Biologic Dental Consultant
a few minutes.
do not get metal braces.
Nickel is added to the metal in braces (and crowns) so they don't rust. It is a known cancer causing agent, added to our government's list a few years ago. They are still able to put it in people's mouths though, along with many other toxic things. I suggest you get invisalign. Nothing is toxic-free, but it is better than nickel.
Irritating Dental Work: Another Leading Cause of Oral Cancer
David L. Lewis, Ph.D.
March 10, 1999
Recently, a national dental journal ran an excellent feature article on oral cancer and urged dentists to be more pro active in educating patients on the dangers of smokeless tobacco. What struck me most about the article, though, was what it didnâ€™t say. It didnâ€™t tell dentists that the second leading cause of this disease, according to medical literature, is ill-fitting dental devices.
Several years ago, I was asked to assist in a case in New England involving oral cancer. A young college student had been balancing her time between beauty pageants and academic studies until she underwent radical neck surgery to remove most of her tongue and much of her face and neck in an attempt to stop a rapidly advancing cancer. For months, she had complained to her orthodontist of pain and soreness where the retainer he placed in her mouth was irritating her gums. He dismissed her persistent complaints, however, as did the dentist at her college infirmary.
Her father, a physician, didnâ€™t learn about his daughterâ€™s problem until he noticed a slight slur in her voice over the telephone. Alarmed at what she told him, he advised her to see an oncologist as soon as possible. Unfortunately, it was too late.
The father contacted me, puzzled that cancer researchers at a nearby medical school found unbelievably high levels of nickel - many times higher than concentrations known to cause cancer - dissolving out of the retainer into her saliva. I explained that many bacteria, such as those that colonize irritated areas of the mouth, cause nickel to corrode and form compounds that are highly carcinogenic. Intimate, prolonged contact between carcinogenic chemicals and irritated tissue is a deadly combination - the same reason snuff causes oral cancer.
These observations gave me pause to think more seriously about something that had been in the back of my mind for a long time. Irritation had developed in the gums around one of my teeth when it was fitted with a crown fifteen years earlier. The problem never went away. I had asked several dentists over the years what they thought but they dismissed my suspicion that the crown was the source of the irritation.
Finally, a microbiologist from Utah and I were lecturing in Europe on the need for dentists to sterilize handpieces (dental drills). When I asked her what she thought about the problem with my crown, she exclaimed: "My husband (a renowned dentist) lectures on that all the time. You should see the pictures heâ€™s taken of reactions to nickel in crowns and bridges."
The good news, she said, is that the condition heals dramatically within days after replacing the devices with nickel-free alloys. Needless to say, my dentist was the first person I visited upon returning home. He was impressed at how soon the chronic irritation disappeared after replacing the porcelain crown with a gold one.
My relief over getting rid of the crown, however, was tempered. I had noticed that a lymph node in my neck directly beneath the crowned tooth had been growing larger for well over a decade. I had asked several physicians to check it during regular physical examinations. They didnâ€™t think it warranted a biopsy.
After having the porcelain crown removed, however, I talked with a local surgeon and insisted that he x-ray the area. I was concerned that nickel may have reached and irritated a lymph node in the proximity of the crown. The node that was troubling me turned out to be far larger than any of my physicians had thought. Immediate surgery was recommended. The good news was that it wasnâ€™t malignant.
Out of curiosity, I dropped by a local dental laboratory one day with my old crown in hand. The technician took one look and said "Sure, the band around the base of that crown is full of nickel. Crowns made of base metals in the mid 1980's are especially high in nickel because the price of precious metals went out of sight."
I took this seriously when it came time for my children to have braces. I was particularly concerned that, like me, they develop skin rashes when they wear rings or bracelets made with nickel alloys. This means any contact with nickel in their mouths will also be a source of constant irritation. I was relieved to find a local orthodontist willing to order nickel-free alloys at no extra cost for making their braces.
My story ends on a flight back to Atlanta last year, when a young surgical nurse seated next to me struck up a conversation. Pointing to my scar, I mentioned that the only thing Iâ€™ve ever had removed was a lymph node. As she touched the corresponding place on her own neck, she said: "You know, Iâ€™ve had that exact same problem for the past ten years."
