[House Hearing, 108 Congress]
[From the U.S. Government Publishing Office]
CALIFORNIA'S COMPLIANCE WITH DENTAL AMALGAM DISCLOSURE POLICIES
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HUMAN RIGHTS AND WELLNESS
of the
COMMITTEE ON
GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTH CONGRESS
SECOND SESSION
__________
JANUARY 26, 2004
__________
Serial No. 108-141
__________
Printed for the use of the Committee on Government Reform
Available via the World Wide Web: http://www.gpo.gov/congress/house
http://www.house.gov/reform
______
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WASHINGTON : 2003
____________________________________________________________________________
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COMMITTEE ON GOVERNMENT REFORM
TOM DAVIS, Virginia, Chairman
DAN BURTON, Indiana HENRY A. WAXMAN, California
CHRISTOPHER SHAYS, Connecticut TOM LANTOS, California
ILEANA ROS-LEHTINEN, Florida MAJOR R. OWENS, New York
JOHN M. McHUGH, New York EDOLPHUS TOWNS, New York
JOHN L. MICA, Florida PAUL E. KANJORSKI, Pennsylvania
MARK E. SOUDER, Indiana CAROLYN B. MALONEY, New York
STEVEN C. LaTOURETTE, Ohio ELIJAH E. CUMMINGS, Maryland
DOUG OSE, California DENNIS J. KUCINICH, Ohio
RON LEWIS, Kentucky DANNY K. DAVIS, Illinois
JO ANN DAVIS, Virginia JOHN F. TIERNEY, Massachusetts
TODD RUSSELL PLATTS, Pennsylvania WM. LACY CLAY, Missouri
CHRIS CANNON, Utah DIANE E. WATSON, California
ADAM H. PUTNAM, Florida STEPHEN F. LYNCH, Massachusetts
EDWARD L. SCHROCK, Virginia CHRIS VAN HOLLEN, Maryland
JOHN J. DUNCAN, Jr., Tennessee LINDA T. SANCHEZ, California
JOHN SULLIVAN, Oklahoma C.A. ``DUTCH'' RUPPERSBERGER,
NATHAN DEAL, Georgia Maryland
CANDICE S. MILLER, Michigan ELEANOR HOLMES NORTON, District of
TIM MURPHY, Pennsylvania Columbia
MICHAEL R. TURNER, Ohio JIM COOPER, Tennessee
JOHN R. CARTER, Texas CHRIS BELL, Texas
MARSHA BLACKBURN, Tennessee ------
------ ------ BERNARD SANDERS, Vermont
(Independent)
Peter Sirh, Staff Director
Melissa Wojciak, Deputy Staff Director
Rob Borden, Parliamentarian
Teresa Austin, Chief Clerk
Phil Barnett, Minority Chief of Staff/Chief Counsel
Subcommittee on Human Rights and Wellness
DAN BURTON, Indiana, Chairman
CHRIS CANNON, Utah DIANE E. WATSON, California
CHRISTOPHER SHAYS, Connecticut BERNARD SANDERS, Vermont
ILEANA ROS-LEHTINEN, Florida (Independent)
ELIJAH E. CUMMINGS, Maryland
Ex Officio
TOM DAVIS, Virginia HENRY A. WAXMAN, California
Mark Walker, Chief of Staff
Mindi Walker, Professional Staff Member
Danielle Perraut, Clerk
Richard Butcher, Minority Professional Staff Member
C O N T E N T S
----------
Page
Hearing held on January 26, 2004................................. 1
Statement of:
Johnson, Karen, State representative......................... 16
Yokoyama, Dr. Chester, DDS, California Dental Board and
former Chair Dental Materials Fact Sheet Commission; Shawn
Khorrami, Esq.; Parin Shah, executive director, Community
Toolbox for Children's Environmental Health and past
president, San Francisco's Commission on the Environment;
and Dr. Harold Slavkin, DDS, dean, University of Southern
California School of Dentistry............................. 21
Letters, statements, etc., submitted for the record by:
Burton, Hon. Dan, a Representative in Congress from the State
of Indiana, prepared statement of.......................... 6
Khorrami, Shawn, esq., prepared statement of................. 31
Shah, Parin, executive director, Community Toolbox for
Children's Environmental Health and past president, San
Francisco's Commission on the Environment, prepared
statement of............................................... 44
Slavkin, Dr. Harold, DDS, dean, University of Southern
California School of Dentistry, prepared statement of...... 40
Watson, Hon. Diane E., a Representative in Congress from the
State of California, prepared statement of................. 12
Yokoyama, Dr. Chester, DDS, California Dental Board and
former Chair Dental Materials Fact Sheet Commission,
prepared statement of...................................... 25
CALIFORNIA'S COMPLIANCE WITH DENTAL AMALGAM DISCLOSURE POLICIES
----------
MONDAY, JANUARY 26, 2004
House of Representatives,
Subcommittee on Human Rights and Wellness,
Committee on Government Reform,
Los Angeles, CA.
The subcommittee met, pursuant to notice, at 2 p.m., in the
Town and Gown Road, USC Campus, Los Angeles, CA, Hon. Dan
Burton (chairman of the subcommittee) presiding.
Present: Representatives Burton and Watson.
Staff present: Nick Mutton, press secretary; Danielle
Perraut, clerk; and Richard Butcher, minority professional
staff member.
Mr. Burton. Good afternoon. A quorum being present, the
Subcommittee on Human Rights and Wellness will come to order.
And we're very happy that Congresswoman Watson is here with us
today. I like those blue glasses, too.
Ms. Watson. 99 cent store.
Mr. Burton. Just goes to show you do not have to spend a
lot of money.
I ask unanimous consent that all Members and witnesses
written and opening statements be included in the record, and
without objection so ordered.
I ask unanimous consent that all articles, exhibits and
extraneous material referred to by Members or witnesses be
included in the record, and without objection so ordered.
Before we start our opening statements, Congresswoman
Watson and I have a couple of opening statements that will take
some time.
There has been some question about scientific evidence
about whether or not amalgams in teeth give off any kind of a
residue or invisible smoke, if you will, that could effect the
neurological system of human beings. So we have a very brief
scientific film here, it's about 3 or 4 minutes long, and I
hope everybody will take a hard look at that at the beginning,
and then we will go to our opening statements.
[Video shown.]
Mr. Burton. I think that's all we need to hear. That was
showing that one picture is worth 1,000 words.
I would like to start off my opening statement by thanking
the University of Southern California, especially Michael Klaus
and Susan Lynch for their assistance in putting together
today's hearing. We really appreciate their efforts. And as
chairman of the House Committee on Government Reform and now
chairman of the Subcommittee on Human Rights and Wellness, I
have along with Representative Watson led a 2-year long effort
to bring to the public's attention, as well as the attention of
my colleagues in Congress, the dangers posed by mercury
containing medical and dental devices.
At previous hearings we have reviewed the concerns about
thimerosal which contains mercury in vaccines and mercury
containing dental amalgams. In each case, credible witnesses
provided testimony that links mercury in the human body to a
variety of developmental and neurological disorders.
Mercury is a base element and the most toxic substance
known in science outside of radioactive elements. It remains a
base element even when mixed with other materials. Mercury is a
substance that human beings were not designed to ingest, so the
body does not have an effective filter or elimination system
for it.
Some of the mercury we ingest is eliminated through normal
bodily functions, but much of it accumulates in the body's
tissue including vital organs such as the brain. The developing
neurological systems of fetuses and young children are
especially susceptible to damage by even the slightest trace
amounts of mercury. And you saw how much mercury comes off of
those teeth at various temperatures.
An ever increasing body of scientific evidence points to
mercury toxicity as a source of neurological problems including
but not limiting to, modest declines in intelligence quotient,
tremors, attention deficit disorder, attention deficit
hyperactivity disorder [ADHD], Alzheimer's Disease and autism.
No one has ever identified a positive health benefit to mercury
in the human body, thus it was sound public policy to eliminate
mercury from thermometers, blood pressure gauges, light
switches, cosmetics, teething powder, horse liniment, hat
making materials, smokestack emissions and mining operations.
In fact, virtually every industry has either reduced or banned
the use of mercury with the exceptions of dentistry and the
pharmaceutical industry.
The amalgam fillings the American Dental Association so
wrongly calls silver are mainly mercury, not silver at all.
Mercury is the single largest ingredient in each filling,
representing about 40 to 50 percent of the mercury by weight or
about one half a gram per filling. That is a colossal amount of
mercury in scientific terms, as much as is in an old fashioned
thermometer.
For example, a young child with six amalgam fillings has
the equivalent of six mercury thermometers worth of mercury in
his or her mouth. And dentists cannot honestly claim that they
were not aware of the dangers of mercury. In fact, dentists
take routine precautions against this potent neurotoxin.
According to protocol, mercury containing amalgam scraps and
extracted teeth with amalgam fillings must be stored in sealed
jars under liquid until special hazardous materials recycler
pick them up for safe disposal. So if dentists are aware of the
dangers of mercury, then why is this toxic material still being
used at all?
The answer is that the dental establishment continues to
hold to the scientific fiction that a material that is
hazardous before it goes into the mouth and hazardous after it
comes out of the mouth is somehow perfectly safe while it is in
the mouth. The truth is that it is not.
A scientific review of mercury amalgams in 1993 conducted
by the U.S. Public Health Service demonstrated that mercury
amalgams continuously vaporize and mercury vapor is then
absorbed into the blood stream and distributed throughout the
human body as you just saw in that brief film.
In addition, particles can and do chip off with regular
chewing, grinding and toothbrushing, further adding to a
person's mercury load.
The PHS study conclusively showed that people with amalgam
fillings have higher concentrations of mercury in their blood,
in their urine, kidneys and brains then those without amalgams.
If that is the case, how can anyone believe that dental
amalgams are harmless.
