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Medical Forum / General / Dentistry / November 2004Finger Points to Fillings in UK Dentistry Crisis
Most people automatically assume that the current crisis in National Health Service (NHS) dentistry in the UK is simply due to a lack of adequate government funding. However, I think that the problem is more complex than this, and that the question of funding may in fact be of only secondary importance. I believe that Dr Lester Ellman, chair of the British Dental Associations's general dental practice committee, puts his finger on the real problem when he says: "It's not to do with the money in terms of their take-home pay, but in order to be able to spend more time with their patients and to do things the NHS cannot do but the public wants." (taken from, "Crisis to get worse, warns union", Manchester News, Monday, 9th August 2004, see: http://www.manchesteronline.co.uk/news/s/126/126624_crisis_to_get_worse_warns_un ion.html ) Dr Ellman highlights a particular problem which is that certain kinds of dental treatments now being demanded by greater numbers of patients are not available under the auspices of the National Health Service. For example, it appears that more and more dental patients are choosing not to have metal amalgam fillings placed in their teeth, whilst the National Health Service continues to insist that the ONLY filling material that dentists are allowed to use when placing fillings in posterior teeth is metal amalgam. Therefore the real truth might be that, since more and more people are both able and willing to pay for private treatment in order that their preference for non-metallic fillings is met, then more and more dentists are able to fulfill their earnings requirements without having to resort to the restrictive practices prescribed by the authority of the National Health Service. And an indication of the degree of influence which this particular example is having on the present crisis in NHS dentistry might be gained if a sufficiently curious investigative journalist were to pick up a telephone and call a few "private" dentists to ask what are the respective percentages of metallic and non-metallic fillings that they place in their patients' posterior teeth. (Remember that the corresponding figures for "National Health dentists" are 100% and 0%.) Does anyone know if anyone has ever done this? And, if so, what were the results? Should NHS dental patients in the UK have the right to choose what material is used for filling cavities in their teeth? Keith P Walsh PS, would any prospective American commentators please note that the National Health Service in the UK is not the equivalent of "welfare" medical provision in the USA. And is there any fundamental reason why non-metallic fillings should be more expensive to place than metallic ones? > PS, would any prospective American commentators please note that the > National Health Service in the UK is not the equivalent of "welfare" > medical provision in the USA. ... 'old on there, Mate... I would argue that in fact it truly *is* the equivalent of the welfare system there or the RAMQ system here. It is all about cost of treatment vs remuneration. If it costs twelve dolars to treat and one is paid twenty dollars by the gov't, there is no proffit, you're only spinning your wheels. > And is there any fundamental reason why non-metallic fillings should > be more expensive to place than metallic ones? At least five: Preparation of the operative site ( no contaminations permitted; bleeding control ); time to do each of the steps, of which there more, time to place a contact so food doesn't accumulate between the teeth; time to finish and polish the restoration; and the cost of these materials compared to Am. My bug with you all is the same: you are all theroeticians. This is why you place more emphasis on the composants of the Am instead of taking a pragmatic approach: what this restoration can do that the white stuff cannot, for the price paid by the gov't or the patient, or as dictated by a less than ideal restorative situation. Get out of your statistics and into a real mouth and see what is and is not possible. Another analogy: We must abolish all petrol using vehicles now if we want a sane planet. Just try to put that one into practice... The theoretical arguement is valid. The practical application is impossible as of now. Cheers SP  SignatureNot a real Addy, yet >> PS, would any prospective American commentators please note that the >> National Health Service in the UK is not the equivalent of "welfare" [quoted text clipped - 23 lines] >Get out of your statistics and into a real mouth and see what is and is >not possible. I am in fact looking for practical solutions which might help to alleviate what is seen as a crisis situation in UK dentistry. My perception is that more and more patients are willing to pay the extra (most of them have already paid their contributions to the National Health Service out of their hard earned wages) in order to ensure that their preference for non-metallic fillings is met. Without any reliable figures I am happy to concede that any effect that this factor might be having in contributing to the crisis remains only theoretical. That's why I have suggested that those who are concerned about this crisis might actually bother to ask those dentists in the UK who no longer treat patients under the auspices of the NHS exactly what percentages of their patients prefer to have non-metallic fillings placed in their teeth. (I feel sure that organisations such as the NHS and British Dental Association should have these figures, but if they have then it appears that they have not been made generally available. Perhaps these figures would represent a potential embarrassment for NHS policy which continues to insist that metal amalgam is the ONLY material that may be used for filling cavities in the posterior teeth of NHS patients.) Although more and more dentists are openly declaring their practices to be "mercury free", these still remain in the minority. However, whilst not specifically declaring that they will not place amalgam fillings in teeth, many