"Have you had any dental work in that area?," I asked. "Now that you mention it," she said, "I had a tooth crowned there ten years ago right when the problem started. Why do you ask?" Just a coincidence? Probably. Nevertheless, dentists should take a closer look inside their own shop when it comes to oral cancer. They need to educate themselves and their patients on its second leading cause â€“ irritation associated with dental work.
Nickel Compounds and Metallic Nickel
Nickel compounds and metallic nickel have many industrial and commercial applications including use in stainless steels and other nickel alloys, catalysts, batteries, pigments, and ceramics. Nickel and â€ścertain nickel compoundsâ€ť were first listed in the First Annual Report on Carcinogens (1980) as reasonably anticipated to be human carcinogens. Nickel compounds as a class were first listed as known to be human carcinogens in the Tenth Report on Carcinogens (2002); this listing supersedes the listing of certain nickel compounds and applies to all members of the class. Metallic Nickel was reevaluated in 2000 and remains listed as reasonably anticipated to be a human carcinogen. Nickel alloys were reviewed in 2000 but were not recommended for listing in the Report on Carcinogens (see Appendix C).
The profile for nickel compounds and metallic nickel follow this introduction. The evidence for the carcinogenicity of nickel compounds and metallic nickel is discussed separately. However, most of the information on additional information relevant to carcinogenicity, properties, use, production, exposure and regulations is
Known to be human carcinogens First listed in the Tenth Report on Carcinogens (2002)
Nickel compounds are known to be human carcinogens based on sufficient evidence of carcinogenicity from studies in humans, including epidemiological and mechanistic information, which indicates a causal relationship between exposure to nickel compounds and human cancer. The findings of increased risk of cancer in exposed workers are supported by evidence from experimental animals that shows that exposure to an assortment of nickel compounds by multiple routes causes malignant tumors to form at various sites in multiple species of experimental animals. The combined results of epidemiological studies, mechanistic studies, and carcinogenesis studies in rodents support the concept that nickel compounds generate nickel ions in target cells at sites critical for carcinogenesis, thus allowing consideration and evaluation of these compounds as a single group. The IARC (1990) evaluation of nickel and nickel compounds concluded that nickel compounds are carcinogenic to humans based on sufficient evidence for the carcinogenicity of nickel compounds in the nickel refining industry and very strong evidence of carcinogenicity of a variety of nickel compounds in experimental studies in rodents.
Several cohort studies of workers exposed to various nickel compounds showed an elevated risk of death from lung cancer and nasal cancer (IARC 1990). Although the precise nickel compound responsible for the carcinogenic effects in humans is not always clear, studies indicate that nickel sulfate and the combinations of nickel sulfides and oxides encountered in the nickel refining industries cause cancer in humans. IARC (1990) made the overall evaluation of nickel compounds as a group based on indications from mechanistic and animal studies that the event responsible for inducing cancer is generation of ionic nickel at the target site. Anderson et al. (1996) reported that nickel refinery workers exposed primarily to soluble nickel compounds had a significant excess risk for lung cancer and that smoking and nickel exposure have a multiplicative effect. An excess risk of nasal cancer was also observed in workers exposed to nickel compounds.
In rats and in some studies with mice, inhalation or intratracheal instillation of nickel subsulfide or nickel oxide led to dose-related induction of benign and malignant lung tumors, including carcinoma (IARC 1990, NTP 1996a,b). Inhalation of nickel compounds also causes tumors to form in organs other than the lung, in particular, malignant and benign pheochromocytoma in rats (NTP 1996a, 1996b). Injection of various nickel compounds has repeatedly been shown to produce dosedependent increases in tumors at a variety of sites in several species of experimental animals. Subcutaneous, intramuscular, intraperitoneal, subperiosteal, intrafemoral, intrapleural, intracerebral, intrarenal, intratesticular, and intraocular injections of nickel compounds all have caused malignant tumors to form at the site of injection. These tumors are usually sarcomas, but other types also develop. Injection of nickel produces distant tumors of the liver in some strains of mice (IARC 1990). Soluble nickel acetate is an effective, complete transplacental carcinogen in rats, and brief intraperitoneal exposure during pregnancy to this soluble nickel salt induces malignant pituitary tumors in the offspring. Additionally, exposure to nickel acetate through the placenta followed by exposure of the offspring to barbital (a known tumor promoter) produces tumors of the kidney (renal cortical and pelvic tumors) (Diwan et al. 1992). In adult rats, injection of soluble nickel salts followed by barbital exposure caused kidney cancer (renal cortical adenocarcinomas) that frequently metastasized to the lung, liver, and spleen (Kasprzak et al. 1990). No adequate data were available to evaluate the carcinogenicity of nickel compounds in animals by the oral or dermal routes of exposure.