There are readily available alternatives to mercury
containing fillings, and every dentist knows about them. Yet
organized dentistry will not act to eliminate this dangerous
substance, thus it is left up to the patients to take the
initiative.
And one of the things that kind of disturbs me about this
hearing today is that there are millions and millions and
millions of people in California and across this country that
have mercury in their mouths and we do not have one television
station here covering this today. And it is something that
should be brought to the attention of everybody; every man,
woman and child in the country ought to know about this.
Unfortunately, most patients are still uninformed about the
materials used to restore their teeth and the benefits and
risks of each. And, again, I believe the blame has to be laid
at the feet of organized dentistry.
And there is no better proof of that than what has been
happening here in California. In 1986 the voters of California
enacted Proposition 65 requiring posting of notices of toxins
in the workplace or office. Soon therefore, the then Governor
Deukmajian with his administration listed mercury as a toxic
substance which required Proposition 65 postings. Nothing
happened until 1992 when the California legislature passed the
Watson law, my good colleague's law, requiring the California
Dental Board to produce a facts sheet to comply with
Proposition 65 spelling out the risks and benefits of various
filling materials.
Named after my good friend and the ranking minority member
of this subcommittee, Ms. Diane Watson who was a California
State Senator at the time, the Watson law was a simple common
sense effort to ensure that the public could make an informed
choice about their dental care. Ms. Watson has been a tireless
advocate on this issue for many years and a staunch ally in the
Congress as the subcommittee works to eliminate this dangerous
threat to our public health. And I really want to thank you for
your hard work. And I thank you for being here.
However today despite the passage of Proposition 65 and the
Watson law, Californians still are not able to get information
from their dentists about the dangers of mercury amalgams. So
far as the subcommittee has been able to determine, the
California Dental Board's only attempt thus far to actually
issue a facts sheet occurred in 1993, and the effort was deemed
by the California Department of Consumer Affairs to be probably
misleading. Regrettably, the board has never corrected the
problem.
In fact, the board's refusal to implement the Watson law
lead California State Senator Liz Figueroa to sponsor
legislation to dissolve the board completely and constitute a
new dental board. The law also mandated the Watson fact sheet
must be given to every dental patient. And we are going to put
that in the record. We have a copy of this which we will put in
the record today, so at least it will be on the Congressional
Record in case anybody wants to know about it.
Yet, under pressure from the California Dental Association
the new dental board has not been any more capable of producing
a fact sheet than the old one. That two dental boards have yet
to create a simple consumer friendly fact sheet in more than 17
years after the implementation of Proposition 65 and 11 years
after the passage of the Watson law is a grave disservice to
the residents of California.
I personally believe that there is no more important
function of government than doing everything in its power to
protect the health and well being of its citizens. When
controversy and uncertainty exists, such as in this case, the
least we should do is ensure that the public is adequately and
objectively informed and given the option of choosing what
materials are used to restore their teeth.
Today's hearing will focus on the lessons learned from and
the progress still being made here in California to implement
full disclosure of adequate information to dental patients.
Dr. Chet Yokoyama, a member of the California Dental Board,
former Chair of the California Dental Board Fact Sheet
Committee and a supporter of the Watson law is here this
afternoon to testify about why the dental board has had such
trouble complying with the Watson law. Although Dr. Yokoyama is
not speaking on behalf of the board nor has he been authorized
to speak on behalf of the board, I look forward to hearing his
personal perspective on this issue. And he testified in
Washington, and I want to thank you once again for being here,
Doctor.
I also look forward to hearing from Mr. Shawn Khorrami, an
attorney who led the recently successful fight in the
California court system to force dentists to post a Proposition
65 warning in their offices. While not as comprehensive as the
fact sheet required by the Watson law, the Proposition 65
warning is at least an important step in the right direction.
And, unfortunately, we have learned recently that the
California Dental Association has tried to stymie even the
modest level of public disclosure by lobbying against the
warning on the grounds that it is deceptive. We asked the
California Dental Association to be here today to participate,
but they declined to send a representative preferring to send a
written statement for the record instead. And it is
disappointing that they choose not to appear today to defend
their record on this issue.
However, we will hear from Dr. Harold Slavkin, Dean of the
School of Dentistry here at the University of Southern
California who can perhaps helps us better under the organized
dentistry's opposition to the elimination of mercury containing
amalgams.
California's population represents approximately one out of
every eight people in the United States. So it is not
surprising that events here can have a ripple effect on similar
activities and movements in other parts of the country. The
Honorable Karen Johnson, a State Representative from Arizona--I
am glad you are here today--is here to talk about her efforts
to pass legislation in Arizona similar to the Watson law here
in California. And we appreciate your hard work on that.
And last but not least, we will hear today from Mr. Parin
Shah, executive director of Community Toolbox for Children's
Environmental Health concerning the environmental impact of
dental amalgams.
When scraps of amalgam or old fillings are washed down the
drain, and I know they are because I have seen it out of my own
mouth, they can end up in our rivers, lakes and oceans and
eventually into our drinking water. If the fillings do get
caught in our waste water treatment plants, they settle in the
treatment plant's sludge which either gets incinerated
releasing the mercury directly into the atmosphere or it gets
spread out onto our agricultural fields as fertilizer
contaminating the food chain. So mercury amalgams are not just
a public health hazard, but an environmental one as well.
I want to thank all of our witnesses for being here this
afternoon.
And I now yield to Ms. Watson.
[The prepared statement of Hon. Dan Burton follows:]
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[GRAPHIC] [TIFF OMITTED] T3640.003
[GRAPHIC] [TIFF OMITTED] T3640.004
Ms. Watson. Thank you so much, Mr. Chairman. And a special
thanks for coming all the way out to California and appearing
in my District. And this great University of Southern
California that has been touted in the last few days of having
four major trophies. We won the Rose Bowl game.
Mr. Burton. I know. Indiana was way down the list.
Ms. Watson. And we are so very pleased. And I would like to
thank the Government Relations Department, particularly Carolyn
deMacias and President Sample for working to make this special
field hearing possible and all of you that have come out this
afternoon.
The Human Rights and Wellness hearing today is a very
important activity for Californians and the rest of the Nation.
The subcommittee seeks to obtain information about the
noncompliance, and I want you to focus on why we are here
today.
We are focusing on the noncompliance by the California
Dental Board regarding public disclosure of elemental mercury
and its use in dental fillings. In previous Government Reform
hearings we have discussed different aspects about the last
remaining use of mercury inside the human body. But, the 12
year failure--the 12 year failure to inform Californians and
Americans about the risk and the efficacies of mercury is very
disturbing to me.
This hearing will focus primarily upon disclosing relevant
information to patients which will enable patients to make
informed choices about the type of dental restorative material
that is used in their treatment.
What we're trying to do, everyone in this room that hears
my voice, is trying to make Americans, particularly
Californians, partners in their own wellness and in their own
health care. Keep that in mind.
In 1992 I wrote a law. It is Section 1648.10 of the
California Business and Professions Code which mandated--1992
it mandated a fact sheet to be produced by the California State
Dental Board stating the risk and efficacies of dental
materials. Over the following 9 years the board has not been in
compliance. I want to know why. However, I am pleased to report
that the last administration installed a new dental board,
because I saw that the dental board of California did not want
to comply with the law. So, there was a new dental board
appointed. The new board held hearings on the safety of mercury
fillings in 2002, but has again failed to fully comply with the
mandate. Why did it take 12 years? These are intelligent
professionals. I am appalled that in 12 years they have not
produced a fact sheet. Why?
The dental board was required to take into account what
would be in the best interest of the patient and the public. I
need to know why a consumer friendly fact sheet, which in July
2003, that's just a few months back, was approved seven to one.
And then again eight to zero in November 2003. And it is not
ready, Congressman, for circulation.
I am especially disappointed after receiving assurances
from the president of the board that the fact sheet would be in
the hands of patients before December 31, 2003, a few days ago.
I do not understand why the fact sheet should not be released
today. And I am terribly disappointed that--is there anyone
from the dental board except Dr. Yokoyama? Anyone else?
And then they all declined, and I got a letter, a polite
letter from the CEO of the board declining to appear. Now, what
does that tell you? Intelligent thinking people can figure it
out. Not one, except the person who was the former Chair of the
committee to do the fact sheet, showed up today.
The fact sheet was produced by a fact sheet committee of
the dental board and approved by the majority. I want to know
why the committee Chair who has worked on the fact sheet for
the last 2 years was suddenly dismissed.
The efforts by Dr. Chet Yokoyama, a mercury free dentist
and a member of the California Dental Board, led to the
production of this fact sheet, which was voted on by the
majority.
So, Mr. Chairman, I hope that we can be enlightened today
by the testimony that is presented here as to why it has taken
12 years to comply with the mandate. There is a violation in
the law going on with the dental board. And I don't think
anyone who sits on that board who does not comply with the law
ought to remain a member of the board. And if anyone in this
room thinks that I'm not going to followup, you do not know how
tenacious I am. I have a partner here who has traveled across
this country to join me. I resent the fact that it has taken 12
years. This was already voted on, it should be in the public's
hands.
So, I would like to thank all of you for your efforts to
come to this hearing, and to provide us with the information we
were seeking on the beautiful campus of the University of
Southern California. Visit South Central Los Angeles again.
This is it.
So, I yield back my time, Mr. Chairman.
[The prepared statement of Hon. Diane E. Watson follows:]
[GRAPHIC] [TIFF OMITTED] T3640.005
[GRAPHIC] [TIFF OMITTED] T3640.006
[GRAPHIC] [TIFF OMITTED] T3640.007
[GRAPHIC] [TIFF OMITTED] T3640.008
Mr. Burton. Well, thank you, Ms. Watson.
We have a video of that--we do not need to show it. I
think--unless you feel you--you want to see it. OK. Well, we
have a video we want to show. This is the last meeting of the
board?
