The results of this study indicate that proper amalgam removal - and in some cases removal of all the other metals too - and replacement with biocompatible composites - can eliminate or reduce 80% of the classic symptoms of chronic mercury poisoning.

These results also show that the strength of an individual's serum-globulin reactions, to many metals used in dentistry, especially the five metals present in amalgam, has important implications for recovery.


It has been documented that mercury escapes from amalgam fillings and adversely affects health. 1.2.3.

Many clinical experiments have also demonstrated that symptoms associated with mercury poisoning greatly decrease when amalgam fillings are removed and replaced by less toxic materials - for example, composite materials.

This study differs from similar clinical studies in demonstrating the correlation between the patient`s serum-globulin reaction to dental metals and the patient's response after amalgam fillings (and other metals) are replaced with composite materials found to be biocompatible with the individual patient.

One hundred eighteen patients participated in this study, consisting of 97 women and 21 men ranging in age from 18 to 73 years. The average age of participants was 45 years. Before treatment began in 1990-91, a blood serum test was performed on each patient in order to determine which dental materials caused minimal reactions in the individual. This serum analysis incorporated globulin reactions for metals.

Scientific research by Pleva, Clarkson, Masi and many others has proven that metals are essential for normal human functioning. However, certain metals are poisonous, even in extremely small quantities, and serve no biological function. Heavy metals, including mercury and cadmium, are in this category.9 10 11. Other metals, for example copper, zinc and selenium, are necessary in minute quantities, but are toxic in large quantities. Products of corrosion and metals which react chemically with proteins or methyl groups are extremely poisonous.12

Removing all dental metals, thereby removing a constant and probably excessive source of exposure to metals, could obviously have a positive impact on the patient. Individuals react differently to many metals, as demonstrated by the blood serum test. This suggests that individuals will show varying degrees of improvement when exposure to these metals ceases.

Method and Result

The 118 patients involved in the study completed a survey discussing 38 classic symptoms of chronic mercury poisoning. Before removal of amalgam (and in some cases, additional metals) each patient underwent a blood serum test of their globulin reaction to 34 different metals and assorted dental materials. The patients then had all amalgam fillings removed. Some patients also elected to have other metal and porcelain dental work removed.

Symptoms Before Amalgam Removal

The survey covered 38 symptoms and complaints common to chronic mercury poisoning, as found in related literature. Participating in the survey were 118 patients who have been with my clinic since 1984.

The following symptoms and complains were common - before amalgam removal - to more than 50% of the participants.

Fatigue 83%  Headache 58%  Poor concentration 76%  Bloating 58%  Poor memory 65%  Throat pain 57%

Irritability 64%  Joint pain 57%  Muscle fatigue 62  Allergies 55%   Metallic taste 61% Poor appetite 51%

Prior to amalgam removal, all patient had an average of 17.4 of the 38 symptoms and complaints listed in the study. The 58 patients who reacted strongly to many metals had on average no more symptoms and complaints than the 60 patients who demonstrated milder total reaction to metals.

Blood Serum Globulin Reaction

All patients had a blood test taken at an authorized laboratory. The separated blood serum was frozen and send via SAS Cargo to the Diagnostic Center`s laboratory in Colorado Springs, Colorado, USA. This laboratory, under the direction of Hal Huggins DDS MS, is state approved and highly reputable.13

Another laboratory in Colorado Springs, under the direction of W.J. Clifford MS, member of IAOMT (International Academy of Oral Medicine and Toxicology), performed the same serum analysis.14

The test performed is described in medical literature as a precipitin test. The test determines the quantity of globulins (IgA, IgG and IgM) formed when the patients blood serum comes in contact with the metals, components and corrosion products in many dental materials.

The globulins are measured photometrically and the results indicate the relative serum reaction of individual patients. Besides the dental materials, the blood serum test applies to 34 additional metals. Participants responded positively to 32 of these metals. The distribution of patients response is shown below.