many dentists in the UK are refusing to offer treatment for the NHS, and are thereby able to avoid any compulsion to use amalgam. Again, I think it might be instructive to find out accurate figures which will allow a direct comparison to be made between the percentages of metallic and non-metallic fillings placed in the posterior teeth of "private" as opposed to "NHS" patients. (Remember that the figures for NHS patients are 100% and 0% respectively.) Keith P Walsh >>Get out of your statistics and into a real mouth and see what is and is >>not possible. > >I am in fact looking for practical solutions which might help to >alleviate what is seen as a crisis situation in UK dentistry. What about 350 mV ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE I had a UK NHS dentist for several years before moving to Belgium. The difference is amazing... My UK dentist had two chairs in adjoining rooms in a small semi detached ex council house. The waiting room would frequently have 6 people in it when you arrive and you might have to wait an hour if the dentist is running late. He would normally work on two people at once and always did so while waiting the 5 mins for your anaesthetic to take effect. The instant he had finished with you (and while you were still horizontal in the chair) he was off backing through the door to avoid contaminating the new gloves his assistant had quickly changed. She would then come back and sort you out while the dentist was drilling the next guy. The assistant wrote your appointment in a diary like book and you had to pay by cash or cheque. Shortly after giving me root canal I gained a cyst on that tooth. Here in Belgium we have to pay 1/3rd of the costs (the other 2/3rds we get back from the Mutuality) so it's not quite the same cost structure as the UK NHS. Overall we pay slightly higher taxes here but there's not much in it. The dentist has an office attached to the side of a huge 5 bedroom detached house of almost unbelievable quality (stone detailing, solid oak period windows and doors etc). I've never seen anyone else waiting in the waiting room and normally I never have to wait more than a few seconds before the dentist is ready for me. An appointment for a filling is allocated about three times as long as the UK. The dentist has time to chat and it feels like he works slowly with more precision. Appointments are stored on computer which is linked to other in the building by wireless LAN. You can pay by credit card or by Bank Contact (eg like Switch in the UK). The difference is so great that when we move back to the UK I may still come back here to see the dentist! >I had a UK NHS dentist for several years before moving to Belgium. The >difference is amazing... Interesting already ...... >My UK dentist had two chairs in adjoining rooms in a small semi detached ex >council house. The waiting room would frequently have 6 people in it when [quoted text clipped - 4 lines] >off backing through the door to avoid contaminating the new gloves his >assistant had quickly changed. She would then come back and sort you out What means "sort you out?" Is that like "Rogering" by any chance? We Americans are weak on English patois. >while the dentist was drilling the next guy. The assistant wrote your >appointment in a diary like book and you had to pay by cash or cheque. >Shortly after giving me root canal I gained a cyst on that tooth. > >Here in Belgium we have to pay 1/3rd of the costs (the other 2/3rds we get >back from the Mutuality) Here we call it the paramutual ...... where the ponies run. >so it's not quite the same cost structure as the UK >NHS. Overall we pay slightly higher taxes here but there's not much in it. [quoted text clipped - 4 lines] >dentist is ready for me. An appointment for a filling is allocated about >three times as long as the UK. Different dentist ...... >The dentist has time to chat and it feels >like he works slowly with more precision. Appointments are stored on [quoted text clipped - 3 lines] >The difference is so great that when we move back to the UK I may still come >back here to see the dentist! GREAT. Please explain "sort you out." Your wife may be listening in. Joel > What means "sort you out?" Is that like "Rogering" by any chance? No such luck. Although removal of a sucking device was involved. >He would normally work on two people at once and always did so while >waiting the 5 mins for your anaesthetic to take effect. The instant he had >finished with you (and while you were still horizontal in the chair) he was >off backing through the door to avoid contaminating the new gloves his >assistant had quickly changed. Good dental surgeons glove themselves. Brain surgery is different. 5 minutes is normal onset time for mandibular local anesthesia with lidocaine. Shorter for aristocaine, and longer for bupivicaine. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > Good dental surgeons glove themselves. Perhaps he did - I was still looking at the ceiling at the time. >Subject: Re: Finger Points to Fillings in UK Dentistry Crisis >From: W_B no_one@nowhere.net [quoted text clipped - 9 lines] >Good dental surgeons glove themselves. >Brain surgery is different. Irrelevant/Diversion. You ALL need to read Tooth Truth which addresses the problem Have you considered the possibility that your sample may not be representative, therefore making generalization to the respective populations of dentists impossible? If and when you move back to the UK, you may want to consider a mixed NHS/private practice (if you can't afford to go private). > I had a UK NHS dentist for several years before moving to Belgium. The > difference is amazing... [quoted text clipped - 26 lines] > The difference is so great that when we move back to the UK I may still come > back here to see the dentist! >Have you considered the possibility that your sample may not be >representative, therefore making generalization to the respective >populations of dentists impossible? If and when you move back to the >UK, you may want to consider a mixed NHS/private practice (if you >can't afford to go private). Exactly. Each dentist could be the outlier in his / her respective