Participant. Actually it is a little culmination of the----
Mr. Burton. I think it is self-explanatory. Could you turn
the sound up so we could be sure to hear it.
Ms. Watson. Can everyone see?
[Video shown.]
Mr. Burton. The last clip is Dr. Alan Kaye, he's the
immediate past president of the California Dental Board.
Ms. Watson. Yes.
Mr. Burton. I see. OK. I see. OK. Thank you very much.
OK. We'll now go to our first panel.
And do you have anything else right now, Ms. Watson?
Ms. Watson. I do not think so.
Mr. Burton. Representative Johnson, would you stand to be
sworn, please.
[Witness sworn.]
Mr. Burton.
STATEMENT OF STATE REPRESENTATIVE KAREN JOHNSON
Ms. Johnson. Thank you so much. That is a very hard act to
follow.
Mr. Burton. And I am not even in vaudeville.
Ms. Johnson. Well, my name is Representative Karen Johnson.
I serve in the Arizona House of Representatives.
Ms. Watson. And welcome.
Mr. Burton. Welcome.
Ms. Johnson. Thank you so much. I feel very, very
privileged to be able to come here today. And I thank you so
much, both Chairman Dan Burton and Ranking Member Diane Watson
for allowing me to speak with your committee.
Chairman Burton, you lead the way in getting mercury
preservatives removed from childhood vaccines, and you have a
national reputation for making government agencies accountable
to the people.
You are now spotlighting mercury in dental fillings, and
those of us from Arizona are deeply appreciative of your work.
Congresswoman Watson, you are the lead sponsor by the
bipartisan Watson-Burton Bill to ban mercury fillings for
children, pregnant women and nursing mothers and for eventually
phaseout their use entirely. We used your bill as a prototype
in Arizona, and I understand lawmakers all over the country are
doing the same.
I am pleased to report that the legislation that I
sponsored last year requiring full disclosure cleared both
relevant committees and got to the floor for a vote. Because of
strong lobbying opposition from the Arizona Dental Association,
the bill was referred back to a third committee from the floor
it hopes that it would die in that committee.
Once again we got the bill to the floor, but the time that
was incurred in all of this allowed the opposition to pull off
several supporters from the floor vote, and we nearly lost the
battle. However, we did get to raise the issue of mercury
fillings as never before.
The State's newspaper editorialized twice for disclosure.
We have been able to bring together a citizens brigade that
ultimately will prevail.
Congresswoman Watson, I also understand that as a State
legislator, as you spoke of here recently, you wrote the State
Watson law requiring the California Dental Board to disclose
the risks of mercury fillings. I believe you are focusing today
on the fact that the California Dental Board will not enforce
the law, and I have a similar story from Arizona.
I represent a district in Mesa, AZ, and I entered the
legislature in 1997. Because of the great interest in the
health of our children and the increased problems in childhood
immunizations, I began research into the mercury issue which
ultimately led me to the Arizona Dental Board and their
harassment of mercury free dentists.
One of my concerns is that our regulatory agencies, Federal
and State, are not enforcing the law and they are restricting
choices. In the area of dentistry, I was shocked to see the
State dental board trying to shutdown a dentist because he
offered mercury free dentistry and other cutting edge
techniques that were not against the law, always with full
disclosure and always based on consumer choice.
As I attended some of the board hearings and alerted other
legislators about what was happening, the dental board backed
off their efforts at that time. Unfortunately, the dental board
did not give up persecuting dentists and continued this
harassment because some dentists offer alternatives to
traditional dentistry.
No profession can change if every member must do what every
other member is doing. It is fair to debate the cutting edge
issues in dentistry, such as the advisability of root canals or
the efficacy of cavitation surgery. The State has no business
taking sides in issues the marketplace can decide. However,
organized dentistry seems to feel otherwise.
One issue of concern is that the American Dental
Association has a gag rule--yes, a gag rule telling dentists
not to give warnings about the toxic effects mercury might have
on the body. Studies now show that mercury does indeed emanate
from the teeth to the rest of the body and it is important that
consumers know it. But the ADA thinks otherwise.
A few years back a scholar at the Arizona based Goldwater
Institute, Mark Genrich, he wrote several articles about the
first amendment rights of dentists to advocate an end to
mercury fillings.
One of the major changes we need, and we may be close to
getting in Arizona, is to give low income families a choice not
to get mercury fillings. AHCCS or the Arizona Health Care Cost
Containment System in Arizona is our Medi-cal. AHCCS simply
told dentists to put in mercury fillings. Our assistant
minority leader and Arizona's only African-American lawmaker,
Leah Landrum Taylor and myself have co-authored a letter that
we sent to Governor Napolitano asking that this program be
changed to include informed choice for our constituents in the
AHCCS program. We have identified the problem and are currently
winding it through the bureaucracy step-by-step to secure a
change, and this is a change that I hope will occur anywhere.
Now if I might quickly address the problem of our State
dental board which ignores the law.
Four years ago, not nearly as long as you folks have gone
through this, but 4 years in Senate bill 1155 we enacted a
statute in Arizona stating it is unprofessional conduct: ``To
fail to inform a patient of the type of material the dentist
will use in the patient's dental filling, and the reason why
the dentist is using that particular filling.''
Now, one would think that every parent and every pregnant
woman would learn in advance that mercury is the major
component of amalgam fillings and would also learn the rational
for and/or against the use of that particular type of filling.
Not so. In the past 4 years the Arizona Dental Board has turned
a deaf ear to enforcing this simple statute. A consumer group
filed a petition. I even appeared personally before the board
and asked for its adoption.
As the Chair of the subcommittee overseeing the dental
board's budget, I have raised this question year after year.
Promises are made and promises are broken. This year I am
proceeding with my House bill to ensure the dental board
follows the law or we have the Governor replace the members of
the board. I believe that this is what you have done in
California.
This legislation will require that the Arizona Dental Board
send a disclosure to every dentist who will then be required to
hand to every patient who gets fillings the following
information: ``You have a choice in dental materials. Amalgam
filling are 50 percent mercury so the term silver is not an
accurate term. Notice to parents and pregnant women as follows:
Because amalgam fillings are 50 percent mercury, the use of
amalgam fillings is increasingly a matter of public
controversy.'' Pretty benign.
My bill would also require neutrality in enforcement where
informed choice, not the economic policies of the Arizona
Dental Association govern. The board would be required to post
such an enforcement policy.
I would be happy to work with this subcommittee in any way
that would be useful. And I look forward to the day when no
child, pregnant woman or nursing mother is subjected to mercury
fillings simply because dentists in this country refuse to
inform them of the toxic dangers associated with mercury.
Thank you so much for your attention to this imperative
issue.
Mr. Burton. Thank you, Representative Johnson. I have just
a few questions I would like to ask you.
I think you pretty much told us a little bit about your
experiences there in the Arizona Legislature. And you have had
a lot of resistance from the State dental board there.
Ms. Johnson. Absolutely. In fact, Chairman Burton, I guess
it is OK to say because it is true; they actually have lied in
their monthly magazine that came out shortly after the
legislation was defeated in the last session.
Mr. Burton. And to your knowledge do the dental schools in
Arizona educate their students about the toxicity of mercury in
the filling?
Ms. Johnson. Chairman Burton, we have not had any dental
schools in Arizona until about 8 months ago. And we have our
first one actually in Mesa, AZ, whose opening I attended. I am
not sure they were real happy to see me there. But I do not
believe that is taught in that school.
Mr. Burton. Are there many dentists in Arizona that are
using alternative materials in fillings there because they are
concerned about the amalgam? Have any of them come and talked
to you about this?
Ms. Johnson. Absolutely. Many, many of them have. I have
had the privilege of talking to them. I would say that between
25 and 30 percent of the dentists in Arizona are what you would
call mercury free. And one of the problems we face is that they
want to advertise as mercury free dentists and our dental board
has given them a great amount of harassment because of that.
Mr. Burton. We had a number of hearings on this issue in
Washington, and the American Dental Association has told some
of our Members of Congress who are dentists that this is all a
bunch poppycock, that the mercury is frozen in the amalgam and
cannot cause any damage. And because of that, some of my
colleagues who are dentists have been very vociferous in their
opposition to us doing anything to get the mercury out of
dental fillings. And it is because it is coming straight from
their main authority.
Ms. Johnson. Right.
Mr. Burton. Doctors listen to the Food and Drug
Administration and the AMA. Dentists listen to the Food and
Drug Administration, whom you saw on the television there who
said, yes, there is a vapor that escapes; that was the FDA
speaking. And the American Dental Association.
And so I think the main thing we have to do is just keep
pounding on this wall until it comes down like the walls of
Jericho. And I know Diane Watson and I are committed to that,
and you are as well. And we really appreciate what you do in
Arizona.
Ms. Watson.
Ms. Johnson. Thank you.
Ms. Watson. I thank you for your courageous work you have
done.
When we make public policy, as you know so well, it takes
years. We try to make public policy that does no harm. So you
are courageous and you are tenacious.
And as I was listening very intently to your testimony I
was wondering what kind of strategy have you put together to
come back again at this? Can you share it with us, and maybe we
could pick up some pointers from you. It has taken me 12 years.
Ms. Johnson. Oh, Congresswoman Watson, no, I was so honored
to be able to come here to find out more from you what I can
do, what we can do.
The sad thing of it is in Arizona this is an issue that is
really looked down upon. I mean, it is not something that has
any kind of a priority with other legislators. I have been very
appreciative of Representative Leah Landrum who has been a good
friend. We came into the legislature at the same time. And she
has a great concern for the minority children in our State that
have no choice but to have the mercury put in their mouth. So
she has been a great ally in this and has helped rally some of
her party to this.
And, unfortunately, I would say that perhaps members of her
party are more receptive to this than mine. And I would give
that charge to the fact that the Arizona Dental Association
lobby appears to give a lot of donations to members of my party
in a large amount. And when they speak, the members of my party
just follow.