Strong reaction:                             Moderate reaction:                              Reaction on "Amalgam-metals:"

Molybdenum 99%                             Titanium       14%                                       

Zinc              97%                            Selenium      14%                                        Mercury 82%

Cadmium      93%                              Beryllium      10%                                           

Copper        92%                             Iridium          3%        

                                                         Platinum        5%

Indium          87%                              Lithium         1%                                         Silver      86%

Silver           86%                             Tungsten       3%        

Mercury      82%                             Cobalt          4%  

Nickel          79%                               Chromium     1%

Aluminium    75%                               Bismuth         3%                                        Copper   92%

                                                          Barium          2%                       

Tin              69%                              Antimony      2%                                                  

Palladium     31%                               Vanadium      8%                                         Tin         69%

Cerium        22%                               Ruthenium      2%                                                  

Iron            14%                                Gallium          1%                                         Zinc       97%

Selenium     14%                                Strontium       1%    

Gold           14%                                Zirconium      0%         

                                                          Rhodium       0%


Serum tests of several hundred patients showed that 98% reacted to some of the most popular composite materials. About 75 participants reacted to aluminium, which is present in many dental filling materials. Because aluminium is present in all glass ionomers, all patients who react to aluminium will react to this material. Some sufficiently strong composite dental materials, for example Posterior II and Conquest, do not contain aluminium. These are composed of substances and metals to which most patients react mildly.

Metals Used In Dentistry

A tremendous variety of metals are used in dentistry. A gold crown normally consist of gold and platinum and may contain many different metals, especially in the case of a "discount crown", where silver, copper, palladium, tin, indium and/or molybdenum are substituted for the expensive metals. The metal hardware under porcelain crowns frequently contains gold, palladium, silver, platinum, tin, indium, gallium and copper. Wires for regulating teeth and bands placed around teeth are composed of nickel, chromium, molybdenum and silicon. Dentures made of metal, so-called unitors are usually made of cobalt, chromium, molybdenum, silicon, titanium and sometimes nickel.

Many patients demonstrate globulin reactions to these metals, as indicated by the blood serum test. participants reacted to a range of 3 to 19 metals, the average participant reacting to 10 metals. The metal reactions were calculated with values ranging from 1 to 9 for each metal, 9 being the strongest reaction. The average combined reactions to all metals totaled 40 points, ranging from 6 to 108 points. When the 5 amalgam metals (mercury, copper, silver, tin and zinc) are considered exclusively, the average reaction is 20 points ranging from 2 to 45 point.

The known potency of the material must be taken into consideration when comparing these reactions. For example, beryllium and mercury are known to cause adverse reactions with extremely small doses. Other metals like copper and aluminium may cause a relatively higher reaction as measured in point, without being more dangerous. However, in this study this issue is immaterial because for each patient we compare the total of reactions to all metal/amalgam metal with their symptoms before and after removal of metals.

We compared the change in the symptoms of participants who reacted strongly to amalgam metals with those of participants who reacted mildly to amalgam metals, and the same procedure was followed for those who had a strong or mild reaction to other metals.

All amalgam fillings were replaced in all participants. 2,600 amalgam areas were removed, averaging 22 areas per patient. 29 patients had all other metals replaced, especially gold/porcelain. This group had 128 gold surfaces, average 4.4 per patient. The replacement of fillings took place according to methods recommended by Hal Huggins DDS MS, Colorado Springs, USA.

His recommendation include:

reinforcement of immune system with antioxidants, vitamins, minerals and special dietary; guidelines before and after treatment;

protect with rubberdam while drilling;

proper ventilation;

strong external and internal oral suction;

carbon tablet ingestion before and after each treatment;

one drink of alcohol immediately before treatment;

electrical checking of polarity of fillings was performed before each drilling to ensure that the fillings in the quadrant with the greatest negative charge were removed first;

treatments were not performed on the same days of the week to avoid depressed immune defense, which occurs on the 7th, 14th and 21st days after stress;

the patients had amalgam fillings and other metals replaced with the most biocompatible plastic material, as indicated by their blood serum test. The composite Posterior II was used in most cases;

each patient received a very detailed explanation and written instructions before treatment began.

