Dental Health Scandal: Playing Politics with Genes

Few empiricists would deny that both environmental and genetic factors determine subtle variations in the physical health, performance and behaviour of human beings. After repeatedly telling us that diet and lifestyle are largely to blame for the obesity epidemic, the popular media now inform that genetics plays a crucial role in our susceptibility to gaining weight, e.g. two different people eating the same intake of junk food may have very different weights. Our genes do after all provide us with blueprint for future development and as noted elsewhere determine largely physiological features. However, to pretend diet plays no role in our health would equally be a travesty of the truth. There are surprisingly few obese people in poor agrarian communities where most people get plenty of exercise in the course of their daily struggle for survival and have little time or resources to indulge in the wonders of convenience food, like microwaveable ready-meals or take-out pizzas, yet many of their genetic close cousins in the prosperous world would put on weight quickly. Often sensationalist media reports simplify our understanding of key issues like emotional well-being, intellectual performance, behavioural problems, dental health and eating disorders. It`s interesting how the establishment media highlight or suppress extensive research into the causes of very real human problems to promote their agendas or defend key interest groups.

We are led to believe that genetics plays a huge role in the determination of psychiatric illnesses, but only a minor role in dental health. We tend to be much more tolerant of severe acne, facial burns and balding than evidence of bad dentistry or bad oral hygiene. One cannot exactly shake hands, smile and discretely inform a new acquaintance that contrary to appearances one brushes and flosses one`s teeth twice a day. One has to have white teeth or hide one`s dental fixtures from general public view. As a result it`s easier to get a psychiatric diagnosis on the NHS than personalised dental treatment. Make no mistake, the consumption of sugary drinks and food, especially refined sugar and lactose, and poor oral hygiene, e.g. a failure to brush one`s teeth regularly and correctly, cause caries in the same way as eating Big Macs cause obesity. If you have a balanced diet, with plenty of vegetables, and consume the occasional hamburger made from premium beef, you may enjoy good health, but a diet of nothing but junk food, consisting mainly of carbohydrates, diary products and cheap meat, makes you extremely susceptible to all sorts of illnesses. However, that`s not the whole picture. The human body has evolved to cope with extreme variations of dietary intake. Our distant hunter-gatherer ancestors became omnivores as a survival strategy with a seasonally variable diet. Our teeth evolved in the pre-toothpaste era to cope with a diet of vegetables, fruit, nuts, fish and meat. In terms of human evolution milk and refined sugar were a very late addition to our diet. Indeed northern Caucasian peoples developed antibodies in order to digest cow`s milk. Later in the 19th century our diet transformed with advent of refined sugar and wider availability of tea, coffee (both served with milk and sugar in Britain), cakes and other confectionaries. Before the mid 19th century dentistry was a dark art confined to the aristocracy, who also happened to be the biggest consumers of sugary delights. By the turn of the 20th century (1900) most working class British adults had severe dental decay with many missing most of their teeth, but as films and photographs from the period can attest many actresses and models retained healthy smiles in age without toothpaste, fluoridation or artificial dental crowns. Dentures were a poor substitute for natural teeth that fooled no-one, but the toothless. In the early twentieth century the streets of British cities teemed with people exhibiting little shame in their visibly decayed, missing or badly patched gnashers. Abroad this became known as the British mouth. The masses could simply not afford restorative dental treatment and had not yet acquired the custom of brushing their teeth.

If we compare the smiles of post-modern image-obsessed young adults with a strict dental hygiene regime, regular dental check-ups and even tooth whitening sessions with Africa`s rural poor, we are struck only by the greater authenticity and relative lack of alignment of the latter group, for caries are exceedingly rare in black Africans with a traditional diet. Open your eyes in a busy cosmopolitan city and observe the huge variation in people`s mouths and dental structures. Some will casually and nonchalantly show the full splendour of their naturally white teeth, while others feel more at ease in more tight-lipped facial gestures barely revealing their teeth, but few of us react very well to an unashamed display of discoloured and crooked teeth. Yet, it seems illogical that we would have evolved in antiquity to suffer perennially from persistent tooth aches, that would inevntably result with the same diet, but in the complete absence of dentistry and toothpaste, with only tooth picks and water. The most critical age for dental health tends to be adolescence when our adult teeth have replaced our primary teeth, our wisdom teeth begin to emerge and we are less likely to care about diet and oral hygiene.

