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Foreign Dental Work Put To Test
WBNS-10TV ^ | 27 Feb, 2008 | 10tv investigative team

Posted on 02/27/2008 5:42:59 PM PST by Patriotic Thunder

COLUMBUS, Ohio - Chris Collier has been a patient of Dr. Dave Rummel for 30 years.

When it comes to teeth, Collier is more concerned about his health than his smile.

"The reason I come here is because I know I can trust the dentist I have," Collier said. "I know I can get good workmanship."

SLIDESHOW: Images From Report

Rummel is one of the few dentists in central Ohio who makes his own crowns, bridges and dentures, but most other dentists rely on outside dental labs, 10 Investigates' Lindsey Seavert reported.

The labs can be down the street or even overseas, increasingly outsourcing work to India, Mexico and China. Chinese imports, like jewelry and toys, have been under heavy scrutiny for the last year because of lead concerns.

The dental community is concerned that unsafe metals have reached their industry, too.

"It's one thing if it's a toy a child plays with for 20 minutes. It's another thing if it is somebody's mouth for a lifetime," Rummel said. "There is an issue here."

10 Investigates obtained a letter from the National Association of Dental Laboratories that outlined the concerns. The organization told the Food and Drug Administration that outsourcing would increase because dental work created overseas is cheaper.

Even more of a concern is that dental labs or mostly "mom and pop" shops are unregulated in Ohio and 46 other states. Because of that, labs can outsource and no one may ever know, Seavert reported.

"Currently, laboratories that are outsourcing work overseas are required to disclose that to their dentist through existing FDA regulations but that is where it stops," said Bennett Napier of the NADL. "That disclosure does not have to pass on to the patient."

10 Investigates learned the deception goes one step further. Sometimes labs don't tell dentists, leaving them to unknowingly place foreign products in patient's mouths.

In the U.S., the materials in dental work are FDA approved. It is supposed to be that way in foreign countries but the FDA has no way to enforce it, Seavert reported.

The NADL said the FDA approached them first in 2004 and then in 2007, concerned about the increasing number of imported dental devices passing U.S. borders and acknowledged the need to better enforce dental lab regulations.

With millions of products and not enough manpower, the work crosses borders to places like Ravenna, Ohio. There, a 73-year-old woman hired a lawyer to sue her dentist. It began when she received a new dental bridge last year. The pain became so severe that she could not chew.

"She began to have some pretty significant complications and reactions and infection that stemmed from the restoration that ultimately had to be removed," Napier said.

The woman, who requested anonymity, told 10 Investigates that she later discovered her bridge was made in China. Worried, she had a lab test it for hazardous materials.

The lab determined that the porcelain filed away in her mouth contained lead. She has since undergone two surgeries, Seavert reported.

With 300 unregulated dental labs in Ohio and an estimated 7 million crowns coming into the country each year, 10 Investigates wondered how much a threat lead is in outsourced dental work.

We ordered eight crowns from four labs in China that advertise in industry magazines. With help from Rummel's lab, we received our product 10 days later.

Only one lab identified materials in the crowns. 10 Investigates first used a device that screens for lead. Of the eight, one crown came up positive.

We sent our sample to a Cleveland lab - NSL Analytics - to provide scientific proof. They specialize in testing metals and began by separating the porcelain from the metal.

The crown is diluted in a test tube that becomes a solution chemists test for lead. The machines give an instant reading of lead. 10 Investigates' results came back at 210 parts per million. The Ravenna woman's bridge measured 160 parts per million.

"We don't know what the FDA or the American Dental Association considers to be a risk as far as lead content," said Carm D'Agostino, a chemist.

With no known research on lead in dental work, the lab can only compare to toy standards.

Toys leaching lead over 90 parts per million are hazardous, so what about 210 parts per million in your mouth?

"I guess that tells me I need to be a little bit more concerned about other potential sources of lead," said Dr. Marcel Casavant, who runs central Ohio's lead program and poison control center. "I never would have guessed somebody would have put lead into a piece or a part installed into a human being."

Casavant said adults can live with lead poisoning for years and not know it.

"The symptoms are what we call non-specific - a little ache or a pain - abnormal bowel function," Casavant said.

Even high blood pressure and kidney trouble could be symptoms, according to Casavant.

He said he would never link lead poisoning to dental work but would have to add it to his list of questions when asking people what kind of dental work has occurred.

The NADL said that 10 Investigates' findings prove that the FDA needs to do more.

"It reinforces the concerns we have as an industry and concerns the FDA expressed to us that the potential is there," Napier said.

The NADL letter asks the FDA to track dental work from foreign labs to patient records. They want the FDA to register all labs, require them to disclose where they get their dental work and label what materials are in it.