Ms. Watson. There has been a gag order placed on dentists
here in California. And I think you mentioned something about
them being gagged in Arizona as well. But, the first amendment
allows them to advertise as mercury free dentists.
My dentist is sitting in the room right now. He had to go
to Mexico to practice his craft because he refused to work on
patients when he was in dental school and to put the silver
fillings. So his practice is down in Mexico.
Now, what this says to me is that we are depriving our
citizens of the knowledge of what effects their bodies. No
professional can come to me and argue that the most toxic
substance on the Earth ought to be in amalgam, but that is the
kind of foolish argument. They ought to know by now that it
does not work with me.
And so I really appreciate you coming and talking about
your struggle. I want you to hold on. Because as you know,
California is always on the cutting edge and when we start
something, it moves across the country.
I am reminded of the smoking policy. It took us 14 years,
and we were the first State that prohibited smoking on
airplanes in California air space. Now it is nationwide and
almost worldwide.
Do not give up. You are on the right side and history will
reward you. Be tenacious and remember what you do will improve
the quality of health for the voiceless and the toothless and
those that have teeth and they think that they are saving their
teeth.
I had a discussion with my dentist. And you know what it
boiled down to, and my dentist is an African-American
practicing just a few blocks away from here. He said it is a
matter of cost.
How does a professional tell me they are willing to put a
toxic substance, I do not care how well it fills. You crack a
nut and your tooth cracks and then the vapors come out. And
chew gum and the vapors come out. You get a tooth knocked out,
and the vapors come out.
So at my age, I went across the border to get all the
mercury taken out of my tooth. I want everyone to have that
same opportunity. I want people to be knowledgeable. And I do
not tolerate professionals coming to me saying that we need to
block the information.
So, I want to encourage you to continue to do what you are
doing. We will prevail.
Thank you so much.
Ms. Johnson. Thank you. And I applaud both of you, and we
will not quit.
Mr. Burton. Well, we have a mutual admiration society. So,
thank you.
Ms. Watson. See, I know who to team up with.
Mr. Burton. We would like our next panel to come forward
now. It is Dr. Yokoyama, he is with the California Dental
Board; Mr. Shawn Khorrami; Mr. Parin Shah and Dr. Harold
Slavkin, who is the dean of the School of Dentistry here.
You know, while they are coming up, I would just like to
say Abraham Lincoln said ``Let the people know the facts and
the country will be saved.'' About the same thing we are
talking about here. Just let the people know the facts and they
will do the right thing.
Would you please stand, please?
[Witnesses sworn.]
Mr. Burton. Be seated.
OK. Since you have been with us before, Dr. Yokoyama, why
do we not start with you. Do you have an opening statement?
STATEMENTS OF DR. CHESTER YOKOYAMA, DDS, CALIFORNIA DENTAL
BOARD AND FORMER CHAIR DENTAL MATERIALS FACT SHEET COMMISSION;
SHAWN KHORRAMI, ESQ.; PARIN SHAH, EXECUTIVE DIRECTOR, COMMUNITY
TOOLBOX FOR CHILDREN'S ENVIRONMENTAL HEALTH AND PAST PRESIDENT,
SAN FRANCISCO'S COMMISSION ON THE ENVIRONMENT; AND DR. HAROLD
SLAVKIN, DDS, DEAN, UNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL OF
DENTISTRY
Mr. Yokoyama. Yes, I do.
Chairman Burton and Ranking Member Diane Watson, thank you
very much for giving me the opportunity to speak here today.
I am speaking today as an individual dentist. I am a member
of the dental board of California. I do not speak for the
dental board and I am giving my opinions only.
So I come today to tell you about an extremely
disappointing turn of events. This turn of events directly
applies to the subject of California's compliance with the
dental amalgam disclosure policies. As you are well aware, the
California law required the dental board to produce a fact
sheet on the risks and efficacies of filling materials. A
second law mandated that these facts be given to every patient.
And this would, of course, disclose the health risks of mercury
in dental amalgam to the public. And to this end I have given
my time and my energy.
I have been proud to serve as the chairman of the Dental
Materials Fact Sheet Committee. And when I approached the
existing document, I quickly realized that it contained several
statements that seemed to be incorrect. I called for a hearing
on the scientific evidence of health risk from mercury in the
amalgam. We learned that there are scientists with relevant
scientific studies and publishing in relevant scientific
journals. When I found there was evidence of a substantial
health risk to members of our California population, I felt it
was my duty to give a clear warning concerning that risk.
It is a risk of exposure to a chemical known to the State
of California to cause birth defects and reproductive harm. A
risk that is a fact in California law known as Proposition 65.
As chairman of the Dental Materials Fact Sheet Committee, I
was able to develop a document that included this warning. I
developed this document over a period of time. There were many
meetings, emails, phone calls and discussions. There was
stakeholder input. Dentists gave their opinions. There was
public debate. The dental board had a hearing and in public
view discussed the contents of the draft fact sheet multiple
times. I dotted all my I's and crossed all my T's. This process
was done by the book, step-by-step.
So why am I so extremely disappointed? I shall explain
further.
Last year at the July board meeting this draft document was
brought to the board and it was voted 7 to l to approve the
idea of including the warning I spoke of and a message to
pregnant women and parents. The board then requested that the
Department of Consumer Affairs make this document into a
brochure and make sure that the language was consumer-friendly.
It was agreed upon by the board that at the next meeting in
November 2003 the board would take the final vote.
Well just before the meeting in November the California
Dental Association sent out a letter to each board member
saying that the Prop 65 warning, the warning about the exposure
to mercury and its connection with birth defects and
reproductive harm, was false and misleading. And it must be
said here that it was the same CDA that sent out the same
warning to dentists. That warning stated ``Dental Amalgam...
exposes you to mercury, a substance known to the State of
California to cause birth defects and reproductive harm.'' The
letter sent to the board members had an opinion from their
expert that this statement was false and misleading. A very odd
chain of events, not easily explained. Nevertheless, this is a
matter for the Cal-EPA scientists to be notified of; because
this warning is a matter of law in the State of California.
So even with this strange letter, the dental board had its
meeting in November and after deliberations, again voted to
approve the brochure, 8 to zero. The board agreed that it was
the right format and ``95 percent complete.'' The committee was
asked to make minor changes and bring it back in 1 month for a
final vote. That vote was to occur by the end of the year 2003.
So I quickly did the board requested editing and sent the
changes off to the other member of the committee for her
approval.
The other committee member was initially too busy. I waited
an appropriate period of time and re-requested her answer. To
my surprise, she sent me a completely new draft fact sheet.
This was laid out professionally and was complete, in brochure
form already. Several questions were in my mind. Where did this
new version come from? Why did the president not ask for an
explanation? Why did the president not direct us to work from
the twice-approved document that was clearly what the board
expected? Then there was no meeting in December.
I was upset by these developments. And then came the most
disturbing turn of events. At the beginning of the year, I was
sent an email that said that I was no longer the chairman of
the committee, and that there was an entirely new committee and
a new agenda. My attempts to comply with the California Dental
Amalgam Disclosure Policies had been side tracked.
I hope that you will urge the dental board to push forward
for full disclosure.
And I'd like to mention just a couple of things while I was
working on this committee that I found. I found several facts
that make it even more important that the dental board continue
on its quest to bring full disclosure of health risks in order
to protect the people of California.
First, to depend on the FDA as the source of safety of
dental amalgam is invalid. These are things I learned along the
way in my opinion. It is often assumed that the FDA has studied
this health risk carefully. For that matter, it is often said
that the FDA has approved dental amalgam as safe. I found quite
the contrary. The FDA claims no jurisdiction over mixed dental
amalgam because it is mixed by the dentist. The dentist is the
manufacturer, mixing the mercury and silver particles in the
office and thereby manufacturing the final mixed product that
goes into the teeth. The FDA therefore has made no
classification, does not regulate, has not studied and does not
approve the mixed amalgam.
The FDA also did not study or demand studies to classify
the separate ingredients, which they have classified the
separate mercury and the separate silver filings. The separate
ingredients were simply ``grandfathered'' in.
As late as January 15, 2004, the head of the Dental Devices
Division of the FDA has said that ``the agency did propose to
classify'' in other words approve, and I'm putting that word in
there to help you out. ``The agency did propose to classify the
encapsulated form of amalgam approximately 1 year ago and at
the present time that process is on hold.'' When asked why, she
said, ``The status of the classification as being on hold is
awaiting additional information from a third review of the
literature on dental amalgam that is being conducted.'' So even
the encapsulated form, which would be the closest to the actual
substance that dentists use to fill teeth is not classified,
and therefore not approved.
So the second realization was that the ADA/CDA, the ADA and
by extension the CDA, has argued successful in California
courts that ``The ADA owes no legal duty of care to protect the
public from allegedly dangerous products used by dentists. The
ADA did not manufacture, design, supply or install the mercury-
containing amalgams. The ADA does not control those who do. The
ADA's only alleged involvement in the product was to provide
information regarding its use. Dissemination of information
relating to the practice of dentistry does not create a duty of
care to protect the public from potential injury.''
So this puts the burden squarely on the shoulders of the
individual dentist who is ``manufacturing'' the amalgam and
therefore responsible.
So I found three important questions: One, has the FDA
approved dental amalgam for safety? My opinion is no. Two, does
the ADA/CDA owe a duty of care to protect the patient from
health risks from dental amalgam? In my opinion no. Three, does
the dental board have the responsibility to protect the public
from known sources of health risk? Yes.
