astonishing results demonstrate that there are methods
to identify the patients who may be cured of the serious side
effects from dental amalgam mercury and other metal alloys.
According to Ulf Lindh, professor at Uppsala University: "We
also have developed an effective methods to help these sick
people. With today's knowledge we can effectively help 70%
of the patients. For the rest, further research is needed."
Background
A
number of studies have been performed in which patients with
symptoms suspected to be related to dental restorative materials,
have experienced improved health following removal of amalgam
fillings and replacement with nonmetallic materials. However,
this treatment is seldom tried by regular health care providers
due to the lack of confirmed laboratory tests.
To
address this issue the Department of Clinical Metal Biology
was established in 1991 by the Uppsala County Council in Sweden.
The main objective was improved health care for patients complaining
about lack of relevant treatment regarding side effects from
dental materials. The clinic was commissioned to develop both
diagnostic procedures and adequate treatment for these patients.
This
study was comprised of patients who were treated at the clinic
until October 1996 and completed dental materials replacement
before the end of 1998. The patients came from all areas of
Sweden. They were referred by either a physician or dentist
and had previously sought help from many health care practitioners
and institutions with no conclusive results. In that sense
they had constituted a "wandering queue" of patients
with low quality of life causing high costs for medical care,
drugs, sick leave and increased early retirements. The majority
of the patients were 45 to 60 years old and more than two
thirds were women.
All
patients had experienced a multitude of symptoms with a characteristic
of chronic fatigue. Skin problems from contact with metals
such as jewelry and jeans buttons were common. From the comprehensive
anamnesis it was often clear that these symptoms worsened
after dental treatment.
The Uppsala Model
The
Uppsala Model patients were evaluated by both a physician
and dentist. Knowledge in the field of dental materials, their
composition and properties was fundamental, as well as knowledge
of techniques to reduce exposure from material emissions during
dental work. In addition, the Uppsala Model involved experts
in trace-element biology and methods to determine and survey
metals in various parts of the body.
"To
our knowledge, this is the first study based on the development
of new diagnostic methods and protocols for treatment, in
which close co-operation between physicians and dentists is
essential." says Professor Ulf Lindh, leader of the group
and first author of this study.
Examining the patients
The
first visit to the clinic included taking the patient's thorough
history aided by extensive questionnaires completed by the
patients in advance. This was followed by a somatic examination
and a panel of routine blood tests. This procedure was repeated
after treatment.
In
addition a number of special blood tests, related to metal
exposure, were performed before and after treatment. These
tests included measurement of mercury in plasma by means of
inductively coupled plasma mass spectrometry (ICP-MS) and
levels of trace elements in single blood cells by means of
nuclear microscopy (NM) with particle induced X-ray emission
(PIXE). Results of NM measurements have been published elsewhere.
To
investigate hypersensitivity to metals an optimized lymphocyte
transformation test in vitro (MELISA®) was used before
and after treatment. A regular patch test used in parallel
initially was soon abandoned due to an unacceptable rate of
side effects. Results of MELISA® have been published elsewhere.
In
cases with emphasis on the deterioration of higher cerebral
functions, an investigation of the spinal fluid was performed
with respect to proteins, methyl-malonic acid, B12 and metal
concentrations.
Individual exposure profiles
In
the analysis of exposure, potentially toxic or allergenic
environmental chemicals, medicines and dental materials were
emphasized, together with any related clinical observations.
To establish these exposure profiles dental restorative materials
in each individual were recorded. Dental amalgam contains
approximately 50% mercury, with the remainder consisting mainly
of copper, silver and tin. Dental "gold" is always
an alloy of numerous metals, often containing some nickel.
Adhesive resin-based dental materials (white composites) contain
a number of components that are potentially allergenic. All
of these restorative materials release compound, which can
be swallowed with varying degrees of distribution and uptake
in organs. Individual sensitivity to this exposure varies
widely, as do the potential symptoms.
If
other sources of exposure were obvious or suspected in the
patient's home or occupational environment, this was further
investigated by an occupational engineer.
Treatment
In
most cases there was no indication for any remedial treatment
other than reduction of exposure to implicated metals in the
dental restorative materials. Other approaches had often been
tried earlier. The recommendation to remove or substitute
dental materials was founded on the general precautionary
principle of allergists: It means if possible, avoid exposure
to compounds that may cause allergy or hypersensitivity.
To
counteract oxidative stress during removal of dental materials,
each patient was prescribed a standard regiment of antioxidants.
This included vitamin C, vitamin B-complex, vitamin E and
selenium supplementation. In cases with positive markers for
vitamin B-12 deficiency in the cerebrospinal fluid, treatment
with B-12 and folic acid was added.
Removal of incompatible dental materials
Based
on previous examination and laboratory results, the possible
removal of implicated dental materials was discussed with
each patient, and most of them chose to perform the recommended
dental treatment.
For some patients the symptoms worsened considerably during
the period of dental treatment. To cope with this, a working
relationship between dentists and physicians was necessary.
About half the patients, among them the most sensitive, had
their ensuing dental treatment performed at a few dental offices
in Uppsala, where a protocol for removal of incompatible dental
materials (RID) and bite restoration with individually compatible
materials was implemented. At these offices precautionary
arrangements had been made to minimize exposure particularly
to mercury vapor. This included equipment, such as catalytic
mercury vapor traps and high-volume suction devices.
Dental
amalgam was found to be the most offending material, followed
by various gold alloys and non-precious metal alloys, e.g.
titanium alloys or chromium-vanadium alloys. In almost all
clinical cases non-metallic materials could be used instead,
due to recent improvements of their mechanical properties.
Evaluation
To
evaluate the outcome of the treatment, a questionnaire was
constructed in co-operation with a group of scientists from
the Uppsala, Umeå and Lund Universities in Sweden. It
was comprised of questions regarding symptom and quality of
life changes before and after treatment. The symptoms included
in the questionnaire were selected to represent those most
relevant from clinical experience in this field. Two earlier
Swedish studies on results of amalgam removal were based on
similar questionnaires. The result shows that more than 70
percent of the patients report better health after treatment..
Published
in:
Vol. 23 No.5/6, 2002
Neuroendocrinology Letters www.nel.edu
Abstract and pdf: here
More
information available: publisher@nel.edu