country. Except if Jan Drew is analyzing it., Then BOTH DENTISTS are the out-LY-y-y-y-y-yers. Joel >> I had a UK NHS dentist for several years before moving to Belgium. The >> difference is amazing... [quoted text clipped - 26 lines] >> The difference is so great that when we move back to the UK I may still come >> back here to see the dentist! > Have you considered the possibility that your sample may not be > representative, therefore making generalization to the respective > populations of dentists impossible? Oh yes quite possible. However - When choosing the dentist in the UK we took recommendations from friends and co-workers and visited 4 or 5 dentists in person. This one appeared to be the best we could find. From what I hear now we may no longer have the luxury of choice. In Belgium we went to the nearest one first and saw no need to visit others. Just go private. Cheaper than flying to Belgium =) > > Have you considered the possibility that your sample may not be > > representative, therefore making generalization to the respective [quoted text clipped - 8 lines] > > In Belgium we went to the nearest one first and saw no need to visit others. > I had a UK NHS dentist for several years before moving to Belgium. The > difference is amazing... [quoted text clipped - 3 lines] > you arrive and you might have to wait an hour if the dentist is running > late. That seems to be common practice in the US. In fact I can't think of a single time for a doctor or dentist appointment when there were not other people in the waiting room and I didn't have to wait at least 10 minutes. that is true whether or not the waiting room served more than one doctor/dentist. > He would normally work on two people at once and always did so while > waiting the 5 mins for your anaesthetic to take effect. I wonder if that is really a good idea. How can a dentist work on two people at once and do good work. Would a surgeon operate on two people at once? Also may encourage using Am scrap from one case in the mouth of someone else if that can happen. >Also may encourage using Am scrap >from one case in the mouth of someone else if that can happen. BS it sets to fast. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Being out in a semi-rural area without a surplus of dentists, I frequently am overworked. Dealing with emergency pain patients crowds the schedule and I am often behind. If someone is in a hurry, or I am running *way* late, we will call patients to reschedule appts., and offer that to anyone currently waiting to be seated. Out here, it isn't just seeing how many patients I can cram into one day's work. I do use three operatories. This reduces the wait by cycling rooms as they are cleaned, and almost all procedures have 'dead time' that I could be doing other treatment in one of the other rooms. If I had 1 or 2 rooms and only had one patient seated at a time, my fees would go up considerably. That doesn't mean that I rush through treatment and do sloppy work. I'm not giving 20 second injections, cutting 3 minute crown preps, eliminating steps in technique, taking shortcuts with sterilization/disinfection, having assistants perform illegal services (or something they aren't trained to do), etc. Quality treatment comes first. I try and stay on schedule as much as possible, but hunting for an MB-2, removing a fractured root tip, or starting an emergency endo all take time. If someone needs to be in and out by the clock, we can usually handle that by scheduling them first thing in the morning, or right after lunch. This morning, I only had to deal with one emergency, all treatment went exactly as predicted, and I had a couple of cancellations so everything has clicked along perfectly. JMO, Fawks > That seems to be common practice in the US. In fact I can't think of > a single time for a doctor or dentist appointment when there were not other [quoted text clipped - 8 lines] > people at once? Also may encourage using Am scrap > from one case in the mouth of someone else if that can happen. > I do use three operatories. This reduces the wait by cycling rooms as > they are cleaned, and almost all procedures have 'dead time' that I > could be doing other treatment in one of the other rooms. If I had 1 or > 2 rooms and only had one patient seated at a time, my fees would go up > considerably. ... Hope you're not shlepping the WaterLase from room to room... If so, whatch out... the mirror alignment may go out and you'll need a service call. SP SignatureNot a real Addy, yet > Being out in a semi-rural area without a surplus of dentists, I > frequently am overworked. Dealing with emergency pain patients crowds [quoted text clipped - 12 lines] > > That doesn't mean that I rush through treatment and do sloppy work. However , Dentist are people too and they get sick, have bad days etc. Consider someone who has chronic fatigue syndrome, early onset parkisons etc. Running 3 rooms is a lot of pressure and before you know it, things could happen that endanger the patient. The denitst may be the last to know or admit that they can't handle the work efficently. Additionally some dentists are obviously much more skilled and quicker to begin with so they can probably handle more than one room at a time. I wouldn't be concerned if Dental procedures, and material handling, such as Am where error proof or if the worst consequence of bad work was a restoration that looks funny, but what I suspect is that poor work combind with the inherent danger in these procedure and materials can have bad consequences. > I'm not giving 20 second injections, cutting 3 minute crown preps, > eliminating steps in technique, taking shortcuts with > sterilization/disinfection, having assistants perform illegal services > (or something they aren't trained to do), etc. Quality treatment comes > first. I wonder how often assistants do perform jobs they shouldn't? Obviously,I realize that having multiple operatories cuts down on costs, however I don't think patients think of it that way. In other words, if patients realized that the dentist would be given more time to do quality work without being rushed and they would substantially have less time in