Dr. Oz Is Worried About Your Teeth. Should You Worry Too?

Mercury fillings have been a popular and controversial subject within the field of dentistry for a number of years. At our office, we rarely use amalgam (mercury) fillings on our patients. This is mainly due to cosmetic appearance and patient choice. However, using amalgam is a viable alternative for some people, and it does not pose a health threat. We found this interesting article, which appeared in Forbes magazine earlier this month, criticizing Dr. Oz’s ignorance of the underlying science of amalgam in dental fillings:

Mehmet Oz hosts a popular TV show that reaches millions of people.  He offers a constant stream of medical advice, and he is popular because he makes his topics sound dramatic, or exciting, or surprising, or all three.

US actor Mehmet Oz poses during a photocall fo...Dr. Mehmet Oz at the 52nd Monte-Carlo Television Festival on June 13, 2012 in Monaco. (Image credit: AFP/Getty Images via @daylife)

Unfortunately, Dr. Oz sometimes demonstrates a poor understanding of science.  At least I hope so, because he promotes so many outrageous treatments, with such enthusiasm, that the only other explanation I can think of is that he is simply a fraud. I don’t think that’s true, so let’s give him the benefit of the doubt and assume that when he makes a mistake, he is simply ignorant of the truth.  His latest startling revelation is that the metal fillings in your teeth are very, very bad for you.  Or are they?

Last week, Dr. Oz hosted a show called “Toxic Teeth: Are Mercury Fillings Making you Sick?  The show looked at silver amalgam fillings, which contain a small amount of mercury chemically bound within them.  Mercury is indeed a toxin.  Should you worry?

One problem with taking a skeptical look at a Dr. Oz show is that he packs each episode with scientific claims, coming at you thick and fast, and it would take hours to critique them all.  Instead, I’ll just pick a few, which illustrate Oz’s lack of concern for accuracy, and his apparent ignorance of the underlying science about dental fillings.

Dr. Oz opens his show with a dramatic claim about mercury:

“This thermometer contains mercury,” he says, holding up a very small thermometer. “If I were to drop it, we would have to evacuate this entire studio immediately!”

Now, this is complete nonsense.  If you drop a mercury thermometer, you should carefully clean up the mercury, which beads up into nice little silver-colored balls.  No one in the room is in danger, unless perhaps they try to inhale it.*

This opening salvo should set off anyone’s skeptical alarm bells.  Here’s a guy who doesn’t seem to mind exaggerating to make a point.  Why trust anything he says in the rest of the show?  I suspect, though, that after watching this episode, thousands of Oz’s loyal viewers raced to the phone and made appointments to have the silver fillings in their teeth removed.

Dr. Oz continues his introduction by explaining that mercury is contained in silver tooth fillings.  No one knew, he claims, that mercury vapor could be released from these fillings, but this news:

“sparked a firestorm 30 years ago [here the show cuts to a graphic of a fireball exploding] when major news reports brought to light the potential TOXICITY of mercury fillings.  … Now there’s mounting new evidence showing mercury is released when you eat, and even when you brush your teeth.”

Quick, run to the dentist!  Get this toxic mess out of my mouth!

But hang on a minute.  Why aren’t people dropping like flies from the fillings in their teeth?  With little effort, I determined that, contrary to Dr. Oz’s statements, nothing new has been discovered lately about silver tooth fillings.  I found studies going back to the 1970s that shown that we’ve long known for decades that mercury is released from these fillings. But Oz ignores all these.  He even announces, a few minutes into the show, that

“for the first time ever, I’m going to show you what happens when you brush your teeth with mercury fillings.”

No, this is not the “first time ever.”  As a scientist, I find it worrisome that Oz seems quite comfortable claiming, incorrectly, that he’s the first person ever to tell the world about this.

Perhaps the most outrageous – and unintentionally funny – segment of the show is the “demonstration,” where Oz introduces an Oz-certified expert on mercury vapor, David Wentz, who has a gizmo that looks like it was built by a sideshow huckster.  The device is a plexiglass box that looks like it was meant to handle biohazards, with black rubber gloves that let you manipulate its contents.  In the box: a set of fake teeth containing… silver fillings!  And a toothbrush!

