Informed Consent for Mercury Fillings
J Environ Pathol Toxicol Oncol. 2008;27(1):1-3. Links
Implementation of revolutionary legislation for informed consent for dental patients receiving amalgam restorations.
Edlich RF, Cross CL, Dahlstrom JJ, Long WB 3rd, Newkirk AT.
Biomedical Engineering, and Emergency Medicine, University of Virginia Health System, Trauma, Education and Research, Legacy Emanuel Shock Trauma Center, Portland, OR, USA.
Mercury is one of the most dangerous environmental toxins. Realizing the environmental dangers of mercury, the Norwegian Minister of the Environment and International Development, Erik Solheim, has therefore prohibited the use of mercury in products in Norway. This ban will include dental filling materials (amalgam) and measuring instruments, as well as other products. This ban is valid from January 1, 2008. Sweden announced a similar ban, and dentists in Denmark will no longer be able to use mercury in fillings after April 1, 2008. It is indeed unfortunate that the United States has not taken a leadership role in enacting Informed Consent Legislations for patients receiving dental amalgam restorations. Informed Consent Legislations have been enacted by Maine, California, Connecticut, and Vermont.
FDA and Mercury Fillings
We Win --
FDA Must Classify Mercury Fillings
We have won our ten-year battle to get the Food and
Drug Administration to comply with the law and set a
date to classify mercury amalgam.
On Monday, we settled our lawsuit, Moms
Against Mercury et al. v. Von Eschenbach, Commissioner,
et al. FDA
will finish classifying within one year of the close of
the public comment period on its amalgam policy, that
is, by July 28, 2009.
There’s more good news. During a several
hour negotiation session, FDA agreed to change its
website on amalgam -- dramatically. Gone, gone,
gone are all of FDA’s claims that no science
exists that amalgam is unsafe, or that other countries
have acted for environmental reasons only, or that the
2006 Scientific Panel vote affirmed amalgam’s
safety. Instead -- see
http://www.fda.gov/cdrh/consumer/amalgams.html
--
FDA has moved to a neutral course, while recognizing
the serious health concerns posed by amalgam in
particular for children and unborn children, for
pregnant women, for those with mercury
immuno-sensitivity or high mercury body burdens.
FDA now states, for example:
“Dental
amalgams contain mercury, which may have neurotoxic
effects on the nervous systems of developing children
and fetus.”
“Pregnant
women and persons who may have a health condition that
makes them more sensitive to mercury exposure,
including individuals with existing high levels of
mercury bioburden, should not avoid seeking dental
care, but should discuss options with their health
practitioner.”
Perfect?
No. A 180-degree reversal from FDA’s
30-year policy of protecting mercury fillings?
Absolutely.
To change FDA policy, we tried petitions, Congressional
hearings, state fact sheet laws, Scientific Advisory
Committee hearings, and letters galore -- to no
avail. So in the great American tradition, we
sued. The case came to a head this spring.
On April 22, working with Johann Wehrle and Gwen Smith,
I filed a motion for an injunction before Judge Ellen
Huvelle. Three sets of briefs later, the
government and I presented our oral arguments on May
16. In a crucial ruling, Judge Huvelle ruled that
our 11 plaintiffs -- the diverse group listed below --
have standing. She said FDA should classify, and
invited the two sides to mediate. On May 30,
before Magistrate Judge John Facciola, Bob Reeves (who
flew in from Lexington KY) and I hammered out an
agreement with FDA officials and
lawyers.
The impact of the re-writing of its position on amalgam
can hardly be understated. FDA’s website
will no longer be cited by the American Dental
Association in public hearings. FDA shows
awareness of the key issues involved. As it
prepares to classify amalgam, FDA has moved to a
position of neutrality. Indeed, having repeatedly
raised the question of amalgam’s risk to
children, young women, and the immuno-sensitive persons
in its website, I find it inconceivable that FDA will
not in some way protect them in its upcoming
rule.