Michael C. Goldman, DDS


INTRODUCTION Mercury (Hg) from dental fillings (as well as from environmental and food sources) is thought to have a cumulative effect on the body. There are other sources of information on the wide range of symptoms that have been reported to result from mercury accumulation in the body.

Since "silver" fillings are about one-half  [or more...] composed of mercury, it is thought by many that these fillings are a major source of mercury in sensitive individuals. You should also be aware that organized dentistry in the US has taken the position that this is not so.


You can begin a program of self-help in which you use dietary changes/supplements to bring about changes in the way your body handles mercury (hg) to see if there is any change in the way you feel. This approach takes time and care. Don't be in a hurry!

1. Don't chew gum. The chewing action stimulates a release of mercury (Hg) from your fillings on the chewing surfaces. Mercury vapor has been measured in the mouth to increase after chewing. The vapor is inhaled and distributed into tissues throughout the body.

2.Glutathione (GSH) is a rich source of sulfur and cysteine. During a program of detox. there can be a redistribution of mercury throughout the body. To prevent a possible buildup in brain tissues and aggravation of symptoms, GSH can help assure your body has the ability to excrete mercury through the bile. Start taking 50mg, 3 times a day on an empty stomach for 3-4 days before adding the next supplement..

3. N-Acetyl-L-Cysteine (NAC) helps your body produce its own Glutathione. Once you cave been taking GSH a few days and see that you have no adverse reaction to it, you can take NAC. Take 3 tablets in morning without food but with half teaspoon honey or maple syrup. Take NAC for 3-4 days before going on.

4. Methylsulfonylmethane (MSM) A rich source of sulfur which binds well with mercury. It is available from AMNI (800-356-4791). Garlic as a supplement is also very rich in sulfur and possibly is another choice here. MSM is free of odor or after taste.

5. Vitamin B6 (Pyridoxine) 3 or 4 days after the GSH or after the NAC if you use that, start B6 which is critical to the metabolism of sulfur amino acids. Take 50 mg of B6 with your breakfast meal.

6. Zinc stimulates production of metallothionein in the body which is one way the body detoxes the effects of Hg.Take 15-30 mg per day with a meal after you have been taking GSH and B6 for 3-4 days and continue these items for an additional 3-4 days, closely observing for any changes.

7. Vitamin C Prolonged exposure to Hg at low concentrations tend to depress the adrenal ascorbic acid content. There are many forms of Vit C. Start out with 500 mg per day, with meals, and after 3-4 days start increasing up to 1500 mg per day in divided doses.

8. Vit B1Thiamine) is next to be added after Vit C. Use a 50 mg taken with each meal for a total of 150 mg per day. B1 is involved in energy metabolism and has been used by injection for Hg poisoning. B1 deficiency and Hg poisoning have almost identical symptoms

9. Selenium is the last one. It binds with Hg and will cause a redistribution of Hg in the body tissues and should help the excretion of Hg from the body. Take inorganic selenium (rather than organic) since the organic form can build up an excess level in the tissues, while excess inorganic selenium is excreted automatically. Take 50 micro-grams three times a day for a daily total of 150 micro-grams. Should not be taken with Vit C. Take between meals or whenever possible, 2 hours before or after you have taken Vit C.

For those allergic to yeast derived products sodium selenite is available from Nutricology (800-545-9960 Ext 200). If you are sensitive to petrochemicals you should be under supervision of a physician or at least initiate selenium use very slowly. Do not take more than 50 micrograms per day until you are sure there are no adverse reactions.

IN SUMMATION you may notice benefit in the first week or it may take 60-90 days to notice improvement. You could also notice nothing! And if you do notice improvements it does not mean absolutely that mercury or lead were the cause....but it is a non-invasive, cost-effective way to do a little health detective work which might result is a sense of improved energy or well-being or easing of a wide range of specific or vague symptoms.




Start as soon as possible but no later than two weeks prior to first amalgam replacement.