All questions arising during treatment were addressed.

Best results are obtained when both doctor and patient follow these methods.

Results After Proper Amalgam Removal

After amalgam removal, 79 participants had no amalgam or metals remaining. 39 had no visible amalgam, having elected to retain one or more gold or porcelain crowns, under which amalgam may be present. One to four years after removal, all patients responded to the same survey as previously noted, inquiring whether the 38 symptoms and complaints had improved, disappeared, or remained unchanged.

The results of this survey indicate that for the average participant,out of 17 symptoms, 8.2 were reduced, 5.1 were eliminated, and 3.7 were unchanged. In other words, 48% of symptoms were reduced, 31% were eliminated, and 21% were unchanged. See Fig.1)

In total, 79% of the symptoms and complaints were reduced or eliminated after amalgam removal.


In over 90% of responses, the following symptoms were reduced or eliminated: tender teeth; bad breath, metallic taste; diarrhea; leg cramps; frequent infections.

In over 80% of responses, the following symptoms were reduced or eliminated: bleeding gums; blisters & sores; throat pains; nasal congestion; nasal discharge; headache; migraine; irrational fear; irritability; insomnia; dizziness; muscle tremors.



This study indicates that patients with mild reactions to metals are more likely to have fewer or no symptoms than those patients with strong reactions,

This difference is more pronounced when comparing patient`s reactions to the five amalgam metals (mercury, silver, copper, tin and zinc). Patients with strong amalgam metal reaction showed reduction or elimination of 74% of symptoms and complaints, whereas patients with mild amalgam metal reaction showed reduction or elimination of 84% .(See Fig.3)



The group with mild metal reaction showed greater than 10% improvement in following symptoms: allergies; skin problems; tender teeth; nasal discharge; constipation; fatigue; insomnia; muscle fatigue; muscle tremors; sciatic pain; joint pain; cold hands and feet; frequent infections. The group with strong metal reaction showed greater than 10% improvement in the following symptoms: blisters and sores; digestive pain; heart problems.




                                Number of symptoms before amalgam removal.

                                          Number of symptoms reduced after amalgam removal.

                                                     Number of symptoms eliminated after amalgam removal.

                                                                         % of symptoms reduced or eliminated for those that had

                                                                                        high metalreaction.

Symptoms/complains                                                                low metalreaction

Allergy                         65    40     3                                  57    73

Skin reaction                51    28    10                                 67    80

Bleeding gums              50    19    25                                 89    87

Tender teeth                 49    20    29                                78    100

Bad breath                   41    20    17                                 90    91

Metallic taste               72    12    59                                100    98

Blisters & sores           46    20    21                                 96     86

Watery eyes                43    19    15                                 82     75

Throat irritation            67    31    24                                 80     84

Facial tension              56    24    18                                  80     77

Nasal congestion         52    29    17                                  84     92

Nasal discharge          32    14    13                                  73      91

Bloating                      69    33    18                                  71     76

Hunger pain                60    22    14                                  62     65

Poor appetite              21                                           77     75

Diarrhea                     48    23    20                                   92     87

Constipation               44    22                                       59     74

Intestinal cramps         50    24    14                                   81     71

Headache                   68    41    17                                   82     89

Migraine                     21    11     6                                    78     83

Fatigue                       98    54   19                                    67     82

Poor concentration     90    50   14                                    67     75

Poor memory             77    41   13                                   74      67

Irrational fear             42    27    10                                   89      87

Irritability                   76    42    19                                   82      81

Depression                56    34    16                                   81      97

Insomnia                   54    31    13                                   79      92

Dizziness                   57   33     18                                   87      91

Muscle fatigue           73   33     14                                   51      80

Muscle tremor           53   21     21                                  74       90

Sciatic pain                30   17                                       57       81

Chest pain                 31   13      9                                   69       72

Legs cramps              39   16     19                                  89       90

Joint pain                   67   34     13                                  60       80

Cold hands-feet         58   20     18                                   51       81

