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MERCURY AMALGAM FILLING REMOVAL

         PATIENT PREPARATION and MEDICAL MANAGEMENT

                                                                                                                  
The following are general guidelines, written for our patients who enjoy good health, or whose health conditions are stable, who wish to undergo amalgam removal as part of a comprehensive detoxification/nutritional optimization program.  More aggressive measures, such as Dr. Lee Cowden’s protocol, presented below, may be appropriate for ill or medically compromised patients.  Again, these are general guidelines, which we will individualize to your personal health status.

Mercury is a toxic substance, actually one of the most toxic substances on the planet.  Your body has no use for mercury; it is a pure toxin.  The scientific literature is clear - even low levels of mercury exposure compromise the health of children, adults, and the unborn.  We don’t care where the mercury came from (fish, vaccines, or amalgam fillings – which are 50% elemental mercury), nor are we interested in attributing blame to any one individual, industry, or institution.  What we care about is helping your body rid itself of this terrible substance.  The toxicology literature tells us that 2/3rds of the mercury present in amalgam bearing Americans originates in their fillings, from which Mercury is constantly being off gassed.  Tissue levels in adults, children, breast milk, and in the unborn correlate directly with the number of mercury fillings present (that’s right, your baby’s brain mercury level rises with the number of amalgam fillings that you bear).  Any professional who tells you that mercury is “locked in” the amalgam, or that “amalgam fillings are safe” is not a professional who you should be working with.  Remember, mercury originating from amalgams placed in your daughters is mercury in the brains of your future grandchildren.  Amalgam mercury is a crazy idea, the safety of which has never been proven (nor even looked at, as we would today if amalgam fillings were introduced as a new procedure).  Fortunately, there are knowledgeable, well read dental professionals who will help you – men and women with enough personal strength to do the right thing despite intensive peer pressure to go along with American Dental Association doctrine.  For the science on mercury, its sources, and how it compromises your biochemistry and your health, please review our four hour, two DVD, presentations on mercury.  The following general guidelines pertain to patient preparation and management in regards to the amalgam removal process.

Initial patient preparation:  Well before you even consider having your amalgams removed, the following basic steps should be taken (and are a plus for your overall health).
A.  Optimize endogenous excretory routes – Toxins leave your body via the kidneys, liver, GI tract, and via sweat.  At a minimum, we need to check your liver and kidney chemistries, address any abnormalities present and/or add in the appropriate supplements.  You should be moving your bowels 2-3 times a day; if not we need to address this.  Remember, if your excretory routes are clogged, we can chelate you all we want, but the toxins will not leave your body.
B. Optimize your nutritional status – We want to get the bad stuff out, but first we need to get the good stuff in (the vitamins, minerals, detoxifiers, and cell membrane lipids that Mother Nature intends we possess).  Actually we need to go a little beyond her recommendations, because mercury has kicked out or bound up several key nutritionals, notable selenium, glutathione, and magnesium.  The basic approach is to begin a 6-a-day multi (taken as two with meals), with additional magnesium and a program of essential fatty acids (see appendix and/or our DVD presentations on antioxidants and fish oil).  Better yet, after you have been on a nutritional program for several months, we can evaluate its adequacy with a SpectraCell white blood cell antioxidant assessment, and either a packed red blood cell or 24 hour urine mineral study.  Gaps in your nutritional defenses should and can be addressed.
C.  Hydrate yourself – Drink three quarts of spring or alkaline water (at the office we use the Athena water purifier/alkalinizer) every day.
D. Genomic assessment – Genomic testing is expensive, but may tell us why you are sick while your neighbors and co-workers are not.  The environment is toxic, but those of us with Methyl Cycle defects seem to be more susceptible to environmental toxicity than those of us not so genetically challenged.  Methyl Cycle testing will also guide our choice of metal detoxifying (chelating) agents (those of you with trans-sulfuration abnormalities will have trouble tolerating sulfur bearing chelating agents such as DMPS and DMSA).  Methyl Cycle genomic testing is discussed elsewhere on this website.  We can screen for trans-sulfuration defects with a urine sulfate determination ($10 at the office). 
E. Ondamed, an FDA registered medical bio-feedback device, utilizes pulse autonomic feedback to elucidate and then address imbalances in one’s physiology.  10 sessions over 5 weeks would be ideal.
F. Estimate of metal burden – Before you begin detoxification, it helps to establish your baseline level of toxicity.  Blood tests are of no value – they reflect recent exposure - but correlate poorly with tissue or body burden.  Our best measure (and admittedly not a perfect one) is a provoked urine metal determination.  We use the triple challenge (discussed on the DVDs and on the website) methodology. Here you receive low to moderate doses of several oral and IV chelators, followed by laboratory analysis of toxic metal levels in a subsequent “provoked” urine sample.  After we establish your baseline, a chelation program individualized to your metal burden and your health status will be initiated.  Periodically we can repeat your provoked metal study to gauge progress and to assess the thoroughness of your detoxification program.