Then it logically follows that: One, amalgam is 50 percent
mercury? Yes. Two, mercury vapor constantly is emitted and goes
to the organs of the body? Yes. Three, amalgam is the
predominant source of mercury exposure in people who have
amalgam filling? Yes. Four, dental amalgam exposes you to
mercury, a substance known to the State of California to cause
birth defects and reproductive harm. Yes. Therefore, dental
amalgam is unsuitable for use in pregnant women and pregnant
women should be clearly warned.
I shall continue to press for full disclosure of the risks
of dental amalgam to patients in order to better enable them to
make informed choices.
And I would just like to say that I am disappointed with
the absence of the California Dental Association. We are trying
to come to an agreement, but it is difficult if you do not come
to the table. And I am disappointed with the absence of any of
the board members or representatives of the board, I will just
say that.
And I thank you for your time.
[The prepared statement of Dr. Yokoyama follows:]
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Mr. Burton. Thank you, Dr. Yokoyama. We will have some
questions for you in just a few minutes.
Mr. Khorrami.
Mr. Khorrami. Thank you, Mr. Chairman. Thank you,
Congresswoman Watson. And thank you for having me over here. I
really appreciate your efforts on this issue, and the full
issue of mercury in pharmaceutical use. It's surely a disaster.
I am an attorney. I practice mostly in the area of
pharmaceuticals. I for the past 5 years have focused quite a
bit on mercury. I have litigated cases, the environmental level
in terms of waste water and discharge, and certainly in terms
of exposure having to do with a variety of products, even
florescent lamps, fish, vaccines. Currently I litigate vaccine
cases with Thimerosal nationally. I am lead and liaison counsel
both in California, and I sit on the board for the National
Steering Committee for vaccine cases.
With respect to amalgam, I have litigated class cases,
public interest cases, individual personal injury cases. One of
my cases is actually pending in front of the California Supreme
Court right now.
And I have also handled cases involving Proposition 65,
again in the entire gambit of toxins that are out there, but
particularly with respect to mercury.
Last year, about exactly a year ago, the Superior Court of
San Francisco entered an order, and that order required
dentists in this State to give warnings, warnings as to mercury
exposure and specifically mercury expose. I know this because I
was the attorney who handled it for over 2 years. I negotiated
the settlement, and it was the California Dental Association
that actually came and solicited the concept of settlement. I
did not go to the California Dental Association. I was
interested in dentists. And I will get into why I did that, but
getting into Prop 65 and sort of looking at the background a
bit.
Proposition 65 was a ballot initiative that the citizens of
this State placed on the ballot. And one of the premises was,
one of the geneses of this ballot initiative was the people's
distrust of government and the failure of their government
agencies to protect them with respect to toxic materials.
Proposition 65 then requires disclosure, and specifically
warnings when the citizens of this State are being exposed to a
toxic material. Mercury, of course, and all of the compounds,
have been listed as Prop 65 chemical for ages.
Now, the manufacturers of amalgam have been under a
continuing duty to warn, and they have settled cases requiring
the warnings. This was one of the first situations I had ever
seen, and I believe it is the only one I have ever seen, where
you have a manufacturer that puts together a warning scheme and
the reason for that warning scheme is for it to get to the
ultimate consumer, the exposed individual. This industry was
the only one that I saw where although manufacturers were
providing these warnings, it never got to the ultimate
individual. And who is there in the middle of the process but
the dentist; the dentist, the dental association and perhaps
the dental board.
This to me was also the only industry that I could find
that when confronted with this issue of what are you doing with
the mercury, they just sat back and clung on to their current
practice of keeping this in use. When you look fluorescent
lamps, those guys have taken the mercury down even though there
is really not much of a possibility of individual exposure.
When you look at vaccines and you have been very involved in
that process, there is at least been a reduction. A lot of
manufacturers said OK, fine, we are going to take some of these
out.
In dentistry there is not even the concept of reduction of
this.
Now, going back to the Prop 65 settlement, the CDA after I
went and sent out notices to the dentists that I was just going
to sue them for not providing warnings to their patients, the
CDA came to me and said that it wanted to settle the matter on
a statewide basis, and here is the reason they gave me: Was
that they wanted uniform warnings across the State, warnings
that were accurate. And we held out and we made sure that the
warnings included mercury and talked about exposure, not that
amalgams contain mercury.
Now, when this was going on the court held three separate
days of hearings. The court took in evidence. The court took in
testimony. Well, not testimony. The position of the various
side. The Attorney General of this State was present. The
California Dental Association was present. Dentists were
present. And the American Dental Association was present.
The American Dental Association vehemently disagree with
the concept of giving warnings, but then also disagreed with
the form of the warning. And after considering everything, the
court said that the warnings were appropriate, that the
settlement was appropriate and they were to be given.
Now mind you, there was no discretion given to the dentists
in that situation. The warning has to be given. You can choose
whether to give a warning or not to give a warning. It has to
be given. And, in fact, that discretion was taken out of the
hands of the dentists in the form that the warning took, which
was a posted sign. It cannot be inside of an informed consent
form. It is not going to be something that you just tell the
patient. You first have to put it up and the patient has to see
it, and the patient has to read it. So that is the way we did
this.
Now, going to the Watson law, as I read the Watson law we
talk about safety, and I know Dr. Yokoyama talked about safety,
and I know Dr. Slavkin is going to be on the other side of the
safety issue, for sure. But that is not the point of the law.
The law says risks and efficacies. Safety is irrelevant. It
has nothing to do with it. We have millions of products in our
safety that are considered safe yet go out with warnings
because they have risks, because you have to have cautions,
because we have precautions. OK. Pharmacueticals is a prime
example of exactly what that is. That is why there is labeling
requirements. That is why we have this.
So safety, forget about. Information, disclosure; that's
the point.
Now, when the dental board comes in and decides well we do
not feel like giving that warning, and this one is OK, and this
way it is beneficial and the other way it is not; that is not
the discretion that the Watson law gave. That is not a
discretion that any of us gave it. That was not what we gave
the dental board when we passed Proposition 65. We said we do
not want them to have discretion. We do not trust them. And
with this dental board, I don't think we should trust them.
But this is exactly what is going on: They are sitting
there and saying well we choose what goes out and we choose
what the patient gets. And let us put aside Proposition 65. Let
us put aside the Watson law. What about informed consent? Is a
profession entitled to decide what is a risk, what it will
disclose, what it will not disclose? The California Supreme
Court has said emphatically absolutely not. Informed consent is
a legal standard. That means Dr. Slavkin cannot get together
with his colleagues and then decide what is something that we
disclose and what is something that we do not disclose.
Even if the dental board of California wanted to do a
position statement on safety, that still does not do anything
to the Watson law and the dentist's duties under informed
consent. What we want is full disclosure to the patient. The
concept of informed consent is full disclosure for the patient
so that the patient, being the ultimate decisionmaker, can
decide I want this stuff or I do not want this stuff. And also
can be in a position to decide whether that safety position
that the dental board took is a valid position or is not a
valid position.
That is why not only it is what the dental board illegal,
not only does it not have discretion to do what it is doing,
but it is also against this State's public policy. It is also
against, frankly, every State I have looked at, the public
policy of that State.
With that, I am ready to answer questions, Mr. Chairman.
[The prepared statement of Mr. Khorrami follows:]
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Mr. Burton. Well, I will have a few questions for you in
just a few moments, and I am sure Ms. Watson does as well.
Dr. Slavkin.
Mr. Slavkin. Thank you. And welcome to the University of
Southern California. I am 1 of the 19 deans of the different
colleges that make up USC, and I am very pleased that we are
sitting in a room that we call Town and Gown, which is the
opportunity of the university to engage with the larger society
about issues of mutual importance.
One of the issues that I have heard today, and I know in
the reputations of both of your distinguished records, that you
are passionately and unconditionally interested in the health
and well being of all Americans, not only in this District but
across the country. I share that with you.
From 1995 to 2000 I served as the Director of the National
Institute of Dental and Cranial Facial Research, one of the
institutes that makes up the NIH, and it's the primary funder
for research scientists not only in this country, but out of
the country to work on problems related to dentistry and the
cranial facial complex. In that capacity I had the opportunity
to review thousands and thousands of papers and grants, and
work closely with CDA and the Environmental Protection Agency,
and the FDA and my colleagues in other institutes. And I would
be more than happy to discuss from that perspective anything
that you might be interested in.
I came here at the request of Steve Sample to join his
leadership team 3 years ago. And began as dean of the USC
School of Dentistry. We are 107 years old. We have almost 900
students in residence at any given time. And we have clearly
been part of the education and training of dentists in the
southern California region and beyond.
I wanted to mention to you that the Watson legislation, as
I learned about it and as it became clear that I was a steward
of dental education, of best practices, of standard of car,
that I wanted to ensure that every faculty member, every
student, every staff member, every alumni knew that there were
risks whether they be potential or less than potential risks in
the handling of mercury.
We immediately posted the signage throughout the School of
Dentistry indicating the potential risk of mercury for
pregnancy throughout the life span and in the elderly.
In 2001 when the board made available something called the
Dental Materials Fact Sheet, we adopted it immediately. It is
in the hands of every patient. We treat thousands and thousands
and thousands of patients from Bakersfield to the San Diego
border. Every patient receives this sheet. Every patient sees
the signage in the school. Every patient is questioned do they
understand, do they have questions and they can evaluate from
their particular point of view the risk and benefit of all
procedures that are done in a health care setting.
Now, at the same time I wanted to ask you if you would
entertain in the spirit of the videos that we saw earlier, in
the remarks that you both made and the testimony given, I would
like to ask you if you would take a few moments. And I brought
copies that might be inserted for you to take a look at.
There is a paper from Tom Clarkson, Laszlo Magos and Gary
Myers that was published in the New England Journal of
Medicine, and it came out on October 30, 2003. The title of the
paper is ``Current Concepts in the Toxicology of Mercury,
Current Exposures and Clinical Manifestations.'' The paper goes
into a critical analysis of the issue that are near and dear to
your heart and mind. It evaluates the very critical references.
