Article [15]

   AMALGAM REMOVAL PREPARATION AND SUPPORT

 By David G. Schwartz, M.D.

     Preparedness is vitally important for mercury amalgam removal from the teeth, especially if you are having symptoms or problems from mercury toxicity.  Medical evaluation beforehand, nutritional support before, during, and after the procedures, proper methods for amalgam removal, and self-education about the process are all needed to make the procedure as safe and healing as possible.

     If you are removing amalgams purely for preventive reasons, if you have no significant health problems, and if you have had annual medical checkups and routine preventive blood tests, the protocol is simpler (plan A); however, if you have poor health, or especially if you have probable mercury-related symptoms, then careful attention to a detailed plan is essential (plan B).                                              

                                                       PLAN A

Hair analysis for toxic metals

Urine test for toxic metals

G6PD blood test    

Nutritional and dietary program

Intravenous Vitamin C 3-hour drip as soon as possible after each procedure

Avoid using any chelating drug such as DMSA, DMPS, or EDTA during or soon after.

Read about proper amalgam removal procedures.

If no recent physical exam or blood tests, get brief physical exam, routine urinalysis, and comprehensive blood chemistry panel.

                                                        PLAN B

All of the above from Plan A apply, with the addition of the following:

More extensive education about the process

More thorough medical evaluation.

  Symptom questionnaire

  Physical examination

  CBC, Sedimentation rate, Comprehensive blood chemistry panel, TSH, Urinalysis

  Compatibility testing (blood analysis) to select best materials for replacement fillings.

More extensive support during the process

  Additional nutrient supplementation

  Vitamin C “flushes”

  Adrenal support for those with adrenal exhaustion

  Acupressure/massage

  Support person to assist in daily activities

After amalgam removal, within 3 months, test urine for toxic metals and consider DMPS  and/or DMSA chelation with proper support protocol, preceded with at least 6 Vit C i.v.’s

     Following is a more detailed description of the preparations:

     It is important to read about the proper procedure, available in publications by Dr. Hal Huggins, such as It’s All In Your Head.  The main caveat is to se a dentist trained in the Hal Huggins methods or something very similar.  The dentist and assistants will be wearing gas masks, the air flow in the room has a special design to move the vapors away as fast as possible, special suction and irrigation is used to clean the mouth of mercurial debris quickly, and a rubber dam is placed in the mouth with the one tooth protruding for its work, so as to reduce the probability of swallowing mercury dust.  The dentist will also test electrical conductivity in the mouth with a galvanometer, and with decide which quadrant to repair first.  The electrical currents caused by the metals can cause just as much illness as the mercury itself, and it is important to know which teeth to do first.  Also, the interval between procedures is made in such a way as to not coincide with the turnover in immune cells every 2 weeks.

     For the basic essentials, (Plan A), the hair analysis may detect mercury not seen in the urine test, may find other toxic metals besides mercury, and may detect deficiencies in nutrient minerals.  The urine test may assess the burden of detect toxic metals better than the hair analysis. 

     The G6PD is an enzyme present in blood cells.  Some individuals who have a deficiency in G6PD could have severe reactions when taking certain drugs, especially sulfa, or if taking high-dose intravenous vitamin C.  The test is a necessary preparation before taking more than 12,000mg Vitamin C, i.v.

     Proper foods and nutritional supplementation are important for assisting the body in removing toxic materials, especially mercury, and to provide extra support for the stress of the procedure and for the extra mercury released in the process, that may be inhaled as vapor or ingested as small particles that may get past the rubber dam.

     Drinking 64 ounces of purified water per day assists the body in removing toxins through the bowels and the kidneys.  It is important to avoid caffeine, sugar, alcohol, and tobacco, because they add toxic burden and additional stress, for obvious reasons.  Fish needs to be avoided because all fish contain mercury until proven otherwise.  High protein (organic) foods help the body in detoxifying mercury and many other toxins.  Extra green vegetables are helpful because of the chlorophyll, fiber and, many phytonutrients.  High sulfur foods like eggs, garlic, onions, and the cruciferous vegetables (broccoli, cabbage, cauliflour, brussel sprouts, etc.) help phase II detoxification enormously.

      Cilantro chelates mercury.   Eating cilantro blended with olive oil and garlic as a pesto can be eaten, and also it can be taken as an herbal extract 10 drops in water 2x/day, 5 days on, 2 days off, but taken on the day of the procedure.  It is important to get organic cilantro, to make it less likely to get cilantro that has already chelated mercury from its environment.  Chlorella is a type of algae that also binds mercury.  It can be taken 8-10 capsules or tablets daily in divided doses as tolerated (can cause intestinal upset in high doses).  It can be used as a mouth rinse immediately after the dental procedure by chewing the tablet form.  Chlorella likewise must be mercury free, and must be obtained from a reputable company that has the GMP label (Good Manufacturing Practices), and that can verify that it monitors for the presence of heavy metals.

    Fiber supplements also help the bowel to detoxify optimally, if taken in amounts to result in 2 bowel movements per day.

     The dietary habits and supplements are best done for 2 weeks in advance of the dental procedures, and for several weeks afterward.

     Supplementation with a good quality high potency multivitamin-mineral is important to provide all-around antioxidant support.  This should include daily approximately 400u Vit. E,  B-complex 50-100mg, Magnesium 500mg, Zinc 30mg, Copper 2mg, Selenium 200mcg, mixed carotenoids 10 to 20 thousand units, as well as many other trace elements, in divided doses.