Pre-amalgam removal detoxification:  Start this program several months before your amalgams are removed, adding it onto your established nutritional regimen.  While your program will be tailored to fit your personal health and genomic status, one or more of the following measures will be recommended.
1. Chlorella five tabs chewed up and swallowed twice a day (felt to help mobilize mercury, making it more available to the chelators).
2. Nutramedix Zeolite, one capsule a day (with water, at least 30 minutes prior to a meal), increasing to one capsule twice a day in two weeks.
3. DMSA (sometimes not well tolerated in patients with trans-sulfuration abnormalities or sulfite sensitivity) is a relatively weak oral metal chelator, the efficacy of which is enhanced within a negatively oriented magnetic field (see MME DVD or discussion on website).  Individuals sleeping on a negatively oriented magnetic sleep pad typically take 500 mg at bedtime, 15 nights on, 5 nights off, in a revolving cycle.  In others the typical dose is 500 mg three days a week.
4. It is best to take your chelators at least 30 minutes apart from one another, and at least 30 minutes prior to meals (but I’d rather have you take them together rather than not take them at all).
5. Do not take Vitamin C the morning of amalgam removal (it is such a powerful detoxifier that your dentist may have trouble numbing you up).

Amalgam removal: 
1. Take Nutramedix Zeolite and/or DMSA (30 minutes apart) several hours before amalgam removal.
2. Immediately following amalgam removal, chew up, swish, and then spit out one chlorella tablet.
3. Following amalgam removal, proceed to the office for an IV treatment, aiming to bind up or neutralize the mercury off gassed from your amalgams as they were removed.  Depending upon our knowledge of your physiology we may use DMPS, EDTA (a poor tissue mercury chelator but effective in scarfing up mercury in the blood), or Vitamin C with glutathione.
4. If you are not overly sensitive to the Lifewave Glutathione patch (lifewave.com/chc), place a patch several hours prior to amalgam removal and remove it several hours after your IV treatment.
5. The following day resume your usual pre-amalgam removal program.

Subsequent Amalgam removal visits: 
1. Amalgams are rarely removal all at once (the procedure would take too long and you would be exposed to too much mercury vapor).  Often, biological dentists will remove amalgams one quadrant at a time.  Follow the amalgam removal day protocol with each round of amalgam removal.
2.  There is a weekly immune system cycle, and many authorities recommend against amalgam removal exactly one week apart.

Post - Amalgam removal detoxification:  The primary source of mercury exposure has been removed, you are watching your fish intake (especially fresh water), and insisting on mercury (thimerosal) free vaccines, but our work is not complete.  It is nowhere near complete, because the half-life of mercury within your body is 10-20 years!  That’s right, is we do nothing more than remove your fillings, the content of mercury within your body will fall by 50% in 1-2 decades.  Mother Nature didn’t design us to deal with mercury so she needs some help.   
1. Continue with chlorella supplementation for three months.
2. Switch from Nutramedix Zeolite to Nutramedix Zeolite HP.
3. Switch from DMSA to transdermal DMPS-Glutathione (separate instruction sheet).  We typically begin at 2 drops late in the day, increasing in 2 drop increments to 25 drops every evening or 50 drops every other evening.
4. Keep up with your nutritional supplements, particularly the minerals, as they may be “drawn out” along with the mercury and other toxins removed in this process.
5. Now that your amalgams are removed, Asyra-based homeopathic or LED (laser assisted detoxification) mercury detoxification can be carried out, and may be recommended.
6. Your post-challenge urine metal levels and nutritional status will be rechecked, typically 6 months following amalgam removal and again one year later. 

The best time to have your amalgams removed is well before you become ill.  The sicker you are, the more difficult will be the detoxification process, and the longer it will take to optimize your health.