It was supported by the National Institutes of Health. It is
not affiliated with the dental school or the dental profession,
or any of those implied self-interested communities. And I
believe you would find it, that it talks to the grayness of the
subject matter. It talks about the level of exposure per
kilogram by day body weight. It talks about 0.1 micrograms
being the ideal threshold from the EPA statements of 2001, from
the WHO responses and analysis of 2002. And I think it is a
very useful scientific peer reviewed presentation that would be
of value to all of us in weighing the risks and the benefits of
ethel mercury or methyl mercury, or mercury out of the ground
and the applications in society.
From my background as a scientists working at the NIH and
in my career as a scientist, I believe that the available peer
reviewed scientific evidence clearly indicates that there are
risks to the use of mercury. And, the scientific evidence
clearly supports that there are many opportunities of utilizing
mercury where the benefit significantly outweighs the risk.
Thank you for the opportunity to be with you, and of course
I would be more than happy to entertain any question that you
might have.
[The prepared statement of Dr. Slavkin follows:]
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Mr. Burton. We would like that. Thank you, Doctor. We would
like to have your documents and we will put those in the
record.
And I am sure Representative Watson and myself would like
to ask you----
Mr. Slavkin. This is the signage throughout the School of
Dentistry, the fact sheets that all patients receive and these
are the copy.
Mr. Burton. OK. Thank you very much.
Mr. Shah. And thank you, Chairman Burton and Congresswoman
Watson for allowing me to speak.
As you introduced me, I am the executive director for
Community Toolbox for Children's Environmental Health and today
I speak to you as a member of San Francisco's Commission on the
Environment and past president of the Commission on the
Environment for San Francisco.
Over the last 2 years we, as a Commission, have looked into
the dental mercury issue as it relates to the citizens of San
Francisco. And I am here today since, in part, fuller
disclosure certainly but also to talk about an example of the
solution to addressing mercury poisoning in our water and
mercury contamination of fish.
As a policy body for San Francisco, we have decided to
define the mercury issue as one, a right to know issue just as
you have. Certainly the amalgams that dentists put in are not
just silver. They rightfully should be known as mercury
amalgams. And myself, I have four cavities from eating too many
chocolates, I guess, as a child and not flossing which is about
enough mercury in my mouth to contaminate a 20 acre lake and
make it unfit for fishing. So, certainly I should know that and
everyone should know that. And we support a brochure on the
part of the California Dentists Association.
We also defined the mercury issue as a human rights issue
or an environmental justice issue. All citizens in San
Francisco and America have a right to clean air, safe water and
ample food, access to open space which is free of toxins that
could be harmful to their health. And so with that said, we
decided to say you know we can go about the process of
policymaking by saying there is science that says this, there
is science that says that, here is a number that is safe and
that number is four, here is a number that is safe and that
number is seven. We chose to step back from that discourse a
little bit and provide a cautionary approach to our
policymaking with regard to this particular issue and try to
implement the precautionary principle issues touched on earlier
and which other speakers have talked about.
So what we did was we did a little bit of research. We held
hearing. We got our information. We had dentists, the CDA, the
ADA, environmental groups, activists come and talk to the
Commission. And we did our own research. And we found that
dentists are the largest contributor of mercury to our waste
water facilities. And that, in fact, on our waste water
facilities is an enormous financial impact on the citizens in
San Francisco.
We evaluated the policies that we had enacted 10 years ago
and 12 years ago. And we found that voluntary compliance on the
part of dentists to reduce mercury in waste water systems just
wasn't working. As of September 2003 there was less than 1
percent of the dentists in San Francisco that were using
amalgam separators to separate essentially when the filling
comes out, to separate the mercury and the amalgam from what
goes into the waste stream. That is less than 1 percent.
So we decided that we wanted to develop a mandatory
permitting process. It is a very simple process whereby
dentists, as a manufacturer, as to submit a permit for its
discharge into the waste water system. The permitting process
was developed in conjunction with the California Dental
Association as well as the San Francisco Dental Society and
activists, city workers, regulators. And we came to the
solution of providing two options for dentists. They could
either purchase amalgam separators so that the mercury would
stay and it could be reused, recycled or disposed of
appropriately at a cost of about $1,200, what the average has
been, or they could go through a monitoring process and not
purchase a processor or implement best management practices as
they may have learned in their schooling or in their continuing
education.
Since we have done that, which we began the education and
the process for that in September 2003 when we had less than 1
percent of dentists that were using separators, we now have 76
percent of dentists in San Francisco who are using these
amalgam separators. That reduces the amount of mercury that
enters into our water system, into our fish and subsequently
into our bodies, especially of bodies of low income individuals
in the immigrant communities that live on the fish that they
get, that they fish for everyday in the morning from the waters
of San Francisco Bay. That reduces the amount of mercury by 90
percent. It is just enormous.
And as we talk about moving forward, as we talk about
moving toward the elimination of mercury or amalgams in
dentistry, you know we will have other issues which is what are
we going to do with all this stuff now that we are going to
make sure we collect. So California is paving the way in many
ways. Hopefully, San Francisco is laying the seed for the next
thing for California to do, which is in its waste water we
certainly must mandate some way, a process where separators can
collect the mercury before it gets into the environment and
into our bodies.
I just wanted to rattle quick statistics off. Like I said,
the two options of the 644 dentists office is 76 percent have
chosen to install separators. We have offered and the process
that really supported the engagement of the dentists was we
offered small rebates through a bit of a local grant that we
got from the California EPA.
We will continue to do education of the staff and the
dentists so that they continue to use the best management
practices. And we have developed various fact sheets which
actually are part of the packet that I gave you all. We also
have it on line. They are available.
And we also have an expo. And this is where we talk about
the economy and we talk about stimulating the economy. This is
where something that is good for public health and good for the
environment can actually potentially spur economic growth.
What we did was we also engaged with producers of the
amalgam separators and said we most likely are going to do this
and there may be more dentists that come to purchase your
equipment. And they on their own started to educate the
dentists about their products.
We held a vendor expo where we had folks come and talk
about their wares. We have a list of vendors, which is also
part of your packet, which meets certain criteria that we went
through. So we sort of flushed that out.
And they are excited. They are engaged in this and they are
helping support it because it helps their bottom line and they
know that it helps the environment and it addresses human
health issues.
So in closing, I say that as we move forward we certainly
need to keep asking the CDA to do the right thing. Sometimes
volunteerism, as I am sure you have learned Congresswoman
Watson, does not always work. You know, sometimes it takes a
little bit of a firmer hand and a little more tenancy that may
twist a bit, right? And maybe a bit of a mandatory process,
especially when it comes to the health of our children.
We have done this in San Francisco but we cannot keep the
Bay free of mercury unless other jurisdictions who are in the
Bay join us in this. And we hope for the State law that looks
at permitting processes or even Federal regulations that looks
at permitting processes. This came about because of, actually,
a reduction in the amount of mercury that our waste water
system was asked to put out.
So we look forward to working with you in any way and
talking about how to implement it in local jurisdictions with
State law and so on.
Thank you.
[The prepared statement of Mr. Shah follows:]
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Mr. Burton. Thank you.
Let me start with you, Mr. Shah. You know we had, I think
from Newport News, VA the Naval base down there, the waste
water treatment system stopped the Naval base from flushing
things from its dentistry lab there where they took care of the
Naval, the personnel of dentistry. They stopped them from
flushing that into the waste water treatment plants down there
and they had them put it into barrels because they were
contaminating the water supply down there so severely. So the
problems that you are talking about that were very real in San
Francisco are not just a problem for San Francisco, you are
absolutely correct. And I would just like to say if we did not
have mercury amalgams, how much would that reduce the amount of
mercury in the water that goes into the fish that gets into the
food chain if there was no mercury amalgam.
Mr. Shah. Absolutely.
Mr. Burton. How much?
Mr. Shah. How much would it reduce?
Mr. Burton. Yes, 100 percent?
Mr. Shah. 100 percent.
Mr. Burton. 100 percent. OK. That is the first thing.
So we know that we reduced or removed mercury from people's
teeth, then dentists would not be flushing it down the drains,
it would not be going into the waste water treatment plants, it
would not be getting into the water and it would not be getting
into the fish, and it would not be getting into our bodies when
we eat the fish. So there is something that we have not talked
too much about, but it is pretty relevant.
Mr. Shah. Yes.
Mr. Burton. Because it is not just the teeth we are talking
about.
Mr. Shah. And may I say----
Mr. Burton. Go ahead, sure.
Mr. Shah. That we did try. Actually that was one of the
first things that we tried to do was basically ban amalgam
fillings in San Francisco. And we leave that to your wisdom----
Mr. Burton. That is what we are working on, yes, right now.
What is the cost difference, Dr. Slavkin between a
composite filling and a mercury filling? Cost?
Mr. Slavkin. Maybe three fold difference.
Mr. Burton. Three fold difference? If it was done on a
massive basis if the vessel was used to replace amalgams, would
the cost go down?
Mr. Slavkin. I do not know the benefit of volume. It is a
very technique sensitive procedure so that the time it takes to
do--a composite done poorly is poor.
Mr. Burton. Sure.
Mr. Slavkin. So the time involved and the technique
sensitive nature, I do not know if there is an economy of scale
by volume.
Mr. Burton. You know, the thing that interests me about
scientific research, we went into the space program and
spinoffs from the space program turned out to include
microwaves. I remember when I had my first microwave. How in
the world can they cook a baked potato like that, when it takes
me an hour when I put it in the oven. It is just not possible.
But it happened.
Do you believe that if we made it mandatory that mercury be
taken out of amalgams, that we might find an alternative source
of composites that maybe would make it less expensive? I mean
if the----
Mr. Slavkin. Well, people are today engaged in developing
biocompatible better materials for all kinds of applications,
hip replacements, bone replacement and all of the----
Mr. Burton. You are the dean of dentistry here. Have you
done any research or are you into----
Mr. Slavkin. I have personally done research and my
colleagues have done research trying to develop a replacement
for enamel, a biological enamel. That is a research project and
we hope that will succeed.