As he walks over to the device, Oz says “I work with Dave Wentz and his Ph.D. dad.”  This goes by really fast, so you would be excused for not realizing that Dave Wentz himself doesn’t have a Ph.D., and for not knowing whether he has any credentials at all.  Dr. Oz conveniently omits the fact that Wentz and his father run a highly profitable nutritional supplements company, USANA http://www.usana.com/dotCom/about/index, which happens also to donate money to Oz’s nonprofit corporation, HealthCorps.  Hmm.

Dr. Oz then reaches into the box, and while the audience watches in hushed excitement, he brushes the teeth, right on top of those silver fillings!  Right on cue, Wentz proclaims that the mercury vapor reading hits 61 in just a few seconds.

“Anything over zero is toxic,” Wentz proclaims.  “And we’re at 61.”
“Oh my goodness, 61!” Dr. Oz exclaims.
“That mercury is coming off the fillings, into your mouth, going across the blood-brain barrier, into your brain,” says Wentz dramatically.

Wow.  I’ve been brushing my teeth (which have several fillings) for years.  How can I not be dead?

As Dr. Oz should know, “the dose makes the poison.”  Even water can kill you if you drink too much of it.   Wentz is clearly wrong to say that “anything over zero is toxic.”

How much mercury is safe, then?

Teeth, a poemTeeth, a poem (Photo credit: Shakespearesmonkey)

According to the EPA, 0.1 micrograms of mercury per kilogram of body weight per day is safe.  For an adult who weighs around 150 pounds, that’s about 7 micrograms.  A 6-ounce can of tuna has about 20 micrograms of mercury, about 3 times the safe amount per day.  Scientists do have real concerns that mercury in tuna and other fatty fish might present a health hazard.

Dr. Oz’s device seemed to show that 61 micrograms of mercury were released from brushing teeth, which would be about 9 times the exposure that is considered safe.  Is there really a risk here?

Well, no.  The EPA has found that “nearly all methylmercury exposures in the U.S. occur through eating fish and shellfish.”  (Admittedly, though, this is not mercury vapor.)  The precise question that Oz claims to be explaining “for the first time” has been examined in multiple studies, and the evidence is that silver fillings are harmless.  (See the FDA summary here.)

A thorough scientific review in 2004 concluded that:

“The current data are insufficient to support an association between mercury release from dental amalgam and the various complaints that have been attributed to this restoration material. … Individuals with dental amalgam-attributed complaints had neither elevated HgU nor increased prevalence of hypersensitivity to dental amalgam or mercury when compared with controls. The findings of these studies suggested that individuals with complaints self-attributed to dental amalgam should be screened for underlying dental, physical, and psychiatric conditions.”

So no, there’s no evidence that mercury from silver fillings causes any health problems.  None.

But what about that device on Dr. Oz’s show, which showed 61 micrograms being released in just a few seconds of brushing the teeth?  My conclusion is that the device in Dr. Oz’s studio was either wildly inaccurate or simply fraudulent.  The setup was almost a parody of what real scientific instruments look like, and nothing about it gave me any confidence that it was reliable.  I would suggest to Oz that before making a claim like this, he should ask rigorously trained scientists to make the measurements using properly calibrated equipment.  A TV studio is no substitute for a real lab.

But wait: Mehmet Oz is a Professor of Surgery at Columbia University – he must know his science!  Plus he has an M.D. from the University of Pennsylvania, and he did his undergrad studies at Harvard.  By all appearances, he is a very smart guy.  If his show were about heart surgery – his specialty – it would no doubt be professional, accurate, and probably far too technical to attract an audience.

Here’s the rub: despite his credentials, Oz is not an expert on mercury amalgam fillings.  He probably could have read and understood the science, but he appears to be unaware, or too busy to  be bothered by, the many scientific studies on this subject. Had he done his homework, he might not have presented such a spectacularly overblown episode that seems intended to scare people into removing the silver fillings from their teeth.

So there’s no need to go out and get your silver fillings replaced.  It’s too bad that a highly educated surgeon like Mehmet Oz, with such a big audience, prefers to present wild exaggerations rather than telling people the truth.  Perhaps, though, the truth just isn’t that exciting.