The Ohio Dental Board admitted that is not sure what is happening in the state's roughly 300 labs and has no plans to regulate them. Lili Reitz, the director of Ohio's dental board, said the burden relies on the dentist.

"Ignorance is not a defense when you are ultimately responsible for what is going into the mouths of the patients that you serve," Reitz said.

Rummel said that 10 Investigates' lead findings only prove outsourcing comes with a risk.

"If a medical device is made out of a foreign country, I think the patient should know," Rummel said.

He recommends that people ask their dentist where their work is made.

"I think you can't really get something for nothing and I think (if) we start going down that road, we all suffer," Rummel said.

In response to our story, the Ohio Dental Board on Wednesday adopted a recommendation to the dentists they regulate.

They are asking dentists to give labs a form that would require the labs to disclose where their dental work is made.

On a federal level, 10 Investigates has asked the FDA for a response to our findings for the past two months.

On Wednesday, they told us that they are reviewing our report and developing a strategy to address our findings on all imported dental devices.

The Ohio Dental Association said that it would require their members to fill out the form in hopes of giving it a better idea of how many labs are outsourcing.


TOPICS:
KEYWORDS: china; competition; crowns; dentistry; dentists; health; lead
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1 posted on 02/27/2008 5:43:03 PM PST by Patriotic Thunder
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To: Patriotic Thunder

Is anybody surprised?


2 posted on 02/27/2008 5:46:26 PM PST by George from New England
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To: Patriotic Thunder

Another casualty of outsourcing and of trade with China.

If you can, ALWAYS pay more for non-metallic crowns. The bonus is that they look almost exactly like teeth, too.


3 posted on 02/27/2008 5:47:19 PM PST by RepublitarianRoger2
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To: Patriotic Thunder

Gee, isn’t that special.


4 posted on 02/27/2008 5:49:03 PM PST by steve86 (Acerbic by nature, not nurture™)
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To: theDentist

American Dentists are placing LEAD contaminated crowns from China


Now I know YOU would never do this, right?


5 posted on 02/27/2008 5:51:09 PM PST by Responsibility2nd
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To: Patriotic Thunder

I’ve been really good at not buying food that says ‘product of china’ and don’t buy generic drugs anymore... but apparently that isn’t good enough with a majority of precursors coming from over there, and major pharmaceutical companies relocating manufacturing over there.

Nixon went to China.

‘Global trade’ is just another way of saying Welcome to the third (turd) world, Americans. We’ve sunk to their level with the gracious help of our friends in power. It didn’t have to happen though. We encouraged it. Ask any bot.


6 posted on 02/27/2008 5:57:36 PM PST by glock rocks ( I can see clearly now the brain is gone... gonna be a bright bright sunshiny day.)
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To: George from New England

well now we can get salmonella infected crowns from Mexico or lead tainted crowns from China. Which would you pick?


7 posted on 02/27/2008 5:59:04 PM PST by utherdoul
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To: Patriotic Thunder

I wonder how the lead you absorb from dental parts from China compares with the leas absorbed from using leaded gasoline...


8 posted on 02/27/2008 6:05:38 PM PST by Kay Ludlow (Free market, but cautious about what I support with my dollars)
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To: RepublitarianRoger2

I had one break the other week, it looked like porcelain on the outside but the inside was lined with some metallic looking stuff, never thought anything of it. I can’t tolerate the metal temporary crowns at all, instant pain.

I wonder if there’s any dentists here who could comment ?


9 posted on 02/27/2008 6:08:12 PM PST by 1066AD
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To: RepublitarianRoger2
If you can, ALWAYS pay more for non-metallic crowns. The bonus is that they look almost exactly like teeth, too.

Aren't they typically porcelain bonded to metal? I don't see how they could be completely non-metallic.

10 posted on 02/27/2008 6:14:39 PM PST by steve86 (Acerbic by nature, not nurture™)
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To: 1066AD

I think there are both porcelain crowns (which may also have some resin or acrylic parts), and then there are metal crowns with porcelain bonded to them on the outside. Sounds like you got the latter.


11 posted on 02/27/2008 6:15:25 PM PST by RepublitarianRoger2
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To: 1066AD; steve86

OK, I’m no dental expert, but I googled for “metal-free crowns” and it appears that they use some kind of tooth-colored zirconium oxide for the inner part.

Feel free to correct me if you know more about dentistry than I do (which wouldn’t be very hard!)


12 posted on 02/27/2008 6:20:24 PM PST by RepublitarianRoger2
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To: Patriotic Thunder

My dentist uses porcelain crowns made by a Japanese artisan living in California. Cheap they are not!


