Dr. Rashmi Bhatnagar Ignoring Science and Potential Risk to Patient Health

Dr. Rashmi (Rush) Bhatnagar

It is disheartening to read articles written by misinformed dentists promoting the safety of dental amalgam while ignoring a vast array of published science and the serious risk to patients health from exposure to mercury vapor and particles.

Dentists judiciously quote their trade organization, the American Dental Association, for proof of safety, yet never offer specifics about the proof of safety; Unfortunately the article below by Rashmi Bhatnagar DMD exemplifies the worst of this kind of writing.



By Dr. Rashmi (Rush) Bhatnagar Special to AFN

In July of 2009, the Food and Drug Administration (FDA) ruled that amalgam is a safe material for dental restorations.

The FDA ruled it was safe without regard to age, reproductive status, or any of the known factors that make a person unusually susceptible to the effects of mercury exposure. Although the FDA ruling purported to be a ‘risk assessment’, the document was nothing of the sort as it did not comply with the standards of practice endorsed and espoused by the professional risk assessment community.

By the end of 2010, the FDA reopened the investigation due to pressures from various health organizations questioning the ruling. In December 2010, the American Dental Association (ADA) created an advisory panel to continue its own investigation on the safety of amalgam material for dental restoration. Last month the ADA panel intensively reviewed existing and new scientific information on amalgam dental safety and found that the FDA ruled appropriately in July of 2009.

Dr. Susan Runner, the 2009 FDA acting division director of anesthesiology, general hospital, infection control and dental devices, announced that the conclusions were based on multiple, evidence-based studies. Long-term studies show that the amount of mercury released by dental fillings is not high enough to cause harm to patients.

The two studies Dr. Rashmi is referring to are the Children’s Amalgam Trials (CAT). What she doesn’t say is that according to a neurologist on the FDA dental products panel, that the 5 – 7 years was not a long enough time to see the kinds of adverse health effects they were testing for. In addition, the studies clearly showed boys retained more mercury. A current study was recently published that re-analyzed the data from the children’s amalgam trials and showed that the original authors concealed evidence of harm from amalgam. Please read more about the Children’s Amalgam Trails in the SCANDALS section, under STUDIES.

In addition, studies have found that there is no adverse health effect of dental amalgam on developing fetuses, breast-fed infants and child under the age of 6. Thus, it is safe to perform amalgam restorations on pregnant woman and children.

Apparently Dr Rashmi has not read the Material Safety Data Sheet (MSDS) that ships with pre-encapsulated amalgam she uses. The following is taken from the MSDS of Disperalloy, made by Caulk. The use of amalgam is CONTRAINDICATION, which means that their material“should not be used in the following circumstances”. 

  • In proximal or occlusal contact to dissimilar metal restorations.
  • In patients with severe renal deficiency.
  • In patients with known allergies to amalgam.
  • For retrograde or endodontic filling.
  • As a filling material for cast crown.
  • In children 6 and under.
  • In expectant mothers.

In addition Dr Rashmi does not cite any scientific studies to back up her absurd claims. Perhaps she forgets that amalgam fillings contain 50% mercury which continually releases toxic mercury vapor and particles on a daily basis.

From the comments by Dr. Rashmi, it would seem she is unaware of the manufacturers warnings and that it contradicts her assertion of “safe for pregnant women and children“, it is ashame she is disregarding potential risk to patients health by not following even the most simplest of instructions from the amalgam manufacturer on safe usage. Elevated Risk: The EPA has determined that over 600,000 newborns are born susceptible to neurological harm from elevated levels of mercury. In this context anything that adds to the body’s burden of mercury should be avoided at all costs, especially a daily dose of toxic mercury vapor and particles on unsuspecting pregnant women and children.

Runner noted that some patients may have an allergy or sensitivity to metals within the dental amalgam. Therefore, special controls will be in place to warn dental professionals and patients of possible allergies, and to encourage adequate ventilation when handling amalgam.

Notice Dr. Runners choice of words. She chooses to use the word “metals” not mercury. The FDA’s estimation that the risk of allergic reaction is “rare” is undocumented and unscientific. In fact, the scientific literature reflects that between 3.8% and 38.7% of the population with amalgams is allergic to mercury.[78] [79] [80] [81]. In addition, none of the controls mentioned by Dr. Runner include informing patients amalgams contain 50% mercury much less any testing or consulting to determine a patients possible allergy to mercury.  

Nancy Stade, the FDA deputy director for policy in the FDA’s medical device center, said that the current guideline for mercury fillings is not being modified during the reinvestigation of the 2009 ruling.

After the ADA panel announced its statement concluding amalgam as a safe dental material, ADA president Dr. Raymond Gist concluded that the use of amalgam restorations is a decision that should be made between the patient and the dentist.

Unless that means an informed dentist discussing the health risks from daily exposure to mercury vapor and particles from dental amalgam. The ADA code of ethics states “the removal of amalgam restorations from the non-allergic patient for the alleged purpose of removing toxic substances from the body, when such treatment is performed solely at the recommendation or suggestion of the dentist, is improper and unethical. ” There are dozens of mercury free dentist from across the USA who have been harassed by their state or local dental boards trying to revoke their licenses because of discussing and or removing dental amalgam fillings related to health concerns.

Patients are recommended to discuss the benefits and risks of amalgam restorations with their dentist prior to dental treatment. Dr. Rashmi (Rush) Bhatnagar, DMD, MPH, can be contacted at (480) 598-5900 visit www.BellaVistaDentalCare.com or email them admin@bellavistadentalcare.com




[78] See, Djerassi, E., et al., (1969) The possibilities of allergic reactions from silver amalgam restorations. Int Dent J 19:481-488, attached hereto as Exhibit 117. (None of controls had allergy to dental amalgam. Of 180 subjects, 16.1 % exhibited an allergic response to amalgam and 11 % were allergic to mercury. Of the subjects who had amalgam fillings for up to five years, 5.8 percent showed positive reactions. For subjects who had amalgam fillings for more than five years, 22.52 % had positive reactions.)

[79] North American Contact Dermatitis Group, Epidemiology of Contact Dermatitis in North America, Arch Dermatol, vol. 108, (Oct.1973), attached hereto as Exhibit 118. (5.0% reacted to ammoniated Hg; 8.0% reacted to thimerosal a mercury containing preservative.)

[80] White, R.R., et al., (1976) Development of mercury hypersensitivity among dental students, J. Am Dent. Assoc. 92:1204-1207, attached hereto as Exhibit 119. (Authors patch-tested 396 dental students. Of those subjects having amalgam fillings for two years or less, 3.8 % had positive mercury patch tests, while 6.0% of those with amalgam fillings for more than five years were positive.)

[81] Miller, E.G., et al., (1987) Prevalence of mercury hypersensitivity in dental students. J. Prosthet. Dent. 58:235-237 (Exhibit 120) (Authors tested 171 dental students and found a greater correlation to the number of amalgam fillings subjects had than to the length of time the fillings were in place. The percentage of the subjects testing positive to mercury ranged from 26.9% to 38.7% by class.){/slide}

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1 Comment

  1. administrator@mercuryexposure.info'

    We would have liked to hear from Dr. Rashmi Bhatnagar, the author of the original article, as we have reached out to her through email and her dental practice facebook page, only to be rebuffed by having our request for comment removed from her page.

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