*Note added on followup: Even swallowing is rarely harmful.  From J. Dodes: “Acute toxic exposures to  elemental mercury are rare but there have been cases of elemental mercury being accidentally released directly into the  bloodstream from broken rectal thermometers and when elemental mercury had been swallowed intentionally in an attempt at suicide.  In all these cases there was no long-term effects from the mercury.”  Dodes, JE.  The Amalgam Controversy:an evidence-based analysis.  JADA, 132:348-56, 2001.

The original article can be found at: http://www.forbes.com/sites/stevensalzberg/2013/04/08/dr-oz-takes-a-big-bite-of-pseudoscience/2/

Teeth Whitening – Enhance Your Smile | Riverside, CA

Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.

Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home tooth whitening system that will whiten teeth dramatically. Since tooth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.

Tooth whitening is not permanent. A touch-up may be needed every several years and more often if you smoke or drink coffee, tea, or wine.

Reasons for tooth whitening:

  • Fluorosis (excessive fluoridation during tooth development).
  • Normal wear of outer tooth layer.
  • Stained teeth due to medications (tetracycline, etc.).
  • Yellow, brown stained teeth.

What does tooth whitening involve?

This type of tooth whitening usually requires two visits. At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear plastic, trays.

At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks, depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.

You will receive care instructions for your teeth and trays, and be encouraged to visit Dr. Gerald Middleton regularly to help maintain a beautiful, healthy, white smile.

To see what whitening can do for your smile, call Dr. Gerald Middleton at (951) 688-3442 to schedule an appointment or visit our website.

Dr. Gerald Middleton also proudly serves Corona, San Bernardino, Redlands, Moreno Valley, Lake Elsinore, and surrounding areas.

Lety’s Story From Peru

My recent humanitarian mission to Peru was such an uplifting life changing experience for me. I would like to once again thank Dr. Middleton and the rest of my extended family here for all the support and encouragement that I received making this trip possible.

I had the opportunity to assist as a surgical scrub along side some amazing surgeons and surgical residents from Loma Linda Medical Center in Oral Facial reconstruction surgeries. I also had the unique opportunity to view an entire open heart surgery from start to finish. That reinforced the valuable message that “we must stay Heart Smart, always, not just in the month of February.”

Other highlights of my trip included our excursion to Cuzco & the Sacred Valley of the Incas, and my venture that I survived my hike up Wayna Picchu.

I am certainly looking forward to next year’s mission.

 

 

April is Oral Cancer Awareness month | Riverside, CA

April is Oral Cancer Awareness month and Dr. Gerald Middleton knows that most people are not aware of the statistics associated with Oral Cancer. Approximately 42,000 people in the U.S. will be newly diagnosed with Oral Cancer this year alone. And as you are well aware, your dentist is often the first line of defense against oral cancer, through the process of early detection and discovery.

Oral Cancer will cause over 8,000 deaths, killing roughly 1 person per hour, 24 hours per day. Of those 42,000 newly diagnosed individuals, only slightly more than half will be alive in 5 years. (Approximately 57%) This is a number which has not significantly improved in decades. The death rate for oral cancer is higher than that of cancers which we hear about on a regular basis such as cervical cancer, Hodgkin’s lymphoma, laryngeal cancer, cancer of the testes, and endocrine system cancers such as thyroid, or skin cancer (malignant melanoma). Although smoking and tobacco use is still a major risk factor for Oral Cancer, the fastest growing segment for Oral Cancer patients are young, healthy, nonsmoking individuals due to the connection to the HPV virus.

If you broaden the definition of oral cancers to include cancer of the larynx, for which the risk factors are the same, the numbers of diagnosed cases grow to approximately 54,000 individuals and 13,500 deaths per year in the U.S. alone. Worldwide the problem is much greater, with over 640,000 new cases being found each year. Oral Cancers are part of a group of cancers frequently referred to as head and neck cancers, and of all head and neck cancers they comprise about 85% of that category. Brain cancer is a cancer category unto itself, and is not included in the head and neck cancer group.

For more information call Dr. Gerald Middleton at (951) 688-3442 or schedule an appointment online.

Dr. Gerald Middleton also proudly servesCorona, San Bernardino, Redlands, Moreno Valley, Lake Elsinore, and surrounding areas.