.................... "It takes seventeen muscles to smile and forty-three to frown." - Anonymous

"When I was looking for an alternative dentist, I had specific requirements due to my former mercury poisoning from my dental fillings. First, it had to be a professional that did NOT use any toxic mercury in their practice and one that truly understood the neurological and neurocognitive damages that mercury causes humans. Dr. Trovato uses composite fillings and is also well aware of the different materials available for durability and color preferences. He is very open to biocompatibility preferences in the type of anesthesia and composite materials used.

I also enjoy the willlingness that Drs. Lou and Barb Trovato provide in securing material samples for biocompatibility testing, in addition to respect for one's time in that they never keep you waiting more than a few minutes. Meetinghouse Dental Care employees are warm and friendly and clearly display job satisfaction. Meetinghouse Dental Care is that unique, I am willing to drive 45-50 minutes for my appointments."

Shirley White, Blue Bell PA


Safe Amalgam-Removal Technology

The safety of amalgam fillings represents an increasingly controversial topic in world dentistry. Sweden, Austria, Denmark, and Norway have banned amalgam use, and the United States' FDA revoked its previously pro-amalgam stance in a landmark decision June 4, 2008. Although the American Dental Association continues to promote amalgam fillings as standard of care dentistry, the FDA's website now warns "Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses" (http://www.fda.gov/cdrh/consumer/amalgams.html).
Regardless of which side of the amalgam-safety controversy seems most reasonable to you, our goal as dental providers is to offer the safest possible removal as old amalgam fillings break down.

For OUR Safety

For us, exposure to ambient mercury is daily, an occupational hazard. Our rubber-based masks have two filters, an outer to trap mercury particulates that can lodge in our lungs during amalgam-removal and an inner to filter mercury dust and vapor.

For YOUR Safety

Upon request and highly recommended: USP FOOD-GRADE, COCONUT-SHELL, ACTIVATED CHARCOAL SLURRY for rinse and swallow. Charcoal slurry, processed to meet purification standards required for medical use, absorbs toxins, drugs and poisons. Charcoal rinse/swallow prior to amalgam removal coats the oral mucosa and tongue with tasteless black powder to prevent absorption of mercury debris into soft oral tissues and the digestive tract. (Charcoal slurry also absorbs birth control pills, antibiotics, chronic disease/prescription medication, etc. ingested two hours prior or two hours post. To avoid charcoal absorption of beneficial drugs, rinse only. Charcoal does not absorb vitamin or mineral supplements.)

The ISOLITE INTRA-ORAL PROTECTOR connects directly to the high speed vac to pull mercury vapor, particulates, and dust from your breathing area (www.isolitesystems.com). The Isolite replaces both the Clean-Up suction tip you may find in other dental offices (although we do have Clean-Ups, should you prefer) and the traditional rubber dam. Clinical trials counter-indicate rubber dams in mercury removal; mercury vapor passes through dam material, and mercury debris and particulates can drop into the oral cavity as the dam is removed.

Copious use of OZONATED WATER during amalgam removal suppresses mercury vapor, particulates, and dust, trapping amalgam debris in the Isolite suction.

The flexible, self-supporting suction arm of the IQAIR DENTAL MERCURY FLEXVAC positions near your head to capture mercury vapor, particulates, and dust, reducing measurable ambient mercury debris (as well as drill aerosols, VOC's, formaldehyde, glutaraldehyde, dust, viruses, bacteria, and microbial contaminates) to nearly zero (www.iqair.us). The combination of the Isolite, IQAir FlexVac, and LG-2 Ionizers replaces the nose-hood that may be found in other offices.

LG-2 IONIZERS from AESI-Air Defense installed in the ceilings of restorative operatories capture mercury debris that escapes the Isolite and FlexVac. LG-2 Ionizers create a continuous electrophoresis effect, negatively ionizing ambient particles to drive them toward positively-charged field collectors that render them inert electrically. LG-2 Ionizers have been shown to reduce recordable ambient mercury levels to zero instantaneously. (LG-2 Ionizers have also been shown to trap and neutralize airborne and blood borne pathogens, bacteria, pollen, allergens, hydro-carbons, and elemental metals. They neutralize particles too small for HEPA filters, even to .001 micron.)

An ORA-SHIELD DENTAL DAM NAPKIN drapes facial skin.

A NARROW, ROUND-TIP BUR sections old amalgam fillings into the largest chunks possible, reducing release of mercury vapor, particulates, and dust.

Meticulous maintenance of equipment and use of ozonated water in dental lines maximize the efficiency of our technology.

As post-removal protocol, we apply MEDICAL-GRADE OXYGEN-OZONE to the preparation site in the tooth from which we have removed decay in order to kill bacteria, fungi, and viruses prior to restoration.

Finally, we protect the environment with the AMALGAMBOSS MERCURY SEPARATOR installed on our wastewater lines. The AmalgamBoss traps mercury-amalgam fragments before they can be released into the public water system. Approximately 64% of the mercury load on city wastewater management comes from dentistry. In fact, studies indicate that some 20 tons of mercury would not be discharged into the environment annually if every dental office had a separator installed on its water lines. Pennsylvania does not yet require amalgam separators for dental offices, but we've taken the initiative. The AmalgamBoss tests at a 99%+ capture rate to help keep municipal sludge mercury-free (www.marsbiomed.com).

Interested in learning more about mercury-amalgam fillings?