Heart problems          25   11       6                                   82       57

Urinary syst.disorders 29  15       5                                   78       75

Frequent infections     43   20    19                                    83     100


For years, science has demonstrated that mercury found in the body comes primarily from amalgam fillings.15 It is also widely understood that many of the metals used in dentistry are toxic or hazardous.16 Innumerable scientific experiments on animals and humans have demonstrated that mercury from amalgam is hazardous to cells and functions of organs. Specifically, mercury affects the immune system;17 the kidneys;18 mouth and colon bacteria;19 the reproductive system;20 and the central nervous system.21

Many clinicians have demonstrated over the course of the past century that removal of amalgam fillings and gold/porcelain fillings improves an extensive array of symptoms, complaints and diseases which have been otherwise unsuccessfully treated. Professor Fredrik Berglund's book which appeared in 1995, surveyed the literature on this subject and collected the case histories of 150 patients whose diseases, symptoms or complaints were eliminated or reduced after removal of amalgam and other metals.22

Metal-free dentistry is possible today

Dental use of metals is no longer necessary thanks to good composites and especially to the new PCDMA-based, shock-absorbing and extremely durable composites.23 24 25

Laminate fortified composites with characteristics very similar to natural tooth material are now used for crowns and bridges.26 27 These materials are tested for biocompatibility with the individual patient.

This study demonstrates the positive results of removing amalgam fillings and other metals from patients who suffer from an extensive array of symptoms which they have not otherwise been able to treat successfully. Obviously, some participants may anticipate improvement, which in itself may result in improvement. This placebo effect results in 20-25% improvement at best and disappears gradually over time. Given that it generally takes 6 to 12 months or longer for symptoms to be eliminated or reduced, in order to counteract this effect, patients completed surveys one year after treatment, and in some cases, again four years later.

Metal Deposits

Patients generally improve gradually as years pass after amalgam removal. This correlates with the fact that large deposits are continuously found in the tissues of the body and are slowly eliminated. An active detoxification treatment could accelerate the improvement. The patients with a strong reaction to amalgam metals did not recover as favorably as those with mild reactions. Metal deposits in tissues and organs may be present for years in different degrees in these two groups of patients.


Periodontal deseases is very common. 42% of the participants in this study had bleeding gums and 46% had tender teeth, before amalgam and metal removal. It is commonly believed that bleeding gums and tender teeth are the early symptoms of pyorrhoea and are caused by plaque and microorganisms on teeth and in teeth sockets.

However, the results of this study indicate that metals and specially amalgam metals are the actual cause.28 In this study, 88% of the incidence of bleeding gums was reduced or eliminated.

91% of the incidence of tender teeth was reduced or eliminated.

Digestive Problems

Digestive problems were very common among participants. They can be caused by many factors, but amalgam removal demonstrates a strong positive effect on these problems. The mercury released from the amalgam fillings combines with the saliva, forming extremely poisonous methyl-mercury in the mouth, stomach and colon. The composition of digestive bacteria is changed as a result, and mostly mercury-resistent bacteria survive. Thus, many bacteria essential to healthy digestion are destroyed. A new study indicates that people with amalgam fillings have many more strains of penicillin-resistant bacteria than those without amalgam fillings.29

The results after amalgam removal are as follows:

74% indicate reduced or eliminated symptoms of pressure and air in stomach (bloating);

60% indicate reduced or eliminated symptoms of acute hunger pains;

76% indicate reduced or eliminated symptoms of poor appetite;

90% indicate reduced or eliminated symptoms of diarrhea;

76% indicate reduced or eliminated symptoms of painful colon cramps.