Letter to Ms Keen, Minister for Health

Dear Assistant of the Right Hon. Ms Keen,

In my recent correspondence about the state of NHS dentistry and my pragmatic, but costly, decision to spend over £6000 on private treatment, I stated quite categorically that I do not wish to be persuaded mercury amalgams are somehow safe. I`ve read and heard it all before. Believe it or I am an intelligent 44 year-old programmer, and have within the limits of normal human imperfection, taken good care of my teeth since early childhood. I did not eat excessive amount of sweets or chocolates as a youngster. Mars bars were a rare treat in my family and have not eaten hardly any chocolate since associating it with acne as a teenager. This was also the period when I has 10 mercury amalgams, only two of which now remain thankfully having had three removed in the last two weeks, others went with tooth extractions. If I had followed the advice of an NHS dentist, not only would I have retained two of these back teeth (one to be replaced with an implant), but it would have impossible to realign my teeth for what is today an essential cosmetic procedure so my front teeth can look vaguely normal. I do not have unreasonable pretensions. You are not addressing some mars-bar chewing, fizzy drink guzzling ignoramus who forgets to clean his teeth twice a day. There are only two reasons I have delayed this essential dental treatment. One financial and the second a psychological aversion to the practices of NHS dentists. I have a complex dental structure, crowded teeth in a small mouth. This makes restoration much more time-consuming. X-rays, of which I finally obtained electronic copies, quite clearly reveal the extent of bad dentistry. My back teeth were drilled and filled in adolescence with little regard to wisdom teeth that had not yet emerged and when two did emerge, they were promptly drilled and filled, and were thus gradually pushed to the left. Do I need lectures on oral hygiene? No I had those 30 years ago.

No amount of official denial of the adverse effects of this crude technique or reports from distant organisations, known to be under pressure from numerous lobbying groups, can replace what is for me a very personal experience. I may rely on remote scientific data to establish the mass of the planet Pluto, but the state of my teeth and my experience with NHS drill-and-fill conveyor belt dentistry are facts I can judge very well on my own.

The so-called evidence you cite is extremely selective. The name of the game is public relations and damage control.

It seems clear to me that your replies did not take into account the actual content of my letters, but were merely treated as another case of a humble subject unconvinced of the purported safety of mercury amalgams. As it is unlikely that you would have spent much time on one individual case, you simply recycle material prepared for other humble subjects. Don`t ever forget, in a democracy you are our servants and should not defend the vested interests of powerful lobbies who do not have the best interests of humble subjects at heart. So if we the people don`t want mercury amalgams because we refuse to believe your pseudo-scientific denials, provide us with alternatives. If those alternative don`t work, then we`ll look into something else. Mercury amalgams are technologically superseded. Currently the NHS wastes money on all sorts of things, overpriced proprietary software, where perfectly functional free alternatives exist, psychoactive drugs and Viagra. In this context the cost of alternatives such as porcelain onlays and inlays in back teeth would be minimal. We pay taxes and national insurance to receive medical treatment to meet our needs, not to be brainwashed by biased lobbying groups.

I also disagree fundamentally with your one-size-fits-all mentality, which underlies NHS policy making. I`ll take my family as a case in point. My mother lost her upper teeth at around my age and can never remember her gorging cakes, chocolate and fizzy drinks. She`d drink plenty of tea, but stopped adding sugar in the early 70s and as far as can recall always brushed her teeth. She now has none of her own teeth. My father on the hand retains all his own teeth to this very day, yet grew up in the same period with a similar diet. The point is oral hygiene and diet are only part of the story. Some of us are simply not blessed with a very resilient dental structure and hence will fall victim to caries much more easily than others.