Send a blank e-mail to our silverfillings@aweber.com to receive the twelve brief, informative e-mails we've compiled. No one will gain access to your e-mail address, and we ourselves will use it for this purpose only. Within minutes, AWEBER will send you a return e-mail to confirm that you want to get silverfillings messages. That's it! Once a day for a dozen days, you'll receive concise information about different aspects of silver fillings, health, and current research consensus. You can contact us personally by return email at any time or press the opt-out button to discontinue receipt at any time. Share this service with family and friends!

Will removing silver fillings improve my health?

There is no way to predict whose health may benefit from amalgam removal. Although one or more of your subjective or objective signs may resemble signs or symptoms of mercury toxicity (access our website www.RemoveSilverFillingsSafely.com for a list of potential signs), such signs do not necessarily mean you are suffering the effects of mercury toxicity either directly or indirectly. As the doctors of Meetinghouse Dental Care, we work with healthcare providers, but we ourselves limit patient advice to the oral cavity and related bones, nerves, and musculature. We encourage you to research safety issues surrounding amalgam restorations for yourself.

Clinically necessitated or elective, removing amalgam fillings will release mercury vapor and debris. We reduce exposure to guest and team to the greatest extent currently possible through physical barriers and advanced technology (see above). Nevertheless, a person who is mercury toxic or sensitive may experience an increase in both physical and emotional symptoms for an unpredictable period of time following an amalgam removal procedure. Nutritional and metabolic precautions can be taken to minimize this effect. If you believe that you are mercury toxic or sensitive, we suggest consultation with a nutritionist/naturopath/ practitioner experienced in mercury toxicity. If you do not have a health practitioner experienced in working with mercury toxicity and wish to consult one, we can recommend Marc Schwartz, DC, CCN, CCSP, The Pavilion, 261 Old York Road, Suite 534, Jenkintown, PA 19046, 215.881.9700 or Phillip Mollica, MS, DMD, NMD, 392 Victor Street, Saddle Brook, NJ 07663, 201-587-0222.

Comparison of Restorative Materials

Amalgam fillings contain 48%-52% mercury. Temperature extremes in the mouth caused by hot or cold drinks and food make mercury fillings expand and contract inside the tooth. Most studies place amalgam-filling longevity at 5½ -11½ years. Over those 5-11 years, expansion and contraction of the fillings inevitably weaken remaining natural tooth structure. Weakened tooth structure can lead to seemingly sudden tooth breakage. Expansion and contraction can also pull the edges of amalgam fillings away from the natural tooth. When space opens between the mercury filling and the natural tooth, bacteria and debris seep under the filling. The metal of the old amalgam blocks x-rays. There is often little or no warning of incipient spread of decay, even if you have two regular exams and cleanings per year. By the time you feel pain, the nerve may already be involved.

White Composite Restorations

The longevity of white composite fillings tends to be inversely proportionate to the size. The smaller composite fillings exhibit longevity similar to that of amalgams. In fact, teeth restored with small composite fillings can reach strength approaching 98% of the original pre-decayed state because composites bond to the tooth, sealing edges. Proper bases and bonding agents provide more protection for the pulp than what is possible with mercury-amalgam restorations. Size-wise, then, a composite performs well if there is more tooth than filling. If there is more filling than tooth, composites tend to flex, lose their bond, and leak. Eventual breakdown allows for recurrent decay, making porcelain the preferred restorative material for biting surfaces, larger cavities, and fractured teeth.

Even for smaller restorations, positive points of comparison with amalgams do not mean composites are the perfect filling material for everyone. There is speculation over potential estrogen-mimicking effects of plastic chemicals like Bisphenol A contained in certain composite resins.

Any dental material made with BisGMA may contain trace amounts of Bisphenol A. Some companies strive to produce significantly less toxic materials. VOCO (www.voco.com) brand restorative materials contain 30-50% less resin than many other composite brands, proportionately reducing potential presence of trace amounts of bisphenols. Furthermore, VOCO does not add Bisphenol A or B to its composites. Because less resin is present in its products, VOCO tests high for biocompatibility (Clifford Labs: http://www.ccrlab.com), and Scientific Health Solutions classifies VOCO products (Admira, Grandio, etc.) in the Least Reactive Components category for dental restorative materials. Other brands similar to VOCO are available.

Porcelain Restorations

Porcelain is the most biocompatible, hypo-allergenic, non-metallic restorative material of which we are aware at this time. Porcelain restorations are also dramatically less effected by factors that influence longevity of both amalgams and white composite fillings: ie restorative technique, filling size, your body chemistry, and your nutritional intake. Porcelain restorations (inlays, onlays, crowns) can last 12-15 years or longer. We offer lab-processed porcelain or, for your convenience, CEREC® CAD/CAM technology for same-day on-site porcelain restorations.

Longevity

Potential longevity of dental restorations is a critical factor because every dental procedure represents trauma to the nerve of the tooth. Repeated trauma to the nerve from filling replacement during the course of a lifetime will eventually cause nerve breakdown. Porcelain restorations cost more initially than amalgams or composites, but porcelain's longevity decreases potential need for root canal therapy.

Whether the filling is of amalgam, white composite or porcelain, longevity is influenced by the amount of natural tooth structure preserved during removal of decay. An amalgam filling can not adhere to tooth surfaces, and the amalgam-placing dentist must create an undercut after removing decay, sacrificing healthy tooth structure to trap the amalgam filling in place. For composites or porcelain, the dentist strives to remove decay only. The cleaned-out space inside the tooth for a composite or porcelain prep often has relatively straight or inward-slanting walls. Healthy tooth structure is preserved.

Again, we encourage you to research safety issues surrounding amalgam restorations for yourself. When existing amalgam fillings are mechanically intact, it must be your personal choice to have them replaced with other materials, whether for health or esthetic reasons.



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the Safe Amalgam Removal Information and Consent Form.