Central Nervous System

Problems with the central nervous system are also very common. (See figures 4-6). Both recent and earlier studies demonstrate that mercury escaping from amalgam fillings, especially as mercury vapor, can harm the central nervous system. Alzheimer`s disease is a primary example of this.21

The results after amalgam removal are as follows:

85% indicate reduced or eliminated symptoms of headache;

81% indicate reduced or eliminated symptoms of migraine;

71% indicate reduced or eliminated symptoms of poor concentration;

70% indicate reduced or eliminated symptoms of poor memory;

88% indicate reduced or eliminated symptoms of irrational fear;

80% indicate reduced or eliminated symptoms of irritability;

89% indicate reduced or eliminated symptoms of dizziness;

79% indicate reduced or eliminated symptoms of muscle tremors;

90% indicate reduced or eliminated symptoms of leg cramps;

Immune System

The immune system is often debilitated by mercury.17 Symptoms frequently include fatigue and frequent infections. These symptoms are significantly reduced or eliminated, as demonstrated by the following results:

71% indicate reduced or eliminated symptoms of fatigue;

91% indicate reduced or eliminated symptoms of frequent infections.

Kidney Function

Experiments with sheep and monkeys with implanted amalgam fillings demonstrate reduced kidney function.30

25% of participants had urinary system disorders prior to amalgam removal;

52% experienced reduced symptoms;

17% eliminated any complaints of urinary system disorders after amalgam removal.


Many symptoms commonly associated with mercury intoxication can be related to harmful effects from metals used in dentistry. About 16,500 observations were gathered during the prolonged study of these 118 patients; these data indicate that about 80% of the symptoms and complaints were eliminated or reduced one to four years after removal of dental metals, especially amalgam metals (mercury, silver, copper, tin and zinc) and proper replacement with biocompatible plastic.

This study confirms other classic and scientific results.30 31 and suggests that dentists should avoid the use of metals because of the reactions they clearly cause in many patients.

The greatest positive reactions are shown by the group with the mildest blood serum-globulin test reaction for the amalgam metals. This suggests that the determining factor for the degree and rate of recovery is dependent on the patient`s individual tolerance and degree of reaction to certain metals.


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2. Stock, A.:"Die chronische quecksilber und amalgam vergistung". Arch Gewerbepath 7:388, 1936.

3. Bauer, J.G.and First,H.A.-"The toxicity of mercury in dental amalgam". Calif Dent Assoc J 10:47-61. 1982.

4. Hanson, M: "Changes in health caused by exchanges of toxic metallic dental restorations". Bio-Probe Newsletter 5:2, 3-6  marts, 1989

5. Siblerud, R:"The relationship between mercury from dental amalgam and health".Ph.D.discertation in process, Dept. of Physiology, Colorado State University, 1988.

6. Lichtenberg, H: "Elimination of symptoms by removal of dental amalgam from mercury poisoned patients, as compared with a control group of average patients". J.Orthomol. Med. Vol. 8,No.3,1993.

7. Siblerud, R: "Health effect after dental amalgam removal". J.Orthomol.Med. 5 (2),1990.

8. Zamm, A: "Removal of dental mercury: often an effective treatment for very sensitive patient".J. Orthomol.Med. 5, 1990.

9. Pleva, J.: "Mercury poisoning from dental amalgam". J. Orthomol.Psych. 12: 184-94.

10.Clarkson, T.W.,Hursh, J.B.,Sager, P.R., and Syversen, T.L.M. (1988)." Mercury.In Biological Monitoring of Toxic Metals" ( Clarkson, T.W., Friberg, L., Norberg, G. F., and Sager, P.R., eds) pp. 199-246. Plenum, New York

11. Masi, J.V.(1995) "Corrosion of amalgams in restorative materials: the problem and the promise". In status quo and perspectives of Amalgam and other Dental Materials ( Friberg, L.,Schrauzer, G.N.,eds) Thieme-Verlag,Stuttgart. In press.

12. Gross, M.J., nd Harrison,J.A.(1989) "Some electrochemical features of the in vivo corrosion of dental amalgams". J.Appl. Electrochem. 19, 301-310

13. Huggins, H: DDS.MS.:Medical and legal implications of components of dental materials.P.O: Box 2589 Colorado Springs, CO 80901. USA 1989.

