“Can amalgam be removed in pregnant and breastfeeding women?”, “I want to have a baby, how long after amalgam removal should I get pregnant?” These are questions I get frequently… I tried to answer them in this article. While doing this, I also gave examples of some studies on the removal of mercury. I think these examples contain interesting information not only for pregnant women, breastfeeders and those who want to get pregnant, but for anyone who has questions about amalgam fillings. Therefore, I think it is a paper that both patients and physicians can benefit from.
IAOMT (International Academy of Oral Health and Toxicology) has created the SMART protocol, which consists of very detailed precautions for the removal of amalgam fillings without harming the patient, physician and auxiliary staff (I have explained the details and points to be considered in this article). If you examine this protocol, you can see that all the ways the patient may be exposed to mercury are calculated and very meticulous measures are recommended against it.
Despite all these measures, IAOMT says we cannot claim that mercury will never be exposed even if the SMART protocol is followed. Some sources in Turkey taking measures much less than they claim Although you might be exposed to no mercury and vice versa. I think that IAOMT’s suggestion that pregnant and breastfeeding women should not be removed is due to this risk. The question may arise: Is it more mercury that a person with a lot of amalgam in his mouth gets more mercury from fillings every day or is it mercury that can be exposed during the process even if it is removed with precautions? It is difficult to answer this question. This will most likely depend on some minor details during the process (whether the rubber-dam was sealed, did the fillings come out in large pieces, was an oxygen mask that covers the nose completely, etc.) and the number and size of the filler to be removed. Nevertheless, despite the possibility of any malfunction during the procedure, it may be considered safer not to remove any amalgam in pregnant and breastfeeding women.
According to researcher Andy Cutler, who has also been damaged by amalgam fillings and so he has researched how mercury can be removed from the body and proposed various methods, this is not the only reason why pregnant and breastfeeding women are not removed. Andy Cutler suggested that a few months after all the amalgams in the mouth have been removed, you will be going through a period in which the mercury in the tissues will be removed more intensively because the mercury you are exposed to every day is no longer there, and therefore, disassembly should not be done. He says that the mercury circulating in the body during this excretion period can pass into the placenta and milk. For this reason, he says that not only during pregnancy and breastfeeding, but also before getting pregnant, a certain amount of time must pass after all the fillings are removed. In this way, it is aimed not to damage the baby not only from the mercury that comes from the fillings on a daily basis, but also from the mercury that has accumulated in the tissues over the years and is thought to be released into the blood after removal.
Unfortunately, I do not have any sources to verify this discontinuation theory other than the experience of those who followed the Andy Cutler protocol. There is a possibility that the symptoms that are thought to be experienced by these people during this period may also occur for other reasons. However, the following study showing long-term blood and urine values after dismantling may help us evaluate this idea (1).
Here, the following graphics were obtained by taking blood and urine samples at various times within 1 year after dismantling of people who used rubber dam in the mouth during amalgam removal. The graph showing the blood values shows a very small increase in the following months, so Andy Cutler may have a point. However, even this increase is below the initial values. So even if there was such a period, it did not affect the blood levels of the people in this study much, and did not even approach the initial level. I don’t know if it would have been a different image over longer periods of time. (By the way, although the initial blood mercury values of the patients without rubber dam were lower than the values of the other group, how did they increase during the procedure!)
The curve in urine values is a little different … (In those using rubber covers, although the level is higher after dismantling, the increase rate is better than those without cover). . I think that the reason for this may be that the mercury level, which rises suddenly in the blood after the removal of the rubber cover, changes the distribution of mercury to the tissues and the functioning of the mechanisms required for its removal.
So, what should be the time to wait before getting pregnant after amalgam removal?
Again, according to Andy Cutler, after all amalgams are removed, at least 18 months should be waited. Andy Cutler made this suggestion, assuming that 12 months of this period passed with the chelation method he created and that it was only expected in the next 6 months, and even added that this period could be longer in patients with poor conditions. In general, he thinks that when you wait for a while after dismantling, you will first go through a period of feeling good, then you will go through the throwing period I mentioned above and you may experience some symptoms during this time and then the symptoms will resolve. That’s why she suggested that you get pregnant only when you go through these periods and feel better. Although his general recommendations are like this, it is worth remembering that Andy Cutler generally works with people who have suffered serious damage from amalgam. So this may not be the case for everyone. How a person’s detox systems work, their genetic makeup, diet and lifestyle, and perhaps the supplements they may take may result in a prolongation or shortening of this period.
We know from cadaver studies that once exposure to mercury is present, it can still be found in tissues even after 17 years (2). Although blood levels are reduced with chelation agents… Therefore, the purpose before pregnancy is not to reset the mercury accumulated in the tissues, but to stabilize the mercury circulating in the body.
In the graphs above, it is seen that blood and urine mercury levels drop below their initial levels within 100-150 days after the procedure and follow a more straight line at the end of the first year.
Another example of how quickly blood mercury levels dropped comes from the findings of the 1970s accident in Iraq. In the incident in Iraq, farmers began to eat wheat and barley, which were distributed to them to plant and contain methyl mercury (!!!) as a preservative. A few months later, hospitals started to be filled with patients coming with serious health problems.
In a study conducted during this accident, the time required to halve the blood level of mercury was found between 40 and 105 days (3)
According to the study that Chris Shade cited (4) (but I could not find the original), this period was up to 120 days for vulnerable groups. (I would like to underline that these times are not for the blood level to fully recover, but to halve the initially measured amount.)
Of course, mercury levels increase so much in this type of poisoning that even when half of the mercury is removed from the body, the remaining amount is still very high. Still, they are important examples in helping us understand the duration of mercury clearance.
In my opinion, despite all this information, we still cannot talk about a clear time that can be recommended to everyone. This time can vary with the amount of mercury exposed, how well the person’s detox systems are working, supportive diet and lifestyle interventions. Therefore, it may be more accurate to determine this period individually. The mercury levels in their circulation will not be the same for someone who has a single filling, who has it removed very meticulously, who does not have obvious health problems, someone who is haphazardly removed 8 grain fillings, and who is already struggling with health problems.
If a tooth with amalgam needs urgent intervention in a pregnant or breastfeeding person?
Of course, if a problem develops in the tooth that cannot be postponed (such as the risk of breaking part of the amalgam filling and swallowing the remaining part), the pregnancy and breastfeeding periods cannot be expected to end. In this case, in addition to the meticulous implementation of the SMART protocol I mentioned above, it is recommended that the mother expresses and expels the mother’s milk for 3-4 days from the procedure, and that enough milk should be milked and stored before the procedure (The time to be milked is said to reflect the opinion of Chris Shade. I read it as 3 days in a source and 4 days in the Andy Cutler group). It is also worth remembering that the mercury released during dismantling can be minimized by wrapping around the amalgam filling without touching it and trying to remove it in large pieces.
Ref. Berglund, A., & Molin, M. (1997). Mercury levels in plasma and urine after removal of all amalgam restorations: The effect of using rubber dams. Dental Materials, 13(5-6), 297–304. doi:10.1016/s0109-5641(97)80099-1 https://www.ncbi.nlm.nih.gov/pubmed/9823089
Bakir, F., Damluji, S. F., Amin-Zaki, L., Murtadha, M., Khalidi, A., Al-Rawi, N. Y., … Doherty, R. A. (1973). Methylmercury Poisoning in Iraq. Science, 181(4096), 230–241. doi:10.1126/science.181.4096.230 https://www.ncbi.nlm.nih.gov/pubmed/4719063