Press kit
European citizens urge the phase out
of dental mercury
Thursday, May 7 at 11 a.m.
European Parliament – Brussels
“Anna Politkovskaya” press room – PHS 0A50 – Entrance : 60, rue Wiertz
Press Contacts :
World Alliance for Mercury-free Dentistry:
Germany : Florian SCHULZE – +49(0)178-1812729 – florianschulze@hotmail.com
France : Geoffrey BEGON – +33(0)652 58 46 06 – namd.asso@gmail.com
Michèle Rivasi : +33(0) 475 60 32 90 – michele.rivasi@europarl.europa.eu
1
INTRODUCTION
The Minamata Convention on Mercury was adopted in October 2013, in Japan; it was immediately signed by
92 governments including the EU. This is the first international regulation on a specific substance, which
highlights mercury as an extreme concern, both for the environment and for health. The Convention has until
now been signed by 128 countries and ratified by 11.
.
According to the report1, which is the basis for the implementation of the Minamata Convention in Europe,
dental amalgam "is, and will probably remain, the main use of mercury by consumers in the EU”.

Dental amalgam represents a quarter of the consumption of mercury in Europe: 90 to 100 tonnes are
implanted in mouths each year, while the global consumption of mercury throughout Europe is between
320 and 530 tonnes.

Dental amalgam is also the third annual recyclable mercury waste (95 tonnes in 285) and significantly
more than half of the accumulated mercury waste in our societies (1000 tonnes in 1784).

Dental amalgam is the largest source of exposure to mercury for Europeans.
In October 2014, the European Commission conducted a public survey 2 seeking citizens’ views on the
implementation of the Convention in the EU. This consultation resulted in 3 surprises:

With 3621 responses from citizens and 81 from organizations, civil society responses were a lot more than
the Commission had expected;

the amalgam issue is the one that has attracted by far the highest number of responses;