the waiting room if they paid more, I think they would pay it. On the other hand, many people are going to be practicing when they shouldn't or do bad quality work no matter what. How can the patient assess this? Demand a dentists health and work history as well as machine/equipment maintenance records? Ask to see examples of previous work, and have their fillings and x-rays reviewed by another dentist for restoration quality? In the real world that is not going to happen, so most people figure if the dentist is liscensed with a decent reputation why pay more? >However , Dentist are people too Dentistssssssssss who NEED dentistsssssssssss are the HAPPIEST dentistssssssssss in the world ........... Streisand classic. >> I had a UK NHS dentist for several years before moving to Belgium. The >> difference is amazing... [quoted text clipped - 16 lines] >people at once? Also may encourage using Am scrap >from one case in the mouth of someone else if that can happen. Wacko .. Stephen Mancuso, D.D.S. Troy, Michigan, USA Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. > >two people at once and do good work. Would a surgeon operate on two > >people at once? Also may encourage using Am scrap [quoted text clipped - 4 lines] > Stephen Mancuso, D.D.S. > Troy, Michigan, USA Hey peabrained twit who still doesn't comprehend that Hg from amalgam is the largest source. If you'd read the posts more carefully in the past weeks, you'd know that the issues I brought up are relevant and not exactly hypotheticals pulled out of nowhere. But I guess you can't read scientifc literature or newsgroups with comprehension. How the heck did you make it through school? > Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. >Hey peabrained twit who still doesn't comprehend that Hg from >amalgam is the largest source. Jan says, "It is always wrong to belittle ...." >> >two people at once and do good work. Would a surgeon operate on two >> >people at once? Also may encourage using Am scrap [quoted text clipped - 6 lines] > > Hey peabrained twit ............ pretty lame but what do you expect from someone that can trip over a cordless phone. carabelli. > >> >two people at once and do good work. Would a surgeon operate on two > >> >people at once? Also may encourage using Am scrap [quoted text clipped - 11 lines] > > carabelli. Not so funny. If I want a good insult I can always go to an alt.politics list with a contentous debate. They come up with some good ones. >> >> >two people at once and do good work. Would a surgeon operate on two >> >> >people at once? Also may encourage using Am scrap [quoted text clipped - 14 lines] >Not so funny. If I want a good insult I can always go to an alt.politics >list with a contentous debate. They come up with some good ones. I already gave you a good insult, and all you did was whine about how you couldn't find the full headers on google groups. -- Adenosine Semi-informed Dental Consumer ? >>> pretty lame but what do you expect from someone that can trip over a >>> cordless phone. [quoted text clipped - 9 lines] >-- >Adenosine CubicZirconia couldn't ... <fill in the blank> if s/he/it's... <fill in the blank>... What was that silly little book series that was popular in the early 70's verb/noun/adjective ??? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>> pretty lame but what do you expect from someone that can trip over a >>>> cordless phone. [quoted text clipped - 17 lines] > >verb/noun/adjective ??? Are you thinking Mad Libs? Early 70s my a.s, I was playing those when I was a kid in the late 80s/early 90s. -- Adenosine Semi-informed Dental Consumer ? >>>>> pretty lame but what do you expect from someone that can trip over a >>>>> cordless phone. [quoted text clipped - 22 lines] >Early 70s my a.s, I was playing those when I was a kid in the late >80s/early 90s. Yeah, Mad Libs, that's the ticket. Twas the early to mid 70's for me kiddo. Graduated from dental school in the mid 80's. Some would consider me a kid, but ... -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >From: Adenosine >I already gave you a good insult, Despeciable talking of one's dead mother. >> pretty lame but what do you expect from someone that can trip over a >> cordless phone. [quoted text clipped - 3 lines] >Not so funny. If I want a good insult I can always go to an alt.politics >list with a contentous debate. They come up with some good ones. Then what are you doing here CubicZirconia ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>> pretty lame but what do you expect from someone that can trip over a >>> cordless phone. [quoted text clipped - 8 lines] > -- > W_B I've seen people like him before, but I had to buy a ticket to get in. carabelli >>>Not so funny. If I want a good insult I can always go to an alt.politics >>>list with a contentous debate. They come up with some good ones. [quoted text clipped - 7 lines] > >carabelli Know what you mean. After the first time, didn't buy a second ticket. This way to the Egress --> -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE "carabelli" <huerter@worldnet.att.net> wrote in message news:nj8pd.55701>>>> pretty lame but what do you expect from someone that can trip over a >>>> cordless phone. >>>> >>>> carabelli. >>> >>>Not so funny. If I want a good insult I can always go to an alt.politics >> Wacko >> .. [quoted text clipped - 3 lines] >Hey peabrained twit who still doesn't comprehend that Hg from >amalgam is the largest source. Nope. Coal burning electrical generation plants, forest fires, and fish consumption. Check epa.gov -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >What about 350 mV ? Well, if you want to know the degree to which the electrical potentials generated by metal amalgam dental fillings are able to dissipate electrical energy through the nerves in people's heads then you have to carry out experimental studies to measure it. And if you want to know the degree to which "private" dentists in the UK place amalgam fillings in their patients' teeth then you have to ask them. The principle is the same. If you don't bother to find out then you don't know. You simply remain ignorant. Keith P Walsh >>What about 350 mV ? > [quoted text clipped - 6 lines] > UK place amalgam fillings in their patients' teeth then you have to > ask them. So Keith, when you get a phone are you going to call some dentists and ask? carabelli >>>What about 350 mV ? Weird event happened. I am reading an excellent Scientific American book about "The Cell." What are they talking about? 