     Vitamin C should be 3000mg/day in divided doses, or as high as tolerated without diarrhea.  It is better tolerated as the buffered sodium ascorbate powder instead of ascorbic acid.  It is important to remember to not take a high dose of Vitamin C immediately before the procedure, as it may inactivate the local anesthetic.

     Other supplements that help detoxification of mercury are L-cysteine 500mg 2x/day between meals, and alpha lipoic acid 100mg 2x/day.

     The essential fatty acids, especially the omega-3 fatty acids, ALA in flax seed oil, DHA and EPA in fish oil are generally deficient in most Americans’ diet, and they are very important for brain function and to reduce inflammatory tendencies.  Fish oil, like previous supplements mentioned, need to be monitored and verified for absence of heavy metals.   These fats are an important part of any supplement program, and mercury related illnesses often have strong inflammatory components.

     Glutathione is not usually well absorbed from the G.I. tract, but it binds mercury, so taking a dose immediately before the dental procedure and another dose immediately afterward can bind mercury that may get swallowed.

     The intravenous Vitamin C is a mercury chelator, weaker than DMPS or DMSA, but much safer.  It is best taken as soon as possible after the dental procedure, within 1-2 days.   Approximately 50 grams (50,000mgs) of vitamin C as buffered sodium ascorbate is given in an arm vein over about 3 hours, in a solution of sterile water or similar solution.  You would need to find a physician experienced in intravenous vitamin therapies.  A list is available through the American College for the Advancement of Medicine at www.acam.org. 

     For people who have illnesses and symptoms from mercury toxicity, the support and preparation needs to be more thorough (Plan B).  In addition to all the previously described support for Plan A, this involves more detailed medical evaluation and testing and more intense support, as listed above. 

     It would be advantageous to read, It’s All In Your Head, by Dr. Hal Huggins, D.D.S, not only for the description of the proper procedure, but to have a better understanding of nutritional support and the relation of mercury to your problems.  Dr. Huggins describes the Vitamin C “flush,” a high dose oral Vit C that causes loose bowels, as an extra help in chelating the mercury. 

     It would be good for the person with Plan B to also read The 7 Day Detox Miracle, by Peter Bennett, N.D., and Stephen Barrie, N.D., and to do some detoxification before the process of amalgam removal begins.  That will familiarize you with how the body detoxifies and you can get some experience with detoxification support.  Also, many symptoms may improve before the amalgams are taken out, and the body can be in a stronger position for handling the removal process. 

     You may also benefit from first undergoing some EDTA chelation therapy, before the removal process.  The EDTA does not significantly bind to mercury, but it can remove many other heavy metals and therefore take a load off the liver and other detox organs and tissues, so they are stronger for removing mercury.

     The compatibility testing is very important because many people who react to mercury in an allergic way can also react to other materials that are put into the tooth for replacement.

     Other supplements that may be of advantage in addition to those of Plan A would be charcoal (2 caps to 2 tsp 3x/day), melatonin to enhance glutathione production, milk thistle for additional liver support, Ultra Clear Plus from Metagenics for support for phase II liver detoxification, probiotics such as lactobacillus acidophilus for bowel support, and turmeric and green tea for additional antioxidant support.

     Low temperature saunas (150-170 degrees) and hydrotherapies as described in The 7 Day Detox Miracle can provide additional detoxification.   The acupressure and massage are very important, and drinking large volumes of water mentioned previously.

     A higher degree of personal support is important in the process for people with mercury-related illness.  A support person to drive you home and to help with the activities of daily living if you are feeling ill, exhausted, stressed out after the procedures.  This may reduce stress considerably if someone is there to help with other personal duties.

     It is often important for people in Plan B to follow up afterward with urine tests for toxic metals and to later do chelation of mercury with much stronger chelating drugs a few months after the amalgam removal is complete.  This should be preceded by at least 6 Vitamin C i.v.’s and should be done by a physician trained and experienced in DMPS and DMSA chelation.  That process also requires special testing and nutritional support.

     If you have symptoms of adrenal exhaustion, low blood pressure, hypoglycemia, afternoon fatigue, etc., you may need to get special support for the adrenals started also before the amalgam removal, with licorice, pantothenic acid, high salt diet, and possibly adrenal hormone replacement therapy from a physician skilled in administering safe (low) doses of cortisol.

     All this preparation can take considerable time, work, and attention to detail, and it needs to be started before the appointments are set up for the dental procedure to allow enough time to get ready.

     This whole process may appear daunting to someone who thought changing fillings in the teeth should be a simple process.  For someone with Plan A, if not all the supplements are taken, there may not necessarily be ill consequences, but if any parts of the protocol is skipped, the main point not to neglect is to have the dental procedure done properly, to have the i.v. Vitamin C,  to follow the dietary do’s and don’ts, and to take the high potency multivitamins with plenty of Vitamin C.  For people with mercury-related problems, it is important to remember that there are people who have had their fillings replaced without any preparation and without attention to protocol, and they became more ill than before, in fact bedfast for several months.  These usually are people who have health problems attributable to mercury.  There is very good reason for doing everything reasonably possible to assure safety and to help the recovery from mercury toxicity to be a speedy one.

     The supporting information for this protocol came from the books mentioned above plus lectures given by Dr. Paula Bickle, Dr. Boyd Haley, Dr. Steven Edelson, and protocols of Dr. Norman Levin and Dr. John C. Cline.