85% of citizens favoured a phase out of dental amalgams, rather than a phase down.
Institutions must now listen to the will of their citizens. Nothing justifies the use of dental amalgam today: this
material is indisputably toxic to humans and the environment, costly to society and completely outdated by
modern mercury-free fillings. Some European countries have already banned amalgam and many others are
going in that direction as well.
OUR DEMANDS
 We call for the implementation of the recommendations of the BIOIS report (2012): The European
Commission should immediately compel member states to take appropriate measures in terms of
pollution. Dental amalgam should be banned by 2018.
 The invasive medical devices, including dental materials, shall be subject to risk assessment reinforced
with marketing authorization and cell toxicity testing. Carcinogenic, mutagenic, reprotoxic (CMR)
substances and endocrine disruptors (EDs) should not be tolerated where there are alternatives.
SUMMARY
INTRODUCTION ...................................................................................................................... 2
OUR DEMANDS ....................................................................................................................... 2
SUMMARY ............................................................................................................................... 2
PROGRAM ................................................................................................................................ 3
WHAT IS AN AMALGAM? ..................................................................................................... 4
WHAT WE KNOW ABOUT DENTAL MERCURY ............................................................... 5
WHAT IS SUSPECTED ABOUT DENTAL MERCURY ....................................................... 5
CHRONOLOGY ........................................................................................................................ 6
BIBLIOGRAPHY ...................................................................................................................... 7
1
http://ec.europa.eu/environment/chemicals/mercury/pdf/REPORT-EU-Hg.pdf
2 https://ec.europa.eu/eusurvey/publication/MinamataConvention#
2
PROGRAM
Florian SCHULZE, Spokesperson of the World Alliance for Mercury-Free Dentistry in Germany
Introduction - "European Citizen voted to ban dental amalgam"
The Europe Union signed the Minamata Convention to regulate and abandon the use of mercury. So far 128 nations have participated and
recognized its hazardous effects and risk for humanity and environment. WHO even considers mercury as one of the most
worrying substances of all. Dental amalgam is likely to remain, the major consumer use of mercury in the EU. By banning dental amalgam, 75
tonnes of Mercury a year will be eliminated from circulation. Ending mercury use in dentistry is now inevitable. Delaying this deletion will
unnecessarily harm human health and contaminate the environment. The large majority of the survey by the EU voted for a phase out of
amalgam fillings. Now the EU should follow this opinion and ratify the Minamata Convention as soon as possible.
Michèle RIVASI, MEP – Greens/EFA group, France
“Medical devices: the Member States are complicit in the deteriorating health of citizens”
Citizens have expressed strong demand to remove the amalgam. Cette demande doit être entendue. L'amalgame dentaire est clairement le
dispositif médical le plus dangereux (MD), car il est la source de l'accumulation de mercure dans le corps des Européens. Il est donc nécessaire
de le retirer dès que possible, en attendant la mise en œuvre malheureusement retardé par le Conseil, une véritable évaluation des risques
liés aux DM, avant leur commercialisation. Aujourd'hui, les Européens sont en effet des cobayes humains, puisque nous tolérons l'utilisation
de MD invasive sans essai de toxicité préalable et il est admis qu'ils contiennent CMR ou PE. Plus généralement, l'évaluation des risques doit
être complètement repensée: exposition à des substances toxiques est un problème en soi, mais des phénomènes multi-exposition générer
de nouvelles préoccupations.
Marie GROSMAN, Vice President of the World Alliance for a mercury-free dentistry, France
"State of knowledge about mercury toxicity"
What we know of mercury toxicity is overwhelming: that is why all mercury uses are gradually prohibited. It is inconceivable that mercury is
still tolerated in a medical device implanted in the body, while its accumulation in the brain is established as well as its placental transfer in
pregnant women. This brings to question the official reports, particularly those of the SCENIHR. The 2008 report was subject to conflicts of
interest; the new one, not yet published, is more faithful to the state of science, yet its very reassuring conclusion is in total contradiction with
its content. But how can it be explained that the report ignores the classification of elemental mercury by the European Commission as
reprotoxic 1B, dangerous for the fetus?
Bobbie BECKMANN, Dentist, Italy
"A 35 years experience of no amalgam filling solutions"
I am a Swedish dentist working in Italy since 20 years. I graduated 44 years ago in Stockholm and the last 35 years I have been working without
using mercury amalgam to do fillings. Indeed, when I saw what a poor material amalgam was and realised the fact that mercury was leaking
from the amalgams, I stopped using amalgam and turned to use only metallic free fillings. Apart from the toxicity of mercury-amalgam, which
in itself is sufficient to ban the use of it, other physical characteristics makes the amalgam a most unsuitable filling material: by corrosion and
expansion, it is likely to crack the tooth; reversals of caries underneath the amalgams are common; amalgam causes functional disorders; it
is unsightly, etc.
Christer MALMSTRÖM, Dentist, Sweden
"How Sweden has turned its back to amalgam: a success story"
Patient organizations, the media, a few whistle blowers and a government survey " Dental materials and Health " were of essential
significance for the politicians to get the courage to ban amalgam in 2009. Very important was also that the Swedish population understood
that mercury in amalgam is as dangerous as mercury in batteries and thermometers. Science that proved the danger with amalgam had long
been known then and alternative materials were at hand, at least as good as amalgam. Since the disappearance of the amalgam, dental care
expenditures remained unchanged.
Elena LYMBERIDI-SETTIMO, European Environmental Bureau, Belgium
Conclusion - "The EU should keep leadership position"
Across the Member States, citizens have clearly spoken the overwhelming majority want the EU to lead the world on reducing mercury
exposure, ratify quickly the Minamata Convention, and do more – and faster – than the Convention requires. Citizens strongly believe that
dental amalgam should be phased out now. Investigations over the course of recent years, lead to the same conclusion: an EU 2012
commissioned (BIOIS) report proposed an amalgam phase out by 2o18; in 2013 amalgam manufacturers recognised the ‘demise of amalgam’,
and in 2014 the SCHER report confirmed that under certain conditions dental mercury released into the environment can turn into
methylmercury, concluding that “a risk for secondary poisoning due to methylation cannot be excluded”. The EU asked and its citizens
responded: the EU should adopt relevant regulatory proposals beyond what is required in the Minamata Convention, including a proposal for
the phasing out of dental amalgam.
3
WHAT IS AN AMALGAM?

Amalgam consists of 50% mercury, Hg (22-35% Ag; 10-15% Sn; 5-13% Cu, 0-0,5% Zn). Amalgam always
leaks Hg, Ag and Cu. More if you drink a cup of coffee, brush your teeth, take medicine, clean your teeth.

Amalgam is the largest source of mercury exposure on humans in Europe.

About 75 tons of mercury per year, end- up in the mouths of people in Europe.

It’s easy to measure Hg vapour in the mouth, but it just shows how unstable amalgams are.

Exposure has to be measured in faeces, 80% . Only about 10% in urine, 10% in sweat.

Amalgam waste must be kept in environment safe storage.