350 mV. I almost fell off my chair! Keith is kinda right! Joel >> Well, if you want to know the degree to which the electrical >> potentials generated by metal amalgam dental fillings are able to [quoted text clipped - 8 lines] > >carabelli >Weird event happened. > [quoted text clipped - 5 lines] > >Keith is kinda right! And as far as I am aware the resting potential of a human neurological synapse is still only 70mV. I suspect I'm kinda right about that too! Do you think that NHS dental patients in the UK should have any right to choose what material is used for filling cavities in their teeth? Keith P Walsh > And as far as I am aware the resting potential of a human neurological > synapse is still only 70mV. Yes, that's correct, inside of the organelle is negative wrt the outside. > Do you think that NHS dental patients in the UK should have any right > to choose what material is used for filling cavities in their teeth? That's for your public to decide: Are YOU willing to up your taxes to cover the added expenses of placing composite materials in NHS patients' cavities? I think it would come down to that. You might want to suggest this question to one of your phone-in type talkshows and see what people say. > Keith P Walsh Cheers SP SignatureNot a real Addy, yet Yep, there you go. Find our what percentage of taxpayers see that as a worthwhile benefit and act accordingly. I'd bet that the numbers might surprise you (Keith) once the money aspect is addressed. I doubt that most citizens really think composites are worth a tax hike. I'm grateful that I don't have to deal with such a system. Fawks >>Do you think that NHS dental patients in the UK should have any right >>to choose what material is used for filling cavities in their teeth? [quoted text clipped - 9 lines] > Cheers > SP >>>Do you think that NHS dental patients in the UK should have any right >>>to choose what material is used for filling cavities in their teeth? >> >> That's for your public to decide: That's for the PATIENT to decide. The first step is to INFORM then that amalgams are 50% mercury, one of the most TOXIC materials known to man. Then INFORM them of the scientific proof of amalgam DANGERS. Money is of NO value if you don't have your health. Ban amalgams, the cost of composites will come down. SP makes fun of serious illness. Jan A truth’s initial commotion is directly proportional to how deeply the lie was believed…When a well-packaged web of lies has been sold gradually to the masses over generations, the truth will seem utterly preposterous and its speaker, a raving lunatic. -Dresden James >> And as far as I am aware the resting potential of a human neurological >> synapse is still only 70mV. >> >Yes, that's correct, inside of the organelle is negative wrt the >outside. Dear Stovepipe, Thank you for your continued correspondence. It has been demonstrated experimentally that metal amalgam dental fillings generate electrical potentials with magnitudes of up to 350mV. You can read all about it at: http://book.boot.users.btopenworld.com/dutch.htm Do you think that it should be possible to determine experimentally whether or not these potentials are able to dissipate electrical energy through the nerves in people's heads? Keith P Walsh > Do you think that it should be possible to determine experimentally > whether or not these potentials are able to dissipate electrical > energy through the nerves in people's heads? > > Keith P Walsh I see no way to do this, and I would think that any metal restoration would produce a galvanic battery effect such as you describe, but again, the significance of such potentials is dubious, IMO. If they were truly nocif, I think we'd have seen demonstrable cause/effect pathology by now. Cheers SP SignatureNot a real Addy, yet >> Do you think that it should be possible to determine experimentally >> whether or not these potentials are able to dissipate electrical [quoted text clipped - 9 lines] >Cheers >SP The following is taken from the University of Illinois' "Physics Van" website. "Very sensitive measuring devices which can pick up tiny magnetic fields can detect neural activity without needing to poke electrodes directly into neurons, .. " See: http://van.hep.uiuc.edu/van/qa/section/Everything_Else/Humans_and_Animals/200208 12111737.htm I think that it should be possible to measure the neural activity in nerves close to the teeth of individuals with and without amalgam fillings and compare the results. Don't you agree? Keith P Walsh PS, Further enquiries concerning the electrical behavior of dental amalgams can be found at: http://book.boot.users.btopenworld.com/intro.htm And by the way, the "Physics Van" website is for kids. Perhaps you missed it. > I think that it should be possible to measure the neural activity in > nerves close to the teeth of individuals with and without amalgam > fillings and compare the results. > > Don't you agree? Where I'd disagree is more on what would be the real significance of these potentials. If the nerves really did not tolerate Am based on increased neural activity, we should see sensitive teeth that stay that way. We don't unless the tooth is sick. > Keith P Walsh > [quoted text clipped - 6 lines] > > Perhaps you missed it. Thanks loads for the link. I don't believe the pipettes know about this at all. I haven't had time to look but I will. Thanks again, adn ssorry for the delay.... armageddon almost came to the clinic this week. Cheers SP SignatureNot a real Addy, yet >> I think that it should be possible to measure the neural activity in >> nerves close to the teeth of individuals with and without amalgam >> fillings and compare the results. >If the nerves really did not tolerate Am based on >increased neural activity, we should see sensitive teeth that stay that >way. Is this assumption based on the findings