Mr. Burton. Have you tried to find a substitute for the
amalgams?
Mr. Slavkin. I personally have not, but----
Mr. Burton. Has anybody that you know of?
Mr. Slavkin. But in Gaithersburg, sort of down the road
from the NIH in Gaithersburg, MD there is a facility called
Paffenbarger Institute.
Mr. Burton. Yes.
Mr. Slavkin. And they have a team of people working on a
number of restorative materials that do not contain mercury or
nickel or cadmium or beryllium which are some of the other
components in an inorganic solution.
Mr. Burton. Well, in any event, I think that science being
what it is could come up with an alternative. I certainly do
not know what it would.
Mr. Slavkin. Sure.
Mr. Burton. But it must be better than having 50 percent
mercury being put into a person's tooth. And if for no other
reason than stopping the environment from being polluted
because of amalgams being flushed into the waste water
treatment systems and into the rivers and everything, that
alone seems to me to be a reason to work toward getting rid of
amalgam.
But let me ask you a question, Mr. Khorrami. You are a
lawyer. When people go on a bank board or a savings and loan
board when we had the savings and loan scandal, those people on
those boards are subject to liability if they do make decisions
that are not in the best interests of the people that they
represent, is that correct?
Mr. Khorrami. That is my understanding.
Mr. Burton. What about this board here in California? If it
is proven, and I will be and it already has been, but I believe
at some point it is going to be so conclusively proven that
there will be no doubt.
Would you say that the dental board here in California
might be subject to a substantial lawsuit because they did not
carry out the will of the people in Proposition 65?
Mr. Khorrami. Well, it is funny you should mention that. I
think it is under a duty to answer just such a lawsuit. We
filed one about a month ago. And we will go through the process
of deposing each and every board member if we have to and
getting all the documents we need to in order to prove whatever
we need to to make sure that those Prop 65 warnings are getting
out and if they are not, yes, we will hold them liable.
Mr. Burton. Let me ask you one more question, because I
think that is a real risk those people are facing. I think they
are really facing, and they probably do not have that kind of
coverage because a lot of people do not even provide that kind
of professional liability coverage anymore. That was my
business before I went into Congress. And a lot of people do
not want to get on boards anymore because of the liability
exposure. And I do not know if anybody is here from the State
dental board, but I hope you will get that message back to them
that I believe they are exposing themselves to a real liability
if they do not comply with the law.
Now let me ask you a----
Participant. [Off microphone.]
Mr. Burton. Good. Do that.
Let me ask you this, the tobacco settlement that we had,
and I know that it has been said here today that the
manufacturers are the doctors or dentists themselves, but the
dental association which is after that putting severe pressure
on dentists not to publicize that they are amalgam free or
mercury free dentists, would you say that there might be some
exposure to them down the road like the exposure that was
released by the tobacco industry when it was proven beyond a
reasonable doubt that tobacco caused cancer and emphysema and
all those other things?
Mr. Khorrami. Well, we feel there is. They do try to keep
themselves about one step removed by saying well we do not
manufacture this stuff, we do not have anything to do with it.
We just sort of speak out in the public. It is amusing that
they do raise up the issue that they have a person and their
right to say all this stuff, and yet the other side does not
have any person and a right. But that would be the only
different. Past that, we feel that----
Mr. Burton. The fact of the matter is, though, I do not
know if you agree or not, that there is a possible exposure
there and the dentists themselves have an exposure if they
continue to knowingly put a toxic substance in people's mouths
and they do not warn them about it and ultimately it is proven
that it results in neurological damage.
Mr. Khorrami. Absolutely. And one thing that I want to not,
actually the dental association were all too happy in Maryland
when we were arguing some motion against them to hang their
members out to dry by actually suggesting that we have sued
their members rather than them for the amalgam issue. And I
thought it was amusing that the members have been paying all
these dues to have the dental association walk into court and
say you should have sued our members.
Mr. Burton. Yes. You know, I have not been a big fan of
trial lawyers in the past and if you watch my record in my
Congress, you have probably seen that. But I have to tell you,
when something as obviously wrong is going on, it seems to me
that the public has a right to be able to sue the pants off
these people until they get this thing right.
You know, Dr. Slavkin, you saw the film that we had on this
a few minutes ago. You talked about the risk benefit issue. It
is obvious that the mercury smoke does come off of a dental
amalgam. There is no question about that in your mind, is that?
Mr. Slavkin. May I respond?
Mr. Burton. Yes. Yes. I mean, do you or do you not agree
with what was on that screen?
Mr. Slavkin. I saw what was on the screen. I do not agree
with the interpretation of what was on the screen.
Mr. Burton. What do you think it was?
Mr. Slavkin. Well, in doing science----
Mr. Burton. Yes.
Mr. Slavkin [continuing]. You raise an idea that you want
to test and you make measurements, and you convert and you
develop tests to determine the biological significance, whether
it is toxicity or not toxicity. So in the case of seeing a
vapor and then interpreting what that vapor to be bad without
knowing the biological burden, the amount of material, the
responding I believe is one of those arguments a little while
ago Mr. Shah inferred that the source of mercury in San
Francisco Bay was from dental amalgam. And all of us in this
room, I believe, would acknowledge that the source of mercury
in Santa Monica Bay or in San Francisco Bay or in Boston Bay is
accumulation of hundreds of different sources and the dental
amalgam source is minuscule.
Mr. Burton. Well, let me interrupt you. Yes. In Newport
News, VA we had the commander from that Naval base there. We
had the people from the sewage water treat plant there. And
they said that there was no question that the mercury amalgams
were causing a huge problem for the water supply in that area.
As a matter of fact, they said they would no longer accept any
refuse coming out of that facility and they had to put it in
drums and take it away to a storage facility so they could
figure out a way to dispose of it. So, you know, sometimes I
think that scientists do not want to look at things as they
really are.
I am not a scientist. But the fact of the matter is, we
have scientists appear before our committee from the University
of Kentucky and elsewhere who attest to the fact that the
things that you saw on the screen was coming from the mercury
amalgams and it could cause neurological damage.
I have talked too long. Ms. Watson.
Ms. Watson. Thank you so much, Mr. Chairman.
Dr. Slavkin, give me your title again?
Mr. Slavkin. I'm a dentist. I am the dean of the School of
Dentistry at USC.
Ms. Watson. You are the dean of the School of Dentistry at
USC?
Mr. Slavkin. Yes.
Ms. Watson. All right. As you train your dentists, your
students who are dentists, what do you tell them about the
various fillings, particularly amalgams? I want to focus in on
amalgams. What do you train your potential dentists to do with
the amalgam before they put them into the filling, before they
themselves mix them and once they remove them? Remove a tooth
that might have the amalgams, what do you tell them?
Mr. Slavkin. Well, I am very impressed with our faculty. We
have 100----
Ms. Watson. No, no, no. I want to keep you on track.
Because this hearing is about----
Mr. Slavkin. Right.
Ms. Watson [continuing]. This particular leaflet. Now, what
do you train----
Mr. Slavkin. If you would like me to respond, I would be
more than happy to.
Ms. Watson. Yes. I want you to respond to my question.
Mr. Slavkin. I think the----
Ms. Watson. Your only response has to address what you
teach the potential dentists about the handling of mercury
amalgams.
Mr. Slavkin. Right. All of the dental students are exposed
to the guideline that I gave you a few moments ago, which has
all of the restorative materials and filling materials that are
used by their name, by the application, by the ingredients. So
they have that.
All of the students have the current EPA guidelines for the
handling of dental amalgam. It is basic--and all other
restorative materials as part of their education. All of the
students. The same goes with local anesthetics or sedation
anesthetics.
Ms. Watson. Let me give you a direct question. Let me see
if you can answer it.
Does your faculty ever mention mercury amalgams?
Mr. Slavkin. Of course.
Ms. Watson. OK. Good. Direct answer.
What do you teach your students about the handling of
mercury amalgams?
Mr. Slavkin. They are taught how to handle it, how to
dispose of it, how to look after it in the most professional
prudent fashion. They are also taught that it has risks because
dentists are people also. And this dentist in front of you is a
member of the ADA and is a member of the CDA and is not gagged
by anybody and is speaking directly to you and is speaking on
behalf of the USC School of Dentistry where we pride ourselves
on making sure that all students understand the risks and the
benefits of all procedures that they are involved with either
as patients or as providers.
Ms. Watson. Thank you so much for that answer.
Now, have you seen this brochure?
Mr. Slavkin. Yes.
Ms. Watson. Is there anything in here that does not do what
you do for your students? Is there anything in here you would
like to contradict?
Mr. Slavkin. In front of you is the----
Ms. Watson. No. No. This is the subject of this hearing. Is
there anything in here----
Mr. Slavkin. I cannot.
Ms. Watson. Take it down.
Mr. Slavkin. The October 2001 version, which I gave you, we
have read carefully and distribute that throughout the school.
I am not sure----
Ms. Watson. Is that the October 2001 version?
Mr. Burton. No, he is referring to the one that he handed
you.
Ms. Watson. No. No. Sir, my reference is to that pamphlet.
That is the one that was approved by the dental board.
Mr. Slavkin. I have not been given this pamphlet before.
Ms. Watson. OK. What I would like you to do is read it
thoroughly. Address a letter to me and the Chair, if you
choose, as to what you find inaccurate in there.
Mr. Slavkin. Inaccurate?
Ms. Watson. Inaccurate.
Mr. Slavkin. Yes.
Ms. Watson. OK. And whether you feel that complies with my
legislation of 1992.