Amalgam exposes the patient to hazardous levels of mercury.
Exposure
No amalgam
Amalgam
Amalgam removed
Exposure when treated with amalgam
Small amalgam,
max protection.
Normal amalgam
WHOs max exposure for industry,

Mercury, Hg
3 µg/24 h (2-5)
54 µg/24 h (9-196)
7 µg/24 h
Silver, Ag
6 µg/24 h
75 µg/24 h
12 µg/24 h
400 µg/24 h
163 µg/24 h
1800 µg/24 h
513 µg/24 h
45 µg/24 h
Stopping the amalgam use will not result in spectacular additional costs.
Expenses for dental care in Sweden in billions of SK. (Landstingen).
2007
2008
2009
2010
2011
2012
2013
4,8
5,0
4,9
5,0
5,1
5,3
5,2
Conclusion: No extra costs without amalgam. The costs will also be reduced in the future for cremations,
environmental measures, mercury related health problems, etc.
Amalgam corrode, expands and cracks the teeth (more pictures: http://www.misac.se/forskning3.html)
Fracture due to expansion of the amalgam
Cracks
Corrosion
Fracture of the whole tooth due to the expansion and
corrosion of the amalgam
4
WHAT WE KNOW ABOUT DENTAL MERCURY
 Risks for the patient. Mercury is a highly toxic substance: a neurotoxic, nephrotoxic, a cardiotoxic a reproductive
toxicant, an endocrine disruptor, immunotoxic and genotoxic, classified as a Carcinogenic, Mutagenic and
Reprotoxic sunstance (CMR1B). There is no threshold effect; ie, there is no known dose below which the mercury
would be safe. Or the mercury in amalgam fillings continuously escapes. Dental fillings are the primary source of
mercury exposure in developed countries and contribute two thirds of the mercury levels in the body. This mercury
is concentrated especially in the brain (where its half-life is 25 to 30 years), endocrine glands, kidneys.
 Risks to the fetus and child. Mercury is also transmitted from mother to child by placental transfer and through
breast milk. The European Commission has tightened the classification of elemental mercury from Category 2
reproductive toxicant to Category 1B (dangerous to the fetus). We know that a child's IQ is inversely proportional to
the amount of mercury in umbilical cord, which is itself proportional to the number of amalgam fillings of the mother.
A significant decrease in the mercury concentration of the umbilical cord of Swedish women has been observed
several years after stopping the use of amalgam in Sweden (after delisting in 1999).
 Risks for professionals. Dental practitioners and in particular their assistants suffer more than the population from
mercurial erethism (emotional instability, memory loss, anxiety, depression ...), cognitive disturbances, neurological
disorders (tremor, visual disturbances, peripheral neuropathy with dexterity loss ...), brain tumors (glioblastomas and
other gliomas), infertility, risk of miscarriage, etc. The suicide rate is among the highest. Classification of mercury as
reprotoxic 1B requires the employer (the dentist) must substitute the substance to protect its workers against the
consequences of occupational exposure.
 Risks to the general population. Mercury stagnates in the intestine of amalgam carrier and is then released into the
wastewater via the faeces; this phenomenon induces antibiotic resistance. This issue must be included in the public debate as
antibiotic resistance is becoming a major public health problem.
 Environmental Risks. Mercury is one of the pollutants of concern because of its toxicity, its persistence in the
environment and its bioaccumulation properties. Dental mercury pollutes the air from dental practices (even those
equipped with separators) or during cremations. Finally, mercury of dental origin eliminated by the body in faeces
and secondarily in urine is found in wastewater, sludge and lastly in the vegetables, mushrooms, cereals, etc. : dental
mercury contributes substantially to the contamination of our food.
 Amalgam is by far the most expensive filling material if one considers outsourcing of environmental costs, without
even taking into account the health costs: up to now, polluters (manufacturers and dentists) do are not the payers
(cost of mercury from crematoria filters, pollution control of sewage sludge, etc.).
WHAT IS SUSPECTED ABOUT DENTAL MERCURY
 Multiple sclerosis (MS). There is a strong correlation between the global prevalence of caries disease and MS. In
2004 a major retrospective epidemiological study revealed the risk of MS increased by 24% for each additional
amalgam. Mercury levels in the blood are higher in people affected by this disease. The removal of amalgam under
secure conditions can lead to dramatic, rapid and sustainable changes, in the characteristics of typical cerebrospinal
fluid proteins of MS.
 Alzheimer's disease (AD). People with AD have higher mercury concentrations in both the blood and the brain than
controls. Moreover, it is well established that the major genetic susceptibility factor for AD is apolipoprotein E (APOE)
gene carrier versions (alleles). APOE2 have much less risk of developing the disease that holders of version APOE4.