14. Clifford, W.J. MS, RM(AAM):Materials reactivity testing Background, basis and procedures for the immunological evaluation of systemic sensitization to components, which emanate from biomaterials. P.O. Box 17597 Colorado Springs, CO 80935 USA 1987. 1988. 1990.

15. World Health Organization (1991) Environmental Health Criteria 118, Inorganic mercury (Friberg,L.,ed) WHO,Geneva

16. Störtebecker, P. "Mercury Poisoning from dental amalgam". Störtebecker Fdn, Res.,Bioprobe, Orlanda,FL, pp,138,149,151-54, 1985.

17. .Hultman, P.,Johansson, U., Turley, S.J.,Linh,U., Enestrøm, S.,and Pollard, K.M.(1994) "Adverse immunological effects and autoimmunity induced by dental amalgam and alloyin mice FASEB J, 8,1183-1190

18 Zalups, R.K. 1991) "Autometallographic localization of inorganic mercury in kidneys of rats; Effect of unilateral nephrectomy and compensatory renal growth". Exp.Mol.Pathol. 54, 10-21

19 Summers,A.O.,Wireman,J.,Vimy,M.J.,Lorscheider,F.L.,Marshall,B.,Levy,S.B.,Bennett,S.,and Billard, L, (1993)"Mercury released from dental "silver"fillings provokes an increase in mercury- and antibiotic-resistant bacteria in oral and intestinal floras of primates". Antimicrob. Agents Chemother, 37, 825-834

20 Rowland, A.S.,Baird, D.D.,Weinberg, C.R.,Shore, D.L., Shy,C.M., and Wilcox, A.J. (1994) "The effect of occupational exposure to mercury vapour on the fertility of female dental assistents". Occup. Environ. Med. 51, 28-34

21. Lorscheider, F.L.,Vimy, M.J.,Pendergrass, J.C., and Haley, B.E. (1994) Toxicity of ionic mercury and elemental mercury vapor on brain neuronal protein metabolism. 12th International Neurotoxicology conference, Hot Springs, AR, October 31, 1994. Neurotoxicology 15, 955

22. Berglund, F. 150 years of dental amalgam. Published by Bio-Probe,Inc. P.O. Box 608010 Orlanda, FL 32860-8010. USA. 1995

23. Waknine, al: Direct/indirect commercial composites characterization on strength shrinkage and wear IADR 1722, Acapulco,1991.

24. Waknine, S., "Conquest DFC: A novel Universal Dental Composite Restorative System", Journal of Esthetic Dentistry Update, Vol 2, No. 4, 70-79, August 1991.

25. Waknine, S.,Goldberg, A.J., Mueller, H.J., Legeros, J., Prasad, A., and Schulman, A., "Fracture Toughness of a new semi-crystalline resin", paper # 1660, J. Dent. Res., March 1992, Amer. Assoc. Dent. Res., March 1992, Boston, Ma.

26. Ogolnick, R., Picard, B. and Denry, I., Cahiers de biomatéiaux dentinaires No 2. Materiaux Organiques, Masson, Paris 1992.

27. Waknine, S. et al,: Fracture toughness of a new semicristalline Dental resin, MDR 1660, Chicago, 1992.

28. Siblerud, R.L., "The relationship between mercury from dental amalgam and oral health". Annals of Dentistry. Vol.49. no.2 (1990) 6-10.

29. Hahn, L.J., Kloiber, R., Leininger, R.W., Vimy, M.J., and Lorscheider, F.L. (1990) "Whole-body imaging of the distribution of mercury released from dental fillings into monkey tissues". FASEB J. 4, 3256-3260

30. Lorscheider, F. L., Vimy, M.J., Summers, A.O. : Mercury exposure from "silver" tooth fillings: emerging evidence questions a traditional dental paradigm. Review. FASEB J. 9; 504-508, 1995.

31. Friberg, L.T., Schrauzer, G.N.: Status Quo and Perspectives of Amalgam and other dental Materials. International  Symposium Proceedings, Georg Thieme Verlag Stuttgart.  New York.


Tandlæge Henrik Lichtenberg et al.

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