CAS No. 7440-02-0 Reasonably anticipated to be a human carcinogen First Listed in the First Annual Report on Carcinogens (1980)
Metallic nickel is reasonably anticipated to be a human carcinogen based on sufficient evidence of carcinogenicity from studies in experimental animals, which indicates there is an increased incidence of malignant and/or a combination of malignant and benign tumors at multiple tissue sites in multiple species of experimental animals. A variety of carcinogenicity studies in rodents indicate that metallic nickel powder can produce tumors when given by intratracheal instillation or subcutaneous, intramuscular, or intraperitoneal injection. Intratracheal instillation of metallic nickel powder induces primarily adenocarcinoma, whereas injection most frequently induces sarcoma, demonstrating that metallic nickel can induce both epithelial and connective-tissue tumors. Tumors have been produced by metallic nickel exposure in both rats and hamsters (IARC 1990).
The available data from human studies of metallic nickel exposures are less informative. The available epidemiological studies of workers are limited by inadequate exposure information, low exposures, short follow-up periods, and small numbers of cases.
Nickel Compounds and Metallic Nickel
Additional Information Relevant to Carcinogenicity
Many studies in cultured rodent and human cells have shown that a variety of nickel compounds, including both soluble and insoluble forms of nickel, damage genetic material. DNA strand breaks, mutations, chromosomal damage, cell transformation, and disrupted DNA repair have been observed in cell-culture studies. Nickel can bind ionically to cellular components, including DNA. The reductionâ€“oxidation activity of the nickel ion may produce reactive oxygen species that attack DNA, and 8-hydroxy-2Â´-deoxyguanosine can be produced in vitro and in vivo in target tissues for cancers caused by nickel (IARC 1990, Kasprzak et al.
1990). Nickel can induce chromosomal aberrations in exposed humans.
The carcinogenic potency of various nickel compounds varies widely, based on solubility properties and speciation. Studies indicate that soluble nickel salts can be complete carcinogens (Diwan et al. 1992) and/or initiators of carcinogenesis (Kasprzak et al. 1990) at sites distant from the application site, which confirms that ionic nickel is the carcinogenic species. Differences in potency of nickel compounds may relate to the specific properties of the compounds that affect the availability of ionic nickel at target sites. The listing is based on a large body of scientific evidence supporting the concept that the nickel ion is carcinogenic. The hazard associated with a particular nickel compound largely relates to the propensity for the compound to release ionic nickel in the body. The evidence suggests that the relatively insoluble metallic nickel is less likely to present a carcinogenic hazard than are the nickel compounds that tend to release proportionately more nickel ion. This view agrees with that expressed by the International Agency for Research on Cancer (IARC) (IARC 1990), which based its overall evaluation of the carcinogenicity of nickel compounds as a group on the combined results of human epidemiological studies, carcinogenicity studies in experimental animals, and other data supporting the â€śunderlying concept that nickel compounds can generate nickel ions at critical sites in their target cells.â€ť The IARC review group correctly pointed out that the carcinogenicity of nickel compounds depends not solely on their capacity to release ionic nickel, but also on factors that promote localization of high concentrations of nickel ions at critical tissue sites. This conclusion is consistent with evidence from experimental animals indicating that nickel compounds of moderate solubility can, under certain exposure conditions, be more carcinogenic than compounds that are more soluble. Thus, it is difficult to predict with any certainty the relative carcinogenic hazard posed by a particular nickel compound without a full understanding of its ability to release ionic nickel under specific exposure conditions.