If major dental associations such as the BDA admitted the neurological and physiological damage caused by mercury amalgams, it would open a can of worms with potentially millions of Europeans claiming damages. A beneficial side effect of the current obsession with cosmetic dentistry is leading all but the most underprivileged and misinformed sections of the European population to avoid mercury amalgams like the plague. As an aside, the downside to this obsession is that anyone with naturally crooked or stain-susceptible teeth (i.e. where enamel turns translucent rather than white revealing the dentin beneath) is likely to suffer from an inferiority complex. The only people I have ever heard defend amalgams are dentists and lobbyists, not ordinary citizens. Some are lucky with resilient well-placed amalgams, but so many others have experienced cracked molars and progressively uglier amalgam replacement fillings. Whenever a back tooth needs a new filling, patients that can afford it almost always choose white fillings, which are of course much larger than they would be had an amalgam never been placed at the outset. Why force people to go private, rather than provide this basic level of care on the NHS. In most cases old amalgams can be replaced with composites (in the case of small cavities), onlays, inlays or crowns. Only in the most severe cases would an implant be required.

Your latest reply simply regurgitates industry propaganda. That it has made its way to the highest echelons of the EU bureaucracy is of some concern but rest assured where democracy works at a local level mercury amalgams are on their way out. It has been completely banned in Sweden and Norway and is being phased out in Denmark and Germany with an absolute ban on mercury amalgams in under 21 year olds. In most of Southern Europe the state does not subside dentistry at all or not to the same extent and so when given the choice most parents will pay extra to have white fillings. In the UK the prevalence of mercury amalgams in adolescents is largely a class and ethnic issue. It is much more common among the white lower working classes, practically the only group with a high risk of dental decay (owing to diet and genetics) unable to afford private dentistry. The logic behind mercury amalgams is that patients will not take good care of their teeth.

“Only 300 studies published since 1996 had sufficient merit to be included in their report — studies that analyzed mercury in urine samples as a marker for mercury exposure. Methyl mercury from fish is not found in urine samples, explains Karol.”

The panel is wrong in using urine mercury levels as a measure of mercury exposure. Science has shown this. In fact, most studies on children indicate that the ones with the highest urine, blood or hair levels of mercury were the healthiest. That is because of those exposed to mercury, the ones with the highest urine, blood and hair levels are the ones effectively excreting the mercury. Three different research groups have shown that autistic children have much lower mercury in their hair, yet have higher body burdens of mercury. This implies that an inability to excrete mercury by a subset of the population represents those that will respond badly to a low chronic exposure to mercury.

I suggest this subset is much larger than the government would like to believe. Consider a simple analogy, many people get away with smoking 20 cigarettes a day into old age, so if we applied the same logic to smoking, we would conclude it`s safe except for people allergic to nicotine inhalation. Clearly absurd, but some smokers die early from lung cancer or heart failure, while others miraculously live into their 90s.

Apparently you cannot read your own Web site, the last place I`d expect to find evidence exposing the dangers of mercury in dentistry. May I refer you to, which states quite clearly.

“A pilot study conducted by ourselves has shown that reductions in memory functioning were measurable amongst a group of dentists using a computerised package of psychomotor tests.”

Ie. in the subset of humanity that fails to excrete mercury efficiently (hence the reason why researchers should measure blood mercury rather than urine mercury levels) the neurological effects of low-level mercury exposure has long been scientifically attested.

Let`s be honest the only group that actively defends mercury amalgams is organised dentistry and its army of litigation-aware lobbyists.

Don`t waste another penny defending it. At the very least, let people have white fillings on the NHS if they pay a little extra. But best of all, follow other European countries and ban it completely.