of any experimental investigation? Or are you just guessing? Would it be possible to determine whether or not the patient suffers any neurological influence which is not perceived as "pain"? Keith P Walsh > >If the nerves really did not tolerate Am based on > >increased neural activity, we should see sensitive teeth that stay that > >way. > > Is this assumption based on the findings of any experimental > investigation? No... it's just emperically derived from my observations of 'normal' Kebec people who have had Mercury Fillings since they were young. > Or are you just guessing? I'd say it's a bit more than a guess. One should not read too much into measures that can be taken of miniscule biological events until one can show that such measures reflect a true influence on the organism. I have seen too many old Ams that are still in fine condition in the mouths of people from all walks of life; successful, unsuccessful, healthy, sickly, etc... to say that the presence or abscence of Ams in their mouths can have a real influence on their health and lives. The lack of dental care has far more influence than does the type of filling. I have seen teeth filled with inappropriate material (like Jello) that were also doing just fine. (I replaced the Jello and corn and broccoli, etc with a real filling, of course... and those people went on to the rest of their lives without incident) Don't misunderstand: if I could eliminate Am fillings from my armamentarium, I would. Unfortunately, we are not all Steve Fawks, that's the bottom line. > Would it be possible to determine whether or not the patient suffers > any neurological influence which is not perceived as "pain"? > > Keith P Walsh Think you'd need a neuro to tell you this. Or an ENT specialist. They wouldn't have any axe to grind one way or the other. I grind the axe of pragmatism. It is quite sharp, at the moment, I believe. Cheers SP SignatureNot a real Addy, yet >> Keith P Walsh > [quoted text clipped - 5 lines] >Cheers >SP Is this your first encounter with the infamous KPW " the 350 mV Parrot " ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >> Keith P Walsh > > [quoted text clipped - 7 lines] > > Is this your first encounter with the infamous KPW " the 350 mV Parrot " ? I'll see your 350 and raise you 500 carabelli >> Is this your first encounter with the infamous KPW " the 350 mV Parrot " ? I sensed myself that "StovePipe" might be a newcomer to this debate. I'll bring him up to speed: - It has been demonstrated experimentally that metal amalgam dental fillings generate electrical potentials with magnitudes of up to 350mV. (*) - I am trying to find out whether or not these electrical potentials are able to dissipate electrical energy through the nerves in people's heads? - Carabelli and the guys can't help (they're too arrogant to admit it, but the truth is they don't know). Meanwhile the UK's National Health Service continues to insist that the ONLY filling material that dentists are allowed to use when placing fillings in posterior teeth is metal amalgam. Keith P Walsh (*) see: http://book.boot.users.btopenworld.com/dutch.htm >Subject: Re: Finger Points to Fillings in UK Dentistry Crisis >From: W_B no_one@nowhere.net [quoted text clipped - 16 lines] > >W_B http://van.hep.uiuc.edu/van/qa/section/Everything_Else/Humans_and_Animals/ 20020812111737.htm http://book.boot.users.btopenworld.com/intro.htm http://www.jageblad.se/research/ == http://www.drdooley.com/id6.html The second fundamental flaw is that there are five dissimilar metals in the amalgam. Galvanic action between these metals in inevitable (the dissimilar metals form a battery). Galvanism produces electricity that flows through the body. The electric currents produced by the amalgam typically are between 0.1 and 10 microamps, compared to the body's natural electric current of 3 microamps. Galvanic effect only occurs in an acidic environment and there MUST be a gap or a permeable insulator (like paper) between the different metals. In addition, there must be a lot of free electrons in one metal, and less free electrons (compared to equilibrium) in the other metal. Oxidization helps free up electrons, but only until equilibrium is reached. Keeping the metals in contact eliminates any electrical potential, as the electrons have gone back and forth and equalized. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> Do you think that it should be possible to determine experimentally [quoted text clipped - 10 lines] > Cheers > SP > Galvanic effect only occurs in an acidic environment and there MUST be a gap > or a permeable insulator (like paper) between the different metals. In [quoted text clipped - 3 lines] > metals in contact eliminates any electrical potential, as the electrons have > gone back and forth and equalized. I always find it intriguing that dentists can appear to be so knowledgeable of the elecrolytic behavior of the inhomogeneous mixtures of dissimilar metals commonly used in restorative dentistry whilst, at the same time, being completely ignorant of their other electrical behaviors. For example, thermoelectric effects in such a material produce electrical potentials without the need for any acidic environment or electrolytic agents at all. The size of the thermoelectric potential generated by an inhomogeneous mixture of dissimilar metals is determined by the property of the material known as its seebeck coefficient. And yet it appears that there isn't anyone anywhere in the world who knows what the seebeck coefficient (measured in volts per kelvin) of a typical dental amalgam is. Furthermore, electrical potentials (and currents) are induced in conductive materials by their interaction with electromagnetic fields. This behavior is defined for any particular material by its electrical and electromagnetic properties. And yet it appears that there isn't anyone anywhere in the world who knows what the electrical conductivity (measured in siemens per metre) of a typical dental amalgam is. And it also appears that there isn't anyone anywhere in the world who knows what the permeability (measured in henry per metre) of a typical dental amalgam is. And it also appears