The available evidence suggests that metallic nickel has carcinogenic properties because it can slowly dissolve in the body and release ionic nickel, an active genotoxic and carcinogenic form of nickel. No available data suggest that mechanisms by which nickel induces cancer in experimental animals would not also operate in humans.
Dr Hal Huggins, D.D.S.
in a lecture to the
Cancer Control Society 1993
More than 75% of the crowns placed today are nickel, and that is present in braces. Here we call it stainless steel. It is like silver fillings, it doesnâ€™t have much silver in it, and you would pay for silver and gold what you wouldnâ€™t pay for mercury. So it kind of boils down to a matter of salesmanship, and stainless steel sound pretty prestigious, so they put that in children, and what happens? You see teenage behaviour that may not have been there a few days before the braces were put on.
At the University of Colorado when I was nearly 50 years old I went back to take a degree in immunology because I could see I was affecting the immune system. The first case we studied, we took a woman and put braces on her, and I am kind of sensitive to immunology, I studied it for 4 years, and about 2 weeks after that I only knew about 2% of what was going on in immunology, it is a field that is expanding very rapidly, but a term I hear many people saying isâ€”you know this product it boosts your immune system. How does it do that? What does it do to the T4â€™s and the T 8â€™s?â€¦.when you can study the cells of the immune system with the sophisticated equipment we have, and we can find that in this case I put the braces in. We did all the sophisticated testing, we put the braces in, and then the patients ends up with big bruises on her thigh. How did they get there? Well, a little sloppy dentistry, but these are huge bruises, no trauma involved there. Emotional things, a lot of change. Sleeping patterns, the first thing to change in an immunological challenge? Yes, big changes there. Things begin to look a little uncomfortable by day 3 so we took the conventional blood test, and what did I find? Nothing I could identify at that time, but this was 10 years ago. Today I could identify it, then I couldnâ€™t, but things were still getting worse, and that afternoon we did the T subsets over again and what did we find? Immune system shutdown. I mean the T4â€™s were zero, the T8â€™s were zero, T11â€™s were zero. All of these things may not have a lot of meaning, but I can tell you zero is not where they should be. Within a few hours of death. We decided maybe we better take the braces off. The patients was for it, the faculty was for it, I was for it, I mean this was my wife we are talking about so it is not a real scientific case. So we took the braces off and the immune system came backâ€¦in 3 moths we were almost half way back where we were 3 days before. It does not recover overnight.
And I have other records on my desk where they did not take the braces off on the fourth day, and the reports show the same changes in the white blood cells, the same changes in the red blood cells, the same changes in the body temperature, everything is identical except when we get to day 4 and the braces were not removed, that was the last date that was entered on the autopsy reports, because these kids died, as they can with what is called the chrome crowns. That is a cutesy little term, chrome crowns, but these kids, I see them in the airport all the time â€¦ and I see little kids with tri-focals on, glasses about that thick. When did you have your chrome crown placed? I see people pushing along in a wheelchair. I wonder when did you have your root canal done? Because root canals so far have turned out to be one of the most vile things that I have ever run into, and my life for the last 20 years has been with a lot of vile essense
In California we found a woman who had some nickel crowns placed, she ended up with a specific type of breast tumour and she went through the lumpectomy, she went to the support group afterwards, and she said to me you know my husband was talking to this guy out in Colorado about nickel being carcinogenic.
What does that mean?
That means it produces cancer.
Do you suppose there is any relationship between my crowns and my breast tumour?
Another woman in the group said - well I went to Dr So and So dentist down the street here.
He put nickel crowns in my mouth and a couple of years later I came down with this same tumour you have got.
She said - that is the same dentist I went to.
And then we found a third woman who had the same crown, the same tumour, the same dentist. Same day we found a fourth woman with the same crown, the same tumour, the same dentist.
Then we found a fifth, then a sixth.
Is this suggestive of the need for further investigation? Or should we cover it up?