I want to really make it clear for everyone within the
sound of my voice, the purpose of the hearing today is to
investigate why the California Dental Board has not released a
mandated pamphlet.
Now, I must commend you for putting this out. I do not
think it is circulated wide enough, because if I heard you
clearly, it goes to the students who are dentists and those
dentists----
Mr. Slavkin. No. It is posted. It is for all patients. All
patients.
Ms. Watson. But all patients where?
Mr. Slavkin. Wherever we are located. We are located----
Ms. Watson. Where are you located?
Mr. Slavkin. We have a mobile clinic that goes as far north
as Bakersfield. We have 14 of them.
Ms. Watson. Does it go to Eureka?
Mr. Slavkin. We are not in Eureka.
Ms. Watson. OK. You just answered my question. It is not
generally circulated----
Mr. Slavkin. Why would you ask if we were in Eureka?
Ms. Watson. Eureka is part of California.
Mr. Slavkin. But, I mean, we are----
Ms. Watson. OK. Listen. Let me----
Mr. Slavkin. But the Dental School----
Ms. Watson. Let me zero in. You cannot snow me with the
scientific talk and methodology, OK.
Now, I am the author of a mandated bill that has been
completely ignored by the board of professional, supposedly
dentists and maybe there might be a non-dentist. I am terribly
upset because we have been working with Dr. Yokoyama. And this
was, the one that you were just handed, a leaflet that was
approved by the majority of the board.
Then they come back in and they give us something that has
never been seen by the Chair of the committee. It all
gobbledygook as far as I am concerned when professionals come
and try to argue scientific methodology to me. Because that is
not what my bill was all about. I directed the California
Dental Board to come up with a brochure that would be user
friendly, elementary language, not four pages of a scientific
debate. That is not what I wanted to do.
Mr. Yokoyama. Ms. Watson.
Ms. Watson. Yes.
Mr. Yokoyama. If I could just respond quickly. I understand
Dr. Slavkin's situation here. He has really been asked to come
and talk about this, but he is not responsible for the
disruption, so to speak, of the fact sheet as it has gone
through the process. So, I do not think he in particular has a
particular responsibility.
I understand that you would like him to read the pending
brochure, and I think that would be important. But I do not
think that it is his responsibility here today, particularly,
concerning that, what I called an extremely disappointing turn
of events.
Ms. Watson. That is not where I am going with this.
Mr. Yokoyama. Fine. I just wanted to let you know.
Ms. Watson. I just wanted everyone to be clear. Am I not
speaking English?
Mr. Yokoyama. Yes.
Ms. Watson. OK. My main concern for having this hearing is
to find out why these California Dental Board has not complied
with the law. OK?
Now, do not give me the scientific gobbledegook about
research. That is not why we are here. That is another debate
at another time.
I commend you, Dr. Slavkin, for putting this in every
office where your program goes. Eureka is part of California.
You do not go that far, so they do not have this. They do not
see this. What I want is for anyone who goes to a dental office
to be aware of what you are putting into their system. I do not
know why that is so difficult to do.
Can you explain that to me, Dr. Yokoyama. I see the hand in
the back.
Mr. Yokoyama. Well, no.
Ms. Watson. Can you explain why that is difficult.
Mr. Yokoyama. I tried to explain in my testimony that it
was done. It was in the hands. I mean, you see the result. The
brochure ready. It was made ready by the California Department
of Consumer Affairs. They went over it very carefully, the
language was----
Ms. Watson. By the way, excuse me for a minute. The bill
was written in the Consumer Affairs Code section intentionally
because my intent as Chair of California Senate Health and
Human Services Committee for 17 years was to protect the
consumer. So that is why we wrote it in that code. Some people
do not get that. It is about protecting the consumer.
Mr. Yokoyama. Right.
Ms. Watson. And I simply ask. Excuse me. I simply ask that
the board of professionals come up with a leaflet that would
show the benefits and the deficits, the risk as well as the
benefits.
Mr. Yokoyama. And I believe that I have come up with that.
I believe that was produced. It is in the hands of the board
ready to go. It was somehow derailed.
Ms. Watson. Thank you very much.
Mr. Khorrami. Congresswoman.
Ms. Watson. Yes.
Mr. Khorrami. If I may speak just a moment. Perhaps a
better question for Dr. Slavkin would be is if he is putting
out this warning which you held up that he has in his clinics
is I believe the Prop 65 warning that we were talking about,
then what would be the opposition to having this same
information handled to the patient in the form of a leaflet?
Because that warning, unfortunately because of the shortcomings
of the law, only has to be passed out by entities that have
more than 10 employees which leaves out a big portion of the
dentists in this State.
So this pamphlet following your law, pursuant to your law,
would take out a huge gap in the law that we have. And perhaps
a better that Dr. Slavkin could answer is what would be the
opposition of doing just that?
Ms. Watson. Yes, that is why I said do you a go to Eureka.
I mean, do you cover the State? Obviously not. And I am just
wondering, that is why I referred to Dr. Yokoyama. Why is it
that we cannot get compliance from the dental board.
Mr. Burton. Ms. Watson, do you have any more questions
right now? I have a couple more if you----
Ms. Watson. OK. If somebody would like to respond to me,
someone who has read the brochure, can you tell me what it is
in that brochure that Dr. Yokoyama wrote that is so offensive
that we have had people blocking us from getting it completed?
If anybody would like to respond. If there is some inaccuracy
in there, if there is something that you question? Is there
anyone in the audience that has seen it who would like to come
forward and point it out? If so, would you write me a letter
specifying.
The National Dental Association, I gave them the same
challenge. I said take my law and take the brochure and then
rewrite it and send it back to me. Well, all I got was the
letter stating their position in opposition. So I'm missing
something and I would like you to help educate me as to what it
is I am missing. Will anyone like to respond?
OK. Well, thank you so much, Mr. Chairman.
Mr. Burton. Thank you. I just have a couple of more
questions.
And before we finish, I want to thank our staffs, your
staff and my staff, who worked so hard to put this together
today. They had to fly all the way out here from Washington,
and I really appreciate your hard work. You picking me up
today, thank you very much. All the things you guy have done,
thank you very much.
Let me just ask a couple more questions here. You are not a
doctor of chemistry, are you, Dr. Slavkin?
Mr. Slavkin. No.
Mr. Burton. All right. Well, in May 2003 there was a
hearing held by my subcommittee, a Dr. Maths Berlin who is a
Ph.D. and professor emeritus in environmental medicine at the
University of London presented the finding of his report, which
was entitled ``Mercury in Dental-Filling Materials--An Updated
Risk Analysis in Environmental Medical Terms.'' Are you
familiar with his study at all?
Mr. Slavkin. No.
Mr. Burton. Well, here is what he said. This was the
conclusion of his report. ``With reference to the fact that
mercury is a multi-potent toxin with effects on several levels
of the biochemical dynamics of the cell, amalgam must be
considered to be an unsuitable material for dental restoration.
This is especially true since fully adequate and less toxic
alternatives are available.''
That was his statement, and he has done extensive studies
on this.
And then the chairman of the Department of Chemistry at the
University of Kentucky Dr. Boyd E. Haley testified before our
committee that were absolutely no doubt whatsoever that what we
saw on the screen today was accurate; that those emissions were
coming from the mercury in those amalgams and they did cause
toxicity to the brain.
These are people whose life's work is in that area. And so
I hope, and I understand what you said and I admire the work
you do here, but I hope you will take a hard look since you are
one of the leaders in this area here in California, take a hard
look at some of these studies. Because some of these people who
have really worked at this as far as from a chemical
standpoint, heads of chemistry departments throughout the
world, are absolutely convinced that the amalgams are a major
part of the problem.
And with that, are there any more questions?
Ms. Watson. I just wanted to ask Dr. Slavkin, since you are
here at USC, would you agree to work with myself and my staff
to give us information? Because I really need to get the input
from your professionals as to why there is a feeling among the
organized dental community that we need to continue to use
mercury in amalgams?
Mr. Slavkin. Yes. Whatever we can do to, I mean USC and the
School of Dentistry. We are interested in facilitating anything
that will improve the quality of oral health in the Nation and
in California. And if we can be helpful, we would like to----
Ms. Watson. You know, since I am very, very proud of this
institution and you happen to be located in my District, I
would like to say that based on the scientific information I
received from the University of Southern California and the
Dental Department that we have been able to come to this
conclusion. I would be very proud to quote the scientific data.
And this is for all the panelists. What I am not going to do is
tolerate more delays in complying with the law. And what I am
going to do, and everyone hear this, is support the lawsuits
against the board. And I hope we can look at them individually.
Because how dare them violate a mandate. In some way they are
not getting that. And I intend to pursue this to its final
conclusion.
I would love to have the support of any of you that are
willing to work with us, but in particular, Dr. Slavkin, I
could use your input.
So let me know.
And thank you so much for putting this out. I wish you
would go all the way to Eureka. And with that, I want to say
thank you for your participation and your input.
Mr. Burton. OK. Well, thank you very much.
I think Representative Watson and I put out a press
release. I do not know if it is printed or will be printed, but
in that press release one of the things that we did was we
commented that there was a school where a very minute amount, I
believe in a chemistry lab, was spilled. The children had to be
taken out of school. Their clothes had to be confiscated. The
school had to be evacuated while they cleaned it up because it
is such a toxic substance. So I think the point you made is
well taken.
I would just like to end up by saying thank you all for
your patience.
Thank you, Ms. Watson, for being here today.
And I would like to make one more comment to the board out
here on behalf of Ms. Watson. I think if they continue to
ignore the law, they certainly are doing it at their own peril.
I think that they are opening themselves up to all kinds of
legal exposures if they do not get on with following the law
very, very quickly. And if I can help you in anyway, you may
rest assured I will.
Thank you very much. We stand adjourned.
Ms. Watson. Thank you.
[Whereupon, the subcommittee adjourned.]
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