13 posted on 02/27/2008 6:20:29 PM PST by proxy_user
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To: 1066AD
The metal could be non-precious or contain gold and other expensive metals. You need to ask the dentist that place the crown. The metal thimble shape is usually fabricated first and the porcelain is baked to the metal.
14 posted on 02/27/2008 6:26:26 PM PST by tongass kid
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To: RepublitarianRoger2

Well, I’ll have to do research. I did look in my Schedule of Services, shows:

Crown - porcelain fused to high noble metal $629
Crown - porcelain fused to predominately base metal $590
Crown - full cast high noble metal $608
Crown - full cast predominately base metal $532

And then the temporary stainless steel crowns


15 posted on 02/27/2008 6:31:09 PM PST by steve86 (Acerbic by nature, not nurture™)
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To: Patriotic Thunder
Toys leaching lead over 90 parts per million are hazardous, so what about 210 parts per million in your mouth?

Let's think about that. How long will it take that crown to "leach" that 210 parts per million? How long does it take a crown to dissolve in your mouth? Is this really a lead poisoning hazard, or just a lot of innuendo that creates the perception. Public service, or fearmongering sensationalism?

16 posted on 02/27/2008 6:31:14 PM PST by tacticalogic ("Oh bother!" said Pooh, as he chambered his last round.)
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To: tacticalogic

I guess for the lady with abscesses and infections, it happened pretty quick


17 posted on 02/27/2008 6:32:58 PM PST by steve86 (Acerbic by nature, not nurture™)
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To: steve86
I got two crowns last week, to the tune of $2,200....they must be filled with gold!

sw

18 posted on 02/27/2008 6:35:28 PM PST by spectre (spectre's wife)
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To: spectre

I did get a $629 model last year. Seems fine.


19 posted on 02/27/2008 6:36:44 PM PST by steve86 (Acerbic by nature, not nurture™)
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To: steve86

Kind of odd that people can walk around with bullets (990,000 ppm?) in them for years and not have that happen.


20 posted on 02/27/2008 6:36:53 PM PST by tacticalogic ("Oh bother!" said Pooh, as he chambered his last round.)
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To: George from New England

US dentists have used fillings containing mercury.

Not that it’s the same thing, but it might raise a few eyebrows if the public were educated.


21 posted on 02/27/2008 6:37:37 PM PST by Brilliant
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To: steve86
They are pricey...

sw

22 posted on 02/27/2008 6:38:35 PM PST by spectre (spectre's wife)
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To: Brilliant
Her we go again with the mercury scare, old news, ok to lower your eyebrows.
23 posted on 02/27/2008 6:48:45 PM PST by tongass kid
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To: tongass kid

Her=Here


24 posted on 02/27/2008 6:50:41 PM PST by tongass kid
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To: tongass kid

Mercury (Amalgam) were usually in a tooth. A crown goes over the whole tooth and contacts the gums, therefore in contact with blood/tissue. I wouldn’t lower your eyebrows, and when you do, it won’t matter anyways.


25 posted on 02/27/2008 6:55:03 PM PST by Patriotic Thunder
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To: Patriotic Thunder

Fear sells very well, scary movies, big foot, UFOs and Nessy.
For a reality check go to FDA.gov and read about the types of filling material available including silver amalgam and you will not be so afraid. Sorry, can not help you with the other scary items.


26 posted on 02/27/2008 7:02:36 PM PST by tongass kid
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To: JACKRUSSELL

ping


27 posted on 02/27/2008 7:06:09 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: Kay Ludlow

Who uses leaded gasoline any more?


28 posted on 02/27/2008 7:07:24 PM PST by metmom (Welfare was never meant to be a career choice.)
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To: Patriotic Thunder

A buddy of mine is a partner at a dental lab in KC. I’ll have to ask him about this.

Mark


29 posted on 02/27/2008 7:08:21 PM PST by MarkL
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To: Patriotic Thunder

American dentists have been using mercury tainted fillings for generations. I think that’s why I’m getting a root canal job every 6 months now.


30 posted on 02/27/2008 7:10:21 PM PST by DManA
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To: DManA

Yep, blame the dentist. This is joke, right?


31 posted on 02/27/2008 7:14:22 PM PST by tongass kid
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To: DManA

I have had so many fillings in my mouth since I was 6 (1957)....I should be dead, if mercury is a problem....(seems I have problem teeth.)


32 posted on 02/27/2008 7:25:38 PM PST by goodnesswins (Being Challenged Builds Character; Being Coddled Destroys Character)
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To: tacticalogic
What is the mass of a crown in grams?

What proportion of that is lead?

Shouldn't be too hard.

The other question is, once the metal core is exposed, what substances which you eat will increase the solubility of the lead? Lead will generally form insