Autism's Rise May Reflect Broader Definition, Better Diagnosis

(HealthDay News) -- How widespread is Autism? And is the condition, which centers on characteristics such as the inability to form personal relationships, being properly diagnosed?

New York City-based YAI-National Institute for People With Disabilities (YAI-NIPD) is a not-for-profit organization that not only assists families who have members with a variety of developmental disabilities, but also holds a series of conferences that highlight the latest research into specific conditions.

Earlier in May, YAI-NIPD held an autism conference that addressed the apparent increase in autism cases. One reason may be a broader definition of autism, said Dr. David Kaufman, medical director of Premier Healthcare, a Manhattan organization specializing in disability services.

"The estimate was one child in 166, made by the epidemiology unit of the [U.S. governments] National Institutes of Health," Kaufman said. "Now it is down to one in 150. I think that since the definition has been broadened, a lot of children are getting diagnosed who are at the milder end of the spectrum."

The cause of autism remains unclear, Kaufman said. "I believe that there is something in these children that predisposes them to autism and maybe something that triggers it, perhaps a viral illness, like children who get diabetes at an early age."

Whatever the cause, "the best treatment so far is diagnosing it early on and intervening early on, sometimes with medications," Kaufman said. "There is a broad array of early intervention services."

When a child's mysteriously detached behavior arouses parents suspicions, "the first line of defense is with the pediatrician," he said. "The child can be referred to a developmental pediatrician or pediatric neurologist or specialist who will do an evaluation and then send the child to a speech therapist, a language therapist or another therapist for treatment. The earlier you intervene, the better children do."

Financial help is often available from state governments, but "each state has different funding lines," Kaufman noted.

Children's basic medical needs should not be overlooked, Kaufman said. "Their medical needs are the same as anyone else, but it is harder to get at them," he said. "Once they get to age 2 or 4, they are able to tell the doctor what is wrong with them, but they are not as cooperative as another child might be."

Although there is a long way to go, "One thing that is being done right is an increased awareness of autism," said Dr. Eric Hollander, professor and chairman of psychiatry at Mount Sinai School of Medicine in New York. "It has become a priority funding issue for the National Institutes of Health. There are findings that directly impact on treatment and also can lead to a better understanding of the underlying causes."

One area that clearly has been neglected is autism in adults, Hollander said. "The high school or college population, the need for residential care is also there. Child psychiatrists and pediatricians will not necessarily be treating these individuals when they get older.

"And those who work with the older population don't have enough training. We need to know a lot more about intervention with medication, how it alters outcome, the repetitive behavior, the rigid behavior, and also new treatments for disruptive behavior."

What causes autism? Attention is being focused on oxytocin, a hormone produced by the pituitary gland, Hollander said. It appears to play a role in social behavior and repetitive behavior. "Now we are starting to have a certain impact on symptoms by administering oxytocin in various forms, such as intravenously."

Attention also is being paid to environmental and genetic factors, Hollander said, "things in the environment that influence what genes are turned on and turned off. We need to know a lot more about environmental factors and how they play a role in some people with autism."

One indicator of how much remains to be learned is the widely differing rates of diagnosis of autism from state to state, Hollander said, but that is just part of the picture. "We don't have predictors of which individuals will respond to which kinds of treatment," he said, but ended on a hopeful note: "With additional funding, there will be more rapid breakthroughs."

Dr. Steven Lowe, the medical director of YAI-NIPD, added that autism treatment still is often a struggle. "It's a challenge, because so little work has been done in the management of patients with autism and also in mental retardation and developmental disabilities," he said. "There has been very limited work on management of such patients in the primary care area and very limited research. There is limited interest for primary health-care practitioners, because it is such a daunting prospect."

But there is impetus for progress from "parents and other caregivers and the media," Lowe said. "Among them, the issue of autism is better recognized, and it is less of a stigma. People with autism are becoming more visible. Caregivers are advocating for better access to the same sort of health care that disabled people are getting.

"There is a tremendous lack of formalized training in medicine appropriate to this patient population," Lowe added. "But there are providers out there -- institutions like our own take care of patients with mental disabilities, mainly through on-the-job training."

For families facing a problem, "my recommendation is to find a place that specializes in this patient population," Lowe said. "Look for a multidisciplinary system where everyone is comfortable with mental retardation or developmental disabilities such as autism. You need a large group of clinicians in various fields, the kind of team approach that has proven to be very effective."

Then there is the influence of other elements, such as diet. Dr. Joseph Levy, a pediatric gastroenterologist who is professor of pediatrics at the New York University School of Medicine, offers a theory that developmental disability is often literally a gut issue.

"There are a whole host of anecdotal reports about how particular diets have enabled children to make progress," Levy said. "Sooner or later, every parent will focus on the dimension of nutrition of child care and will experiment with it. For example, if there is aggressive or self-injurious behavior, the explanation is that the child has reflux irritation or difficulty with bowel movements."

The problem is that parental concentration on dietary factors means that they "sometimes are committed to thinking that autism is the manifestation of a leaky gut," Levy said. "But we don't know whether it is proven that autism is really a disease that affects the immune system in the gut, with toxins that are absorbed from the intestines."

It is necessary to work with nutritionists to be sure that children with autism get the proper micronutrients, but "autism is not one diagnosis, and this can put parents to great restrictions and might even be harmful," Levy said. "We do have to move forward the science that enables us to understand what is going on in the gut of the child, but we must do that without a preset ideology."

More information
There's more on autism at Autism Speaks.

Indoor Smoking Bans Kick Carcinogens to the Curb

(HealthDay News) -- Bar and restaurant smoking bans are forcing more and more smokers to head for the exit, only to create noxious "smoke zones" on the sidewalk, new research shows.

"In the past few years, we've effectively banned smoking in most public places in many parts of the country, and one unintended result are these 'smoke zones' in front of restaurants and bars," noted study author L.P. Naeher, an assistant professor at the University of Georgia College of Public Health in Athens.

"This is a relatively new phenomenon," he added. "So, we wanted to study it, to see what the smoking exposure is for nonsmoking patrons and for the workers. And what we found is that the level of secondhand smoke in front of restaurants and bars was several times higher than the safety standards established by the EPA's Clean Air Act."

The findings were presented Monday at the American Thoracic Society's International Conference in San Francisco.

Signed into law in 1963, and most recently updated in 1990 and in 2005, the U.S. Environmental Protection Agency's "Clean Air Act" sets national air quality regulations and air pollution standards.

According to the American Lung Association (ALA), the EPA classifies secondhand smoke as a carcinogen containing hundreds of toxic chemicals, including formaldehyde, benzene, vinyl chloride, ammonia and cyanide.

ALA estimates suggest that in the United States about 3,400 lung cancer deaths and upwards of almost 70,000 heart disease deaths occur each year as a result of exposure to secondhand smoke. And last year, a U.S. Surgeon General report revealed that nearly half of all nonsmoking Americans are routinely exposed to secondhand smoke.

In their study, Naeher's group measured the level of pollutants in the air outside several drinking and eating establishments in and around Athens, Ga.

Athens is a college town with more than 100 bars and restaurants, all of which began implementing a full smoking ban in 2005. The team tested air near two bars and two restaurants, plus one location away from restaurants and smokers.

On two consecutive Friday and Saturday afternoons, air sample readings were taken directly outside each locale every 30 seconds. Each of the four establishments had a designated smokers area with or without seating, either outside the main entrance or in an internal courtyard.

The researchers sampled levels of smoking-linked carbon monoxide levels and fine particle matter. The latter, called PM2.5, can penetrate deep into the lung.

The result: the more smokers present in the smoking zones, the greater the amount of carbon monoxide and PM2.5.

Smoking areas outside bars had the highest substance readings, followed by those outside restaurants. Compared with the location away from any of the four establishments, PM2.5 readings were nearly three times as high outside bars and twice as high outside the restaurants.
Naeher stressed that the study readings seemed to correlate exclusively with smokers, not nearby car traffic.
It's tough to asses the exact health hazard posed by the observed curbside pollution levels, Naeher said. But his group is conducting follow-up research that tries to measure that impact, based on urine and saliva samples from people loitering in smoking zones.

In the meantime, one longtime anti-smoking advocate said moves to ban indoor smoking in restaurants and bars are still important.

"The fact is that you're better off having it outside than inside," said Stanton A. Glantz, a professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. With bans on indoor smoking in place, "the only choice smokers have is to go outdoors," he said. "And while that could cause a problem for people who choose to go to those areas, presumably people who don't smoke are not going to hang out there."

He pointed out that some states, such as California, have also tackled concerns about outside smoking zones by making it illegal to light up within a certain distance of a public facility.

"But even where this isn't regulated, the smoke will get blown away," added Glantz. "And there's good literature that shows that when you make a workplace smoke-free people cut down cigarette consumption overall. So, this is a far better way to go than what we had before."
Naeher agreed.

"It's not illegal to smoke, and when you have smokers, you're going to have secondhand smoke," he acknowledged. "There's no way to get around that. But the real question is, are these levels high enough to pose a danger to health? We don't have a clear answer to that. So, it certainly warrants further investigation."

In related research, a team at Columbia University's Mailman School of Public Health found that nonsmokers living and working in a completely smoke-free environment are two and a half times more likely to say they are in better health than those living without such bans. The findings, which are published in the May/June issue of the Journal of Urban Health, were based on surveys conducted among almost 1,500 Chinese Americans living in New York City.

More information
For more on secondhand smoke, visit the American Lung Association.

Holistic Dentistry

As people become increasingly concerned about medical techniques and learn more about alternative health procedures, a new field of dentistry has popped up. Known as holistic dentistry, this type of dentistry combines dental knowledge with procedures from a variety of medical systems that are designed to improve a person’s oral health. Rather than focus on one area of a person’s body, holistic dentistry is concerned with the patient’s overall health. Therefore, instead of focusing solely on a patient’s teeth, holistic dentists are concerned about the relationship between a person’s mouth and the rest of their body.

Also known as alternative dentistry or biological dentistry, holistic dentistry promotes a preventative approach to dentistry. Rather than dealing with dental concerns as they pop up, holistic dentists use techniques that are designed to avert common dental problems like tooth decay, tooth disease, and tooth loss. Spurning the traditional dental goal of creating aesthetically pleasing quick fixes to dental problems, holistic dentistry is concerned about the effect of the mouth to the overall balance and harmony of the patient’s body. Believing that an imbalance in any part of a person’s body can lead to health problems in other parts of the body, holistic dentists are concerned with fully correcting any dental problem so that this health problem will not spread to other parts of the body.

The differences between holistic dentistry and traditional dentistry can be seen in their approaches to orthodontic dentistry. Orthodontic dentistry is a dental specialization that deals with problems of tooth alignment and bite problems. In traditional dentistry, the goal is to straighten out any teeth to create a visibly attractive and seemingly healthy set of teeth. However, holistic dentists feel that this view of orthodontic dentistry is not enough and can lead to further health problems. Rather than just limiting orthodontic treatment to teeth straightening, holistic dentists will use a practice known as orthopedic orthodontics in which they will ensure that the muscles of the patient’s face and the patient’s head and neck are properly aligned. By engaging in this practice, holistic dentists are not simply limited themselves to treating an oral condition but are creating preventative solutions to problems that may affect the patient’s jaw, head, neck, and spine.

Additionally, holistic dentistry strongly promotes alternative dental treatments from potentially toxic dental treatments that are used in traditional dentistry. An example of this is the issue of anesthesia that is used in dentistry. Anesthesia is a vital component to many dental procedures and is designed to help the patient feel as little discomfort during extensive dental work.

Whereas, traditional dentistry uses strong forms of anesthesia, holistic dentistry attempts to utilize as many natural forms of anesthesia as they can. One popular method of anesthesia that is used in holistic dentistry is acupuncture anesthesia. In this method, tiny acupuncture needles are placed at various points of a patient’s body prior to and during the dental procedure. This approach to anesthesia utilizes the patient’s body’s natural electrical system that produces the same effects as conventional anesthesia. This approach to using alternative, safer dental methods is also evident in holistic dentist’s attempts to minimize the use of mercury during dental treatment. Many holistic dentists feel that the convenient and diverse use of mercury is offset by its negative long-term effect on a person’s nervous system and immune system.
For an overview of holistic dentistry, it is important to view many of the beliefs held by holistic dentists.

Holistic dentists:
Believe that proper nutrition and healthy eating habits, which includes the avoidance of certain foods, is essential to oral health.

Caution against root canal treatment due to the belief that the bacteria that are trapped within the treated tooth can create further health problems by migrating to other area’s of the patient’s body, including vital organs.

Conduct biocompatibility tests to determine which restorative material is best suited to the needs of the individual patient.

Renounce the use of any unnatural and potentially toxic dental devices and treatments, which includes mercury fillings and fluoride treatment.

Study the balance and relationship between a patient’s mouth and the rest of their body.

Doctors Frequently Asked Questions About DMPS

Q: Is it legal to prescribe DMPS?

A: It is considered like any other chemical you would order by prescription to be compounded for a patient.

Q: Is DMPS now FDA approved?

A. No. Its current status is as a bulk chemical that may be used in compounding. It is included on the FDA list of Bulk Chemicals That May Be Used In Pharmacy Compounding. Final approval of the list is still pending. The appearance of DMPS or any chemical on this list in no way should be construed as FDA approval. FDA approval generally infers that a drug has been subjected to clinical trials under an IND application to ascertain its safety and efficacy.

This has not been done in the US with DMPS as of this date. (To our knowledge, Heyl is the only DMPS manufacturer with an IND application on file with the FDA.) You may access additional information on the history and the chemicals under consideration through the internet address – http://www.fda.gov/cder/fdama/draft4.pdf

Q: Can DMPS be used orally?

A: Yes. Oral administration is common in other parts of the world. According to Heyl-Berlin, the leading manufacturer of DMPS, oral capsules are the preferred route of administration in chronic metal intoxication with IV administration being reserved for acute poisoning cases or in instances when oral dosing is not possible.

Q: IS DMPS used for conditions other than metal toxicity?

A. The Heyltex Scientific Monograph lists all the known experiments with DMPS in conditions other than metal toxicity on pages 69-71.

Q: Can I use DMPS with DMSA or other chelators?

A: Many physicians alternate use of DMPS with other chelators such as DMSA and EDTA. Heyl does not recommend this. DMPS should not be administered concomitantly with other chelating agents . NOTE: (The manufacturer’s of DMSA do not recommend mixing their chelating agent with any other chelator. DMSA information in the Physcian’s Desk Reference recommends a 4 week "rest" period after the last dose of DMSA before the initiation of any other chelator).
Q: Can you administer DMPS by the IV drip method?

A: DMPS is a dithiol chemical and as such it oxidizes fairly rapidly once in solution when exposed to ambient air. It also oxidizes rapidly at approximately a pH of 7 or greater, therefore IV drip method would probably not be the best route of administration. There is no scientific evidence that oxidized DMPS is of any value in any condition it may used for.

Q: Can I use DMPS as an admixture in a vitamin C IV formula?

A: Oxidation of DMPS is still of concern in this instance. Sodium bicarbonate is generally added to IV-C solutions to adjust the pH. This may cause oxidation, particularly if administered over the usual 2-3 hour time period for this type of IV. (Vitamin C is a reducing agent, it’s possible that it prevents the oxidation of DMPS but this has not been tested or documented. )

Q: What should I mix DMPS with?

A: Generally DMPS should not be mixed with any other chemical or solution. (ie; other chelating agents, normal saline or sodium bicarbonate). This may change the pH which will cause oxidation of the DMPS. A review of the scientific monograph will reveal that it was never mixed with any other solution.

Q: Does DMPS cross over the blood brain barrier?

A: Animal studies indicated that it does not cross over. It also did not carry metal into the brain of animals.

Q: Does DMPS dissolve amalgams in the teeth?

A: DMPS has been used in Germany for a number of years. There have been no reports of dissolved Amalgams.

Q: Is oral DMPS considered a nutritional?

A: Absolutely not. Under no circumstances should DMPS in any form be considered a nutritional product.

Q: Should everyone with suspected metal toxicity receive DMPS?

A: Not necessarily. Data from various researchers around the world indicate that some people spontaneously excrete toxic metals once the individual has been removed from exposure. In the prescribing of any drug or compound, a physician must consider the risk/benefit ratio and make a decision based upon the clinical and laboratory evidence at hand. Not everyone will benefit from the use of DMPS.

Q: Can DMPS be applied topically or as a suppository?

A: According to leading toxicologists and Heyl scientists, there is no benefit to administering DMPS either topically or rectally. There is no data on the absorption of DMPS by these routes of administration. Also of concern is the pH and air exposure of these preparations and the rate of oxidation of the DMPS. The preferred route of administration is oral.

Q: Can DMPS be given to children?

A: Yes. If children are not yet able to swallow capsules, the powder in the capsule can be mixed with cold orange juice (or some other acidic juice) for ingestion.

Q: What is the protocol for administering DMPS?

A: Heyl does not have their own protocol for administering DMPS. Treatment is left to the clinical judgement of the attending physician. Our monograph lists the various dosing protocols for mobilization of heavy metals by several researchers on pages 109-111. The literature describes IV injections of 3mg/kg BW with a maximum dose of 250mg given every four hours for 24-48 hours in severely poisoned individuals, with follow-up oral dosing for several days to several weeks. Acutely poisoned persons are usually hospitalized. Duration of treatment is determined by the continued monitoring of blood and urine samples for excretion of toxic metals. Each physician, who ascertains in their professional and clinical assessment that their patient would benefit from DMPS, must decide the best route to follow for the individual patient.