1. Glutathione (GSH) 50 mg tablet 3 times a day on empty stomach

2. Methionine (MSH) one 200-500 mg tablet three times a day on same schedule as GSH, starting 3-4 days after GSH.

3. N_Acetyl-L_Cysteine (NAC) 3 tablets in morning without food but with half teaspoon honey or maple syrup.

4. Methylsulfonylmethane (MSM) 500-2000 mg per day

5. Vitamin B6 50 mg per day with breakfast. Also 100-200 mg one hour before dental appointment and then again after you get home can help reduce pain and swelling form tissue trauma during treatment. Then go back to 50 mg per day.

6. Vitamin C one 500 mg tablet with each meal. NOTE: Vit C can affect how well some people respond to local anesthetic so do not take it 12 hours prior to the dental appointment.

7. Zinc 15-30 mg after supper

8. Magnesium one 100 mg tablet per day after supper or at bedtime. Make sure tablet provides 100 mg of elemental magnesium

9. Vitamin B1 one 50 mg tablet with each meal. Increase like B6 just before and after dental appointment to help deal with tissue trauma.

10. Vitamin E can be helpful if you have no reason to think Vit E might adversely affect your blood pressure. Take 50-100 IU per day and gradually work up to 800-1200 IU per day. Discontinue use if any adverse reaction or increase in blood pressure.

11. Selenium one 50 microgram tablet or liquid. Do not take within 2 hours of taking Vit C. Sometimes provided in combination with Vit E.

12. Acidophilus capsules or powder or liquid, or yogurt with live acidophilus culture taken regularly will help restore normal intestinal microflora. Product literature will indicate when and how to take that product.


13. B Complex read label and take amount to give 15-25 mg of each of the various B vitamins. NOTE: If you are taking large doses of B12 or B12 injections ask your physician to use hydroxocobalamin during entire replacement process.

14. Activated charcoal Taken only just before dental procedure it can absorb mercury from swallowed particles of fillings being drilled out.

15. Garlic products contain high levels of sulfur and selenium.


Ideally you should be supervised by a physician or health professional knowledgeable in nutrition and toxicology. Unless you have been told specifically to take iron or copper supplements, do not take them during amalgam replacement. If you are starting on your own, phase into this slowly to give your body a chance to adjust and adapt to the changes.


It is not unusual to experience an increase in symptoms or flu-like symptoms for 2 or 3 days after amalgam replacement appointments. If the adverse changes persist or new symptoms appear after a week you can make the following changes:

1. Increase the GSH to 2 capsules, 3 times a day for a total of 6 capsules or 300 mg.

2. Increase Vit C to 1,000 mg with each meal plus 1,000 mg 1 hour after supper.

3. Add pantothenic acid. One 100 mg tablet with breakfast and supper.

4. Add an amino acid complex. Take one hour before meals or at bedtime.

Continue supplements at least 30 to 60 days after the last amalgam has been replaced. High fiber diet, avoiding chewing gum during replacement, and any activity that causes a lot of sweating are beneficial during this process.


There are other protocols some using specific brand products, like Chlorella, Ultraclear and others, What I have outlined here was chosen because it seems to have been well thought out and the products recommended are more easily available. This is complicated nutritional theory and practice. You would do well to work closely with a physician or nutritionist to help you through this, especially if you feel you are one of the more sensitive individuals and have symptoms you feel are probably related to mercury.

For others that are less motivated or don't think there is so strong a link to mercury with their symptoms or have no symptoms but just want to take an "ounce of prevention" to play it safe during replacement there are simpler protocols. For example the International Academy of Oral Medicine and Toxicology recommends essentially only mega doses of Vitamin C supplemented be B6 and Zinc starting a week or so before replacement and tapering off slowly afterward.

Acute or other diagnosed cases of mercury toxicity are treated by a physician/toxicologist by using FDA approved metal binding drugs and that is beyond the scope of this pamphlet, but information is available!

There is a lot of information about mercury and possible problems with it and a lot of controversy also. You need to be the judge of what you think is important to you. It does appear that some people are very much affected by mercury while others seem not affected. Organized dentistry in the US would have you believe that those that are significantly affected comprise only a minute fraction of the population. Others feel up to 90% or more of us are affected adversely. If you feel you could be adversely affected by the mercury in your fillings now, and by the mercury which would likely be temporarily increased during replacement of your fillings with non-mercury materials, these are things you can do to help take back some control in your own health and well-being. Done carefully and especially with guidance, it can do no harm and just might turn around symptoms that have been a problem for a long time...or prevent the appearance of new ones.