Are there really 100,000 women in the state of California growing breast tumours as a result of their nickel crowns right now as we are sitting here today? Is that a possibility? And you know what? They paid for that. They paid to have that done
Now, is there anything in the scientific literature on this?
Dr Moss was mentioning someone talking about 1000's of articles.
Yes, there are 1000's of articles on nickel being a carcinogen.
There are not thousands, but maybe hundreds of articles showing that nickel does something else. After nickel gets the cancer going how do you keep it under control?
You keep it under control with one of the white blood cells called a natural killer cell, the NK cell. What does it do?
It goes out and it kills off the cancer cells. Now all the rest of the immune system has to ask somebody. The B's have to ask the T lymphocytes, and so on, everything is a committee in the immune system, except the NK cells.
There is cancer---bang. They don't ask anybody. These are nice guys to have around. What does nickel do? It suppresses your NK cells. So nickel starts the tumour, then takes away your defences system. Is that nice? No, that is not nice. That is not nice to put on children aged two with their chrome crowns. That is not nice to put in our teenagers, or adults, with braces. It is not nice to use as crowns and bridges just because you save ten bucks. Is it worth ten bucks to go through breast surgery? If you feel that way have it but be informed ---if you want mercury in your mouth, if you want nickel, OK, but how many people in this room have nickel crowns in their mouth?
How many people have nickel crowns put in their mouth when they paid for gold crowns?
It is estimated that 50% of the dentists put in nickel crowns and charge the insurance companies, or charge you for gold. Nickel does not cost the same as gold. Nickel is not as safe as gold.
"Nickel is rapidly gaining a reputation for its toxicity, too. Most partial dentures are made of nickel. Approximately 80% of crowns use nickel, even "porcelain" crowns. Braces usually are nickel. Stainless steel is usually nickel alloy. Nickel compounds have been unequivocally implicated as human respiratory carcinogens in epidemiological studies of nickel refinery workers, and there appears a relationship between nickel crowns and breast cancer in women."---Thomas Levy, M.D.
"Nickel is used routinely by national cancer centers to induce cancer in laboratory animals to study can-cer. The nickel alloys they are using are very similar to those we are using in patients' mouths. Dentists are causing a major health problem."--- Dr. David Eggleston
Nickel and beryllium are 2 other metals commonly used in dentistry that are very carcinogenic, toxic, and cause DNA malformations. Nickel ceramic crowns and root canals have also been found to be a factor in some breast cancer and some have recovered after TDR, which includes amalgam replacement, replacement of metal crowns over amalgam, nickel crowns, extraction of root canaled teeth, and treatment of cavitations where necessary. Similarly nickel crowns and gold crowns over amalgam have been found to be a factor in lupus and Belle's Palsy from which some have recovered after TDR and Felderkrais exercises.
When two dissimilar metals are present in the mouth with saliva, an electric current will flow. Saliva acts as an electrolyte when it mixes with amalgam fillings, to create a measurable electric current of 900 millivolts. This current overpowers the body's normal 450 millivolts, interferes with energy flow to the brain and is suspected as a catalyst in many illnesses.
Other alloys, such as nickel in the metal base of bridges and under porcelain crowns, have been documented to lower the T-4 and T-8 lymphocyte levels (David Eggleston, DDS. "Effect of Dental Amalgam and Nickel Alloys on T-Lymphocytes: Preliminary Report", J. Prosthetic Dent, 1984, 51(5);617-623.) In predisposed patients, exposure to nickel can be a contributory factor in the development of cancer of the lungs, nasal passages and larynx.
Any metal materials in the mouth such as gold crowns, chrome cobalt partial dentures, mercury fillings, titanium implants, etc. will set the stage for galvanic currents. In 1985, a research team (A. Knappworst, E. Gura, D. Fuhrmann and A. Enginalev) revealed that when mercury fillings were in close proximity to gold crowns, the mercury release was ten times greater when compared to mercury fillings alone (p132. Mercury Poisoning from Dental Amalgam- a Hazard to Human Brain by Patrick Stortebecker, MD, Ph.D. published in USA by Bio Probe, Orlando, FL). Electro galvanism frequently is the cause for the following symptoms:
Lack of concentration and memory