Q: If I specifically want a prescription I write for DMPS to be filled with the Heyl product, how can I be sure that this will be done?

A: When writing a prescription for any compound, a doctor may specify the manufacturer of the bulk chemical to be used. You may also want to request a copy of the Certificate of Analysis that is provided by the chemicals’ manufacturer.

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Chemical & Heavy Metal Cleanse Starter Kit $149.85 [ learn more ] The Chemical & Heavy Metal Starter Kit was designed by Dr. Group for individuals that are new to the cleansing process, or are simply looking for an easy-to-perform, cost effective cleanse program. The Heavy Metal Starter Kit is comprised of LIFE Detox Foot Patches™, NDF Plus™, and Quantum Zeolite™.

What is Chelation?

Chelation is a term derived from the Greek chele, meaning "claw."
A chelation agent is a chemical agent that, like a claw, grabs and chemically bonds with metals or other minerals and toxins. Simply put, chelation is the process in which chemicals bind with minerals.

While chelation is a naturally occurring biological process (hemoglobin binds with iron to provide oxygen to tissues), synthesized chelation agents were first developed during World War II as a way to clear toxic metals from the body. Chemists discovered they could create a heterocycling ring of molecules which surround or "sequester" mineral molecules and carry them from the body through normal elimination.

This process of chelation actually removes unwanted metals from the bloodstream. In fact, chelation therapy is the only way to treat lead poisoning. But lead is not the only metal cleansed from the body through chelation. A chelation agent will also bind with most metals, mineral deposits, calcium-based plaques and other chemical toxins. Because of its positive impact on the bloodstream, chelation therapy has proven to benefit a number of medical conditions, including atherosclerosis and arteriosclerosis.

What is EDTA?
EDTA chelation is a therapy by which repeated administrations of a weak synthetic amino acid (EDTA, ethylenediamine tetra-acetic acid) gradually reduce atherosclerotic plaque and other mineral deposits throughout the cardiovascular system by literally dissolving them away.

EDTA, ethylenediamine tetra-acetic acid, chelation has frequently been compared to a "Roto-Rooter®"; in the cardiovascular system, because it removes plaque and returns the arterial system to a smooth, healthy, pre-atherosclerotic state. A better metaphor might be "Liquid-Plumber®," because, where Roto-Rooter violently scrapes deposits off the interior surfaces of your plumbing with a rapidly rotating blade, Liquid-Plumber simply dissolves them away.

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Body Detoxification

Body Detoxification, simply put, is the process of removing toxins from the body.

Common sense will tell us that having toxins in our body can’t be a good thing.

Proactive health clinicians accept the fact that in order for us to be healthy, we need a healthy immune system. Toxins undermine good health with the chronic assault of various toxins. Mercury is high on the toxic list.

We need to remove the toxins from our body if we are to experience good health. There are a number of toxins that the body is exposed to every minute, and we have an immune system that is capable of neutralizing these toxins in a number of ways, providing that the systems is not compromised. Our body is capable of mounting a successful defense system from the toxins originating in the body, those being consumed, and those that are airborne. The reader may do well to consult a number of sites regarding the detoxification process.

NATURAL DETOXIFICATION: The processes by which the individual’s own body biochemical structure works to neutralize or eliminate toxins that are considered to be foreign. The biochemical processes work to remove the foreign substance from the tissues and metabolize it into a less toxic form or cause it to bind or complex with one of the many transport systems in the body so that its toxic properties are neutralized, or reduce it to a form that is more easily excreted. This is a normal body process that is enzymatic in nature often requiring cofactors that are derived from essential nutrients, whether from food or from supplements. Chronic toxicity with persistent symptoms can be related to chronic nutritional deficits or metabolic impairments.

ASSISTED DETOXIFICATION: Normally accomplished by the administration of drugs orally, by injection, or intravenously. Such drugs are usually designed to bind, complex, or change the chemical structure of a particular toxin and change to reduce its toxic properties or to make it easier to eliminate from the body.

In the months to come, we will feature articles that will assist us in methods of detoxification, both Natural and Assisted.

Mercury fillings called safe

Mercury fillings called safe2 studies track health of children over years
By Ronald KotulakChicago Tribune science reporterPublished April 19, 2006

Dental fillings containing mercury do not cause any measurable neurological problems in children who have had the fillings for at least seven years, according to two studies reported in Wednesday's issue of the Journal of the American Medical Association.