While mercury is a major toxin, it is not the only toxin, nor is mercury the only cause of ill health.  Thus we view mercury detoxification not as a mono-therapy, but rather as one component of a comprehensive health care program.

Appendix I, Nutritional Support:  For nutritional support in preparation for amalgam removal/mercury detox I recommend:
1. A 6-a-day multi, such as Douglas Labs’ Basic Preventive V.  Similar preparations are available at area health food stores or on line from the major nutraceutical firms.
2. Magnesium glycinate ½ scoop twice a day and Nutramedix Trace Minerals Relax 10 drops in water twice a day.
3. Fish Oil, 2 gelcaps each day or Ethyl EPA 1 per day, ideally combined with GLA (gamma linolenic acid, from evening primrose or borage seed oil) 260-300 mg/day.

Appendix II, picking a Dentist:  If you are ill or medically frail with a chronic illness, it is best to work with a committed biological dentist, one affiliated with the International Academy of Oral Medicine and Toxicology (www.iaomt.org), or a related Mercury Free Dentistry group.  If you are young and healthy, and wish to undergo amalgam removal as part of a pre-emptive health optimization program (as I and my family did), then your personal dentist can remove your amalgams, provided he or she is intellectually on board with you.  You do not want your amalgams to be removed by a dentist who does not understand the problem.  You do not want to work with a dentist who will not take steps to protect you from the mercury vapor off gassed during the amalgam removal process, and who might leave some mercury behind.  American dentists are in a difficult position.  Everyone with half a brain knows that mercury is toxic and that mercury is constantly being off gassed from amalgam fillings, but the American Dental Association is sticking to the position that amalgam mercury is safe.  Dentists smart enough and strong enough to ignore the peer pressure have been subject to regulatory sanctions (although this time has passed).  The problem for the ADA, I believe, is one of liability.  If they do an about face and state publicly that amalgam mercury is unsafe, the trial lawyers will crucify them along with the pro-mercury dentists.  This is the same reason, in my opinion, that mercury is still being used in vaccines.  The solution (my opinion again) is for Congress to pass laws forbidding the use of mercury in dentistry and in vaccines.  This way the ADA, vaccine manufacturers, and dentists can stop using mercury, without leaving themselves open to liability issues.

                                                                                                                                                                James C. Roberts MD FACC 11/08

 

Dr. Cowden’s Mercury Amalgam Protocol

The following are the recommendations that W. Lee Cowden M.D. makes to his patients who have mercury amalgam fillings in their teeth and are being adversely affected by those fillings. Mercury is one of the deadliest poisons.  Great care should be taken in the removal of mercury amalgam fillings and the mercury body load as well as the selection of the healthcare professional team who will be performing the work.  All of the following is intended for educational purposes only and not to diagnose or treat any individual. Because unintended harm could result from the misapplication of this knowledge, it is strongly advised that this protocol be carried out only under the direction of a skilled health practitioner.

Preparation Before Mercury Amalgam Removal

1.     Select Health Professionals

a.       Select Qualified Health Practitioner - Establish a relationship with a health practitioner who will work closely with the dentist that is chosen and who will do patient evaluations before, during and after the mercury amalgam removal process.  It is preferable if the health practitioner is skilled in energetic medicine (electro-dermal screening or evaluative kinesiology).

b.      Qualify Dentist - Schedule an evaluative appointment with the dentist who will potentially remove the mercury amalgam fillings.  Use the answers to the questions from the attached “Dental Office Screening Questionnaire” to determine which dentist will likely do the best and safest work.

2.     Prepare Body

a.       Hydrate - Start drinking enough pure spring water (not distilled water and not reverse-osmosis water).  Drink 2 ½ to 3 quarts or liters per day for a person weighing 150 pounds (68 kg).  Drink proportionately more for heavier individuals and proportionately less for lighter weight individuals.

b.      Supplement Magnesium - If no kidney dysfunction is identifiable by serum creatinine measurement, also start Nutramedix Magnesium Malate caps at a different time of the day than the Zeolite.  The starting doage of Magnesium Malate is usually one (1) capsule per day for someone less than 50 pounds (23 kg) and one additional capsule per day for each additional 50 pounds (23 kg) of body weight.  It is usually best to spread the daily dosage out over 2-3 doses per day and it can be taken with food.  Decrease the starting dose if diarrhea develops or increase the daily dose if constipation persists (less that 3 bowel movements per day is constipation).  Normal bowel function is critical in detoxifying mercury because much of the mercury mobilized from tissues is processed in the liver and dumped into the intestine from the bile ducts.  If constipation is present, the excreted mercury gets reabsorbed out of the bowel before it can be eliminated from the bowel.