that there isn't anyone anywhere in the world who knows what the permittivity (measured in farads per metre) of a typical dental amalgam is. Amalgam fillings are placed in children's teeth. There is no justification for this ignorance. The following abstract indicates that experimental studies show that the electrical potentials generated by amalgam fillings are not necessarily "eliminated" as readily as you suggest. "The regeneration of the electromotor force E of the electric piles formed by two amalgam fillings was measured as a function of time t after the moment of interruption of the short contact of their poles. The measurements were carried out in 30 patients at a mean age of 27.0 +/- 08 years. Automatic recording of the equation E = f (t) demonstrated that in the first phase of from several to about a score of seconds the E value rose rapidly, while in the second phase lasting from several scores to over a thousand seconds the E value approached asymptotically its initial value Eo." (from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2 103035&dopt=Abstract ) On the contrary, it appears that these electrical potentials might quickly re-establish themselves after a temporary discharge. And other studies have shown that the electrical potentials generated by amalgam fillings measure up to 350 millivolts in magnitude. (see: http://book.boot.users.btopenworld.com/dutch.htm ) I believe that further experimental studies should therefore have been carried out in order to determine whether or not these potentials are able to dissipate electrical energy through the nerves in people's heads. Do you not agree? Keith P Walsh PS, an elementary description of the thermoelectric effect can be found at: http://book.boot.users.btopenworld.com/thermo2.htm - along with other scientific information regarding the electrical properties of dental amalgams. >And other studies have shown that the electrical potentials generated by >amalgam fillings measure up to 350 millivolts in magnitude. We sure have missed your 350mV message lately... not. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >Subject: Re: Finger Points to Fillings in UK Dentistry Crisis >From: "Dr Steve" nospam@home.net [quoted text clipped - 8 lines] >metals in contact eliminates any electrical potential, as the electrons have >gone back and forth and equalized http://home.iprimus.com.au/asomat/caulk/Dispersalloy-DFU.htm From the manufactures: Suggestions for best results with Dispersalloy® Manufacturer's variation in amalgamators and differences in local electrical current may necessitate adjusting trituration time http://tinyurl.com/6o5yz : Eur J Oral Sci. 1996 Jun;104(3):300-8. Related Articles, Links Galvanic corrosion and cytotoxic effects of amalgam and gallium alloys coupled to titanium. Bumgardner JD, Johansson BI. Department of Dental Materials Science, Umea University, Sweden. jbumgard@abe.msstate.edu The aim of this study was to examine and compare the galvanic corrosion of a conventional, a dispersed high-copper, and a palladium-enriched spherical high-copper amalgam and a gallium alloy coupled to titanium in saline and cell culture solutions, and to evaluate the effects of the couples on cultured cells. The potentials and charge transfers between amalgams and titanium were measured by electrochemical corrosion methods. Cytotoxicity of the couples, as indicated by the uptake of neutral red vital stain, was determined in 24-h direct contact human gingival fibroblast cell cultures. Results of this study indicated that before connecting the high-copper amalgams to titanium, the amalgams exhibited more positive potentials which resulted in initial negative charge transfers, i.e. corrosion of titanium. However, this initial corrosion appeared to cause titanium to passivate, and a shift in galvanic currents to positive charge transfers, i.e. corrosion of the amalgam samples. Lower galvanic currents were measured for the amalgam-titanium couples as compared to the gallium alloy-titanium couple. Coupling the conventional or the palladium-enriched high-copper amalgams to titanium did not significantly affect the uptake of neutral red as compared to cells not exposed to any test alloy. However, significant cytotoxic effects were observed when the dispersed-type high-copper amalgam and the gallium alloy were coupled to titanium. Even though the corrosion currents measured for these couples were less than gold alloys coupled to amalgam, these results suggest there is the potential for released galvanic corrosion products to become cytotoxic. These data warrant further investigations into the effects of coupling amalgam and gallium alloys to titanium in the oral environment. PMID: 8831065 [PubMed - indexed for MEDLINE] following information is about signs and symptoms of mercurypoisoning related to amalgam fillings: the amount of mercury to which one isexposed is a function of the age, number and size of filling.It makes adifference if there are two different types of metals in the mouth, producing aflow of electric current(the electro galvanic effect. The flow of electric currenthastens degradation of the metals and releases a increased quanity of mercury Oh BTW, Admiral StovePipe, Keith is a kook and best if ignored. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> Do you think that it should be possible to determine experimentally [quoted text clipped - 10 lines] > Cheers > SP >Subject: Re: Finger Points to Fillings in UK Dentistry Crisis >From: "Dr Steve" nospam@home.net [quoted text clipped - 4 lines] > >Keith is a kook and best if ignored Translation: Keith presentd truth that wil hurt the EGO. > >Subject: Re: Finger Points to Fillings in UK Dentistry Crisis >>From: "Dr Steve" nospam@home.net [quoted text clipped - 8 lines] > > Keith presentd truth that wil hurt the EGO. Translation - when I post as Chuck I use my fingers to type instead of my beak. carabelli >> Keith presentd truth that wil hurt the EGO. > >Translation - when I post as Chuck I use my fingers to type instead of my >beak. > >carabelli And all that time I though that they were using someone elses' ... Too horrible to contemplate.... -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >> And as far as I am aware the resting potential of a human neurological >> synapse is still only 70mV. >> >Yes, that's correct, inside of the organelle is negative wrt the >outside. 