The studies are the first to compare children receiving mercury amalgam fillings with children who got mercury-free fillings made of composite materials, and were undertaken because of long-standing concerns about the use of mercury in "silver" fillings.

Dental amalgam, which contains 40 percent to 50 percent elemental mercury, has been in use for 150 years because the material is relatively cheap and long lasting. U.S. children currently have an estimated 100 million amalgam fillings.

However, the use of amalgam to fill cavities has sharply declined over the last 15 years, as patients increasingly prefer the look of composites, which better match the natural color of teeth. Seventy percent of fillings in the U.S. are now done with composite materials, generally a combination of plastic and silicate, according to the American Dental Association. Amalgam is still the material of choice for cavities that are difficult to keep free of saliva during filling.

Although the findings from the two studies may allow parents to breathe easier about mercury fillings, they still leave open the question of subtle neurological problems that may occur over decades.

"The studies indicate that on average we probably don't have much to worry about from amalgam used in the quantities that it is used for dental purposes," said Harvard Medical School neurologist David Bellinger, lead author of the New England Children's Amalgam Trial. "The studies do leave open the question that there could be some small percentage of children who are particularly sensitive [to mercury], and we wouldn't have been able to detect them in our study."

In an accompanying JAMA editorial, Dr. Herbert Needleman of the University of Pittsburgh School of Medicine, who played a key role in exposing the danger of lead poisoning in children, said further studies are needed to assess any long-term risks from dental mercury, including factors that may make some children more vulnerable.

Bellinger, who also was involved in lead-poisoning research in the 1970s, agreed that further studies of possible long-term adverse effects are warranted because mercury in high doses is known to damage the brain and nervous system.

A number of population studies have failed to find a link between mercury fillings and learning or memory problems.

But because the act of chewing can release a tiny amount of mercury vapor, scientists have been cautious about giving the metal a clean bill of health. Some people have become so concerned about a potential threat from mercury that they have had their amalgam fillings removed and replaced with composites.

Bellinger's trial, funded by the National Institutes of Health, was designed to assess the risks directly. It involved 534 children from the Boston area and Farmington, Maine, who were 6 to 10 years old and who never had a cavity filled, despite needing dental care. Half of them were randomly assigned to receive mercury amalgam fillings and the other half a mercury-free composite. The average child received 10 fillings.

After five years the researchers found no significant difference between the two groups in IQ scores, memory, visual-motor function and kidney function. The children were evaluated yearly with a large battery of tests.

Children receiving the amalgam fillings had 50 percent more mercury in their urine than those getting the composites, Bellinger said, though the levels were still relatively low.

Children with amalgam fillings averaged 0.9 micrograms of mercury in their urine, compared with 0.6 in children with composite fillings. (A microgram is one millionth of a gram.) Levels of mercury in urine higher than 50 micrograms have been associated with neurological, kidney and immunological impairment.

Other common sources of mercury exposure include contamination in some foods--such as fish--and air pollution.

The second study, headed by Dr. Timothy DeRouen of the University of Washington, involved 507 children ages 8 to 10 in Lisbon, Portugal. The children were randomly assigned to receive mercury or composite fillings. After seven years the researchers found no significant differences in neurological function between the two groups.

The only difference was that the children with the composite fillings were 50 percent more likely to need them replaced.

"These findings, combined with the trend of higher treatment need later among those receiving composite, suggest that amalgam should remain a viable dental restorative option for children," DeRouen said.

"The fact that two studies done independently in different regions of the world come up with the same conclusion suggests to me that we probably are on the right track," Bellinger said.

The International Academy of Oral Medicine and Toxicology, which is opposed to mercury fillings and water fluoridation, criticized the two studies in a statement as "designed to fail." The group also called the research unethical, saying the child subjects and their guardians were not fully informed of the potential risks of exposure to a toxic substance.

Chicago-area dentists said they rarely receive questions about potential health problems from mercury fillings.

"The studies provide more scientific proof that amalgam fillings don't cause neurological problems," said Dr. Trucia Drummond, a dentist with offices at 30 N. Michigan Ave. in Chicago. "In the last 10 years I've had almost no questions from patients about the safety of amalgam. They usually opt for the more aesthetic composite fillings."

Dr. Keith Suchy, a dentist who practices in Westchester, agreed.

"The trend toward composites is being driven by their ability to match tooth color and not by any concerns about amalgam safety," he said.