c.       Supplement Other Minerals - Take 30 drops of Nutramedix Trace Mineral Relax with the Magnesium Malate twice daily. Continue taking the Magnesium Malate and the Trace Mineral Relax until the Zeolite-HP is stopped several months after amalgam removal.

d.      Start Detox - Start taking Nutamedix  Zeolite caps (not Zeolite HP) at a dose of one (1) capsule daily 30 minutes before a meal with water only.  If one weighs 100 to 200 pounds (45 to 90 kg) then, after a few days, increase to two(2) capsules once daily.  If one weighs more than 200 pounds, increase slowly to 3 capsules once daily 30 minutes before a meal with water only. If one weighs less than 100 pounds, continue only one (1) capsule of Zeolite.  Zeolite-HP, at the same number of capsules once daily as Zeolite, will replace the Zeolite after all amalgams have been removed.

e.      Self Adjustment – Daily adjustment to the neck, back, pelvis, and other major joints.  (To see a demonstration video please visit www.mouthofhope.org.)

3.     Prepare for Removal Procedures

a.       Initial Dental Visit - Reverify with the chosen dentist that all the steps initially posed to the dentist as questions in the “Dental Office Screening Questionnaire” will be followed on each visit to the dentist’s office.  Have the dentist do the initial evaluation including dental x-rays (Panorex preferred), galvanic testing of each amalgam, blood testing for G6PD deficiency and compatibility of dental restorative materials as well as discussion of the dentist’s plan and schedule for the dental restoration.

b.      Verify Materials Compatibility - When the compatibility blood test results return, have the dentist make hardened samples of each of the most compatible materials (composites, adhesives, etc.) about the size of half of an English pea and each with a unique shape.  For one hour twice daily for 1 week, place all the samples of compatible materials between the lower lip and the lower gum.  After 1 week get energy tested by the dentist or health practitioner for each of the sample materials.  Make sure the dentist is willing and able to use only the materials which are most compatible by energy testing.

c.       Schedule Dental Work - Arrange for the dental appointment(s) to remove all amalgams (should remove teeth if they have root canals and amalgams).  Make sure that the appointments are never 7, 14, 21, 28, 35, or 42 days apart from each other, if more than one appointment is necessary. 

d.      Schedule Health Practitioner -Arrange to meet with the chosen health practitioner immediately after your dentist will have completed all mercury amalgam removal in order to start mercury detox procedures.

e.      Stop Certain Supplements – No vitamin C, vitamin E, Fish Oil, Ginger, or Garlic during the 48 hours before dental procedures.


Typical Dental Amalgam Removal Procedures

1.     Basic Procedures for All Dental Work

a.       Dentist numbs the mouth with local anesthesia free of epinephrine and preservatives.

b.      Dentist uses rubber dams on each tooth for amalgam replacement.

c.       Dentist uses copious water irrigation and continuous high-vacuum suction.

d.      Dentist uses a very small-diameter, low-speed (less than 120,000 RPM), diamond-tipped burr, applying light pressure to cut the amalgam out in large chunks that are placed in a bio-hazard container.

2.     Procedures for Non-root-canalled Teeth

a.       All amalgams in non-root-canalled teeth should be removed before treating root-canalled teeth with amalgams.

b.      Amalgam replacement progresses from the most negatively-charged tooth to the least and then from the most positively-charged tooth to the least.

3.     Procedures for Root-canalled Teeth

a.       All amalgams in non-root-canalled teeth should be removed before treating root-canalled teeth with amalgams.

b.      Tooth extraction progresses from the most negatively-charged root-canalled tooth to the least and then from the most positively-charged tooth to the least. The extracted tooth’s dental ligament is removed and all dead bone and debris is scraped out of the socket until easily bleeding bone is exposed on each wall of the socket.

c.       Partial denture (preferably non-metallic) is used for a few months after extraction(s) before considering bridge(s), etc.

4.     Procedures for More Than 2 Hours of Dental Work or Both Sides of the Mouth on the Same Day (in addition to the above procedures)

a.       The dentist should use Versed or Valium intravenously to achieve light sedation.

b.      Dentist starts a 10+ gram vitamin C drip to run IV during the amalgam removal (as long as the patient does not have G6PD deficiency).

c.       Optional: If the dentist and the health practitioner agree, place an oxygen canula in the patient’s nose at 2 liters per minute flow-rate during the amalgam removal.