350 mV minus 70 mV leaves 280 mV. I got the wrong number! >> Do you think that NHS dental patients in the UK should have any right >> to choose what material is used for filling cavities in their teeth? [quoted text clipped - 8 lines] >Cheers >SP >Subject: Re: Finger Points to Fillings in UK Dentistry Crisis >From: Keith P Walsh keith.p.walsh@btinternet.com [quoted text clipped - 20 lines] > >Keith P Walsh Yep. However as long as the lies are told, the general public has no idea what is in amalgams, and that's the way dentistry wants to keep it. Some states are ENFORCING the risks be displayed in the waiting room of dentists offices. .Lies Deceit and EGO is causing much suffering, and some don't give a hang. One day they will answer for these sins. Jan A truth’s initial commotion is directly proportional to how deeply the lie was believed…When a well-packaged web of lies has been sold gradually to the masses over generations, the truth will seem utterly preposterous and its speaker, a raving lunatic. -Dresden James >Do you think that NHS dental patients in the UK should have any right >to choose what material is used for filling cavities in their teeth? > >Keith P Walsh Not if they are not paying for it. How much extra tax is Keith willing to pay out of his own pocket so people in the UK can choose filling materials? .. Stephen Mancuso, D.D.S. Troy, Michigan, USA Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. >>Do you think that NHS dental patients in the UK should have any right >>to choose what material is used for filling cavities in their teeth? >> >>Keith P Walsh > >Not if they are not paying for it. But they are paying for it, you ignoramus. The majority of working and salaried people in the UK have their National Health Insurance contributions deducted from their hard-earned wages at source. When are you Americans going to understand that the UK's National Health Service is NOT WELFARE. Keith P Walsh They are paying taxes for a given level of dental care. This level of care covers the cheapest materials. Posterior composties *are not* being covered because it would be more expensive. Therefore the citizens *are not* paying for it at this time. Taxes would have to increase to cover this service. Once the taxes were raised *then* they would be paying for it. Not now. Reading comprehension skills are needed before you hurl insults. Fawks >>Not if they are not paying for it. > [quoted text clipped - 8 lines] > > Keith P Walsh >When are you Americans going to understand that the UK's National >Health Service is NOT WELFARE. > >Keith P Walsh Never, because it is welfare. The fees barely cover the dentists' costs. The whole system is poised for a disasterous collapse. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>When are you Americans going to understand that the UK's National >>Health Service is NOT WELFARE. [quoted text clipped - 4 lines] >The fees barely cover the dentists' costs. >The whole system is poised for a disasterous collapse. WELL, even if its WELFARE, its the dentist who is extending the consideration, not the government. LOW FEES means we are donating our time and energy and materials .... for some reason. And there is usally a limit to that! Joel >>>What about 350 mV ? >> [quoted text clipped - 10 lines] > >carabelli He musta been temporarily banned from the local library. Too much spare Voltage. Them multiple 350 mV's shootin' outta his toes stunk the place up. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>What about 350 mV ? > >Well, if you want to know the degree to which the electrical >potentials generated by metal amalgam dental fillings are able to >dissipate electrical energy through the nerves in people's heads then >you have to carry out experimental studies to measure it. Why have you not funded these experiments that you have already defined ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > Should NHS dental patients in the UK have the right to choose what > material is used for filling cavities in their teeth? No. The NHS is there to provide treatment to secure oral health. If a patient wants to select a posterior composite over amalgam because it looks better, then that's cosmetic treatment and it shouldn't come off other people's tax. To view it in a different light, a posterior composite is a very delicate procedure. It requires skill, TIME (very important) and expensive materials (new bonding agents, flowables, good matrix bands, rubber dam preferaably etc). If the NHS came out tomorrow with a fixed price for a posterior composite, it would still be an incredibly low crappy NHS price - don't forget we're talking about the same system who pays for a filling less than a pizza and for a RCT less than a videogame. This means that Mr and Mrs Patient would decline amalgam fillings (of course anyone would go for the white fillings given the choice), but the dentists would still have to rush them in order to do a living. This would inevitably result in 1) thousands if not tens of thousands of people suffering from postfilling sensitivity and perhaps much more serious problems, 2) the access problem worsened because more people would demand more time-consuming procedures and 3) many dentists going bust because they were counting on the private fees from the composites to balance the outrageously low NHS fees, which will also worsen the access problem. Also, another thing I would like to point out is that there are no NHS dental patients and no NHS dentists. There are just patients and dentists; if one or the other chooses to go the NHS way it's his choice, but it's not an obligatory choice. George > There are just patients and >dentists; if one or the other chooses to go the NHS way it's his >choice, but it's not an obligatory choice. > >George Then again there are patients and there are Patient$ Same goes for Denti$t$ -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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