However, the latter are unable to eliminate mercury from their brain because the proteins encoded by their APOE4
gene lack sulfur bonds to bind strongly to the cerebral mercury and remove it, in contrast to the proteins encoded by
the APOE2 genes.
 Autism Spectrum Disorder (ASD). Several studies have shown a relationship between environmental mercury
exposure and risk of ASD. It is also established that children with autism have higher levels of mercury. Biochemically,
there is a close parallel between the neurological effects of mercury poisoning and brain characteristics observed in
autism. The severity of the disease correlates with the number of amalgam fillings of the mother.
5
CHRONOLOGY
1984: The International Academy of Oral Mecidine & Toxicology (IAOMT) is created by dentists who are alarmed at the dangers of
mercury in dental amalgams
1995: In Germany, 1,500 people who claimed their health was affected by dental mercury filed a complaint against the leading
supplier of amalgam in this country, Degussa. To avoid lawsuits, the company requested an arrangement: it paid 300,000 DM DM
300,000 to the state for research purposes and 1.5 million DM to compensate patients. Finally, it will withdraw from the amalgam
market.
1997: In Germany, the study of Tübingen, conducted on 20,000 people, showed that people with amalgam fillings have significantly
more mercury in saliva than people without amalgams.
1998: Directive 98/24 / EC requires the employer to take steps to protect the health and safety of workers exposed to hazardous
chemicals, including mercury. This legislation was completed in 2009 by Directive 2009/161 / EU on the indicative limit values for
occupational exposure.
1999: Sweden wants to ban amalgam but the Maastricht Treaty does not allow it because of the free movement of goods. It bypasses
the problem by ceasing to repay amalgam, whose use falls rapidly.
2002: EU begins to ban certain uses of mercury, first in electrical and electronic equipment; then come measuring instruments (2006
and 2012), batteries and accumulators (2008).
2003: an official Swedish report, Dental Materials and Health, by indisputable specialists inorganic mercury, concluded that "for
medical reasons, dental amalgam should be deleted as soon as possible." This is the scientific basis of future ban on amalgam in
Sweden.
2003: in France, the National Research and Safety Institute for the Prevention of Accidents and Occupational Diseases (INRS) admits
the risk of mercury poisoning for dental professions.
2008: Norway banish amalgam.
2009: Sweden banish amalgam and ask other European countries to follow its example.
2010: Opening in Stockholm from conferences organized by UNEP for a progressive reduction in mercury use worldwide. The World
Alliance for Mercury-free dentistry is created.
June 2011: the Council of Europe unanimously adopted a resolution that calls for "the restriction or prohibition of amalgam dental
filling materials".
October 2011: The health risk associated with amalgam fillings are confirmed by WHO, in a report showing that children are
particularly susceptible to the neurotoxic effects of mercury; that amalgam was associated with general health problems; finally, the
majority of the side effects of dental materials are related to amalgam.
March 2012: the report "The real cost of dental mercury" shows that dental amalgam is the most expensive filling material taking
into account environmental costs.
April 2012: a Norwegian dental assistant is recognized as a victim of mercury inhalation on her workplace. This will be confirmed
in January 2014 by the Supreme Court of Norway, which recognizes that mercury is harmful to health and that it has actually
deteriorated health dental assistants exposed to mercury vapor in their daily work.
July 2012: the BIOIS report recommends strengthening legislation on mercury waste from dental offices and a ban on amalgam
in 2018.
December 2012: The European Food Safety Authority (EFSA) notes that “inhalation exposure of elemental mercury from dental
amalgam is likely to increase the internal inorganic mercury exposure; thus the TWI might be exceeded”.
October 2013: MEPs believe that medical devices directly exposing patients to carcinogenic, mutagenic or toxic for reproduction
(CMR) or endocrine disruptors (EDs) should be withdrawn from the market wherever there are alternatives. Mercury is an ED and
CMR 1B.
2014: European Commission adopts the following classification for elemental mercury: “Repr 1B H360D (May damage the unborn
child), Acute tox 2 H330 (Fatal if inhaled), STOT RE1 H372 (Causes damage to organs through prolonged or repeated exposure),
Aquatic acute 1 H400 (Very toxic to aquatic life) and Aquatic Chronic 1 H410 (Very toxic to aquatic life with long-lasting effects).”
6
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7
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8