Testing for Mercury in the body

Various tests, blood, urine, hair analysis have been used to test for mercury and other heavy metals.  I think the most reliable test   is done with a  fecal sample.  Not the most esthetic approach, but hey, there are no needles and you don't have to cut off lumps of hair close to  the scalp... Every cloud has a silver lining, they say.  Anyway,  it's a take home thing (you probably don't want your dentist helping you with it anyway, right?) that you can put  a sample in and mail it away to  the lab.  The results come back   with literature to help interpret them.  For info on where to get the test done if you are not near my office  call:

Doctors Data Inc.                         800-323-2784
PO Box 111                                  Fax 630-587-7860
Chicago Illinois 60186-9986        

email: inquiries@doctorsdata.com


Here are some thoughts regarding other methods of testing

  • Intra-oral Vapor Testing      An interesting test  to demonstrate the fact that mercury is present in your mouth from your mercury fillings.  It's a motivator and can be a scare tactic but it doesn't show you  how much mercury your body tissues are storing.

  • Blood and Urine Testing     Again, interesting,  but both high and low  urine mercury levels could be a problem.  It won't necessarily tell you the level of stored mercury.  It only shows you what is presently being excreted.  Blood levels can indicate  recent exposure, recent excretion, or  high levels. 

  • DMPS Challenge Test     A urine mercury test before and after  a chelation "challenge" with DMPS  that liberates  mercury  stored in body tissues. This is much more  accurate and meaningful than plain blood or urine testing.

  • Hair Testing   Indicates levels of mercury  and other metals stored by your body over a period of time.  hair closest to the scalp [newer, more recent growth] gives the most   recent indication.  Apparently there are  many variables with hair - possibly including the  kind of shampoos and conditioners etc. used - so that the alternative "experts" mostly seem to have little faith in hair analysis.  I trust them since they are closer to the scientific research that checks these things out.

  • Skin Patch Testing - Hypersensitivity    This is controversial.  There are concerns that it could "sensitize" a person  and make things worse.  It should only be done by a medically trained professional like a dermatologist or medical allergist and should be done with ammoniated  mercury [not mercury chloride].

  • Electrical Galvanic Testing  Interesting in that it shows how the  amalgam fillings have created a "battery" in your mouth and actually  produces an electrical current that can speed the  release of mercury and maybe even create havoc with acupuncture meridians.  But it  does not tell you  how much of a problem you have with   mercury toxicity or stored mercury levels.

This pamphlet was written in the hope that it will increase understanding about a topic that seems important from time to time. Obviously it is only part of the whole story, so if you have questions after reading this please do not hesitate to ask or call. Also, if there is a topic that you think would be helpful, please suggest it.

Michael C. Goldman, DDS

General and Cosmetic Dentistry
3815 East-West Highway
Chevy Chase, Maryland 20815 Phone (301) 656-6171



Holism in  dentistry is an approach to dental treatment, primarily  caring for  patients' health and safety from both a conventional as well as  "alternative healthcare" point of view.   It is sometimes called "biological" dentistry or "biocompatible" dentistry.  In it's fullest sense, I believe it   acknowledges and deals with  the mind, body and spirit of the patient, not just his or her "teeth".  See Topics / Info.....

Cosmetic dentistry is about doing   quality , esthetic dentistry in a way that looks natural to begin with, and furthermore,   can even  improve  one's  attractiveness through techniques such as bonding, bleaching, veneers, caps, implants and more.  It can   be like "instant orthodontics" in correcting  crooked, twisted or misplaced teeth in many instances.  Dark or misshapen teeth can be restored.   Smiles that lack youthful vigor or beauty can be revitalized! See Topics / Info..

Bleaching, veneers, bonding, caps, bridges, and implants  are cosmetic dentistry treatments that are also  discussed in  Cosmetic Dentistry, and more...