Mercury Detox Procedures After Amalgam Removal

  1. After all amalgams are removed, stop taking Nutramedix Zeolite and start taking Nutramedix Zeolite-HP.  The initial dose is one capsule 30 minutes before a meal with water only every 3 days.  If one weighs 100 to 200 pounds (45 to 90 kg), then after 1-2 weeks, increase to two capsules 30 minutes before a meal every 3 days.  If one weighs over 200 pounds, then after another week, increase to 3 capsules as one dose every 3 days 30 minutes before a meal with water only.  Continue Zeolite-HP for at least 4 months.
  2. If one weighs more than 100 pounds, take Di-Mercapto-Succinic Acid (DMSA) 100 mg with each of the first few doses of Zeolite-HP.  Start with only 25 to 50 mg if the person taking it weighs less than 100 pounds.  When and if the Zeolite-HP dose is increased to 2 capsules (as described above), then double the starting dose of DMSA (still to be taken only simultaneously with the Zeolite-HP).  When and if the Zeolite-HP dose increases to 3 capsules, triple the starting dose of DMSA (still taken only with the Zeolite-HP doses).
  3. Continue to drink enough spring water and take both Magnesium Malate and Trace Mineral Relax each day as previously described in “Preparation Before Mercury Amalgam Removal”.
  4. If the chosen health practitioner is knowledgeable in Laser Energetic Detox (LED), have them perform LED for “Sulfa” first, if it is energetically present, then for other toxins based on energetic testing protocols.

Dental Office Screening Questionnaire

(Place a mark in the box for each question answered “Yes”)

 Does the dentist routinely remove amalgam dental fillings and replace them with composite fillings if requested by the patient or the patient’s doctor?

 Does the dentist do blood tests for determining patient compatibility with the dental restorative materials used?

Does the dentist use a galvanometer to check the electrical charge of each amalgam filling before removing the amalgams?

Does the dentist remove the most negatively charged amalgam first, followed by the next most negatively charged, etc. then, when all negatively-charged amalgams have been removed, proceed next to the most positively-charged amalgams, etc. finally ending with the least positively-charged amalgam?

Is the dentist willing to extract teeth with root canals if a patient’s doctor is convinced that the root canal teeth are adversely affecting the patient’s general health?

When teeth are extracted does the dentist remove the dental ligament and scrape out of the socket all dead bone and debris?

Is the dentist skilled at surgically cleaning out ostitis cavitations?

When removing amalgams, does the dentist use a rubber dam over each tooth being worked on?

When removing amalgams does the dentist use a very small diameter low-speed (less than 120,000 RPM) diamond-tipped burr (with low pressure applied) to cut the amalgam out of a tooth?

Does the dentist attempt to get the largest chunks of amalgam out of  a tooth intact for deposit into a bio-hazard container rather than pulverizing the entire amalgam into mercury vapor and tiny particles?

Does the dentist us copious water irrigation and high vacuum suction during the entire time of amalgam removal?

Is the dentist able and willing to use nasal oxygen on the patient during amalgam removal if the patient’s health practitioner recommends it?

Is the dental office equipped with a mercury scrubber on the water drain and suction devices so that the mercury being drilled out does not contaminate the environment or the water-ways and oceans?

If the amalgam removal takes longer than 2 hours or the dental work involves both sides of the mouth is the dentist able and willing to use light intravenous sedation, such as Versed or Valium, on the patient during the procedure?

If the amalgam removal process is not completed in one day, is the dentist willing and able to schedule subsequent days of work on days other than the 7th, 14th, 21st, 28th, 35th, or 42nd days after the preceding visit(s)?

Is the dentist able and willing to give 10,000 to 20,000 mg of intravenous vitamin C (not corn derived) to the patient during the amalgam removal process (starting the IV drip just after completing local dental anesthesia)?

If requested will the dentist use local anesthesia that is free of epinephrine and free of preservatives?

Is the dentist willing to allow the patient to swish a water solution of Zeolite powder around in their mouth for 2 minutes after all of the amalgam fillings that are planned for removal on a certain day have been removed but before the composite materials are placed in the involved teeth?

                                                                                                                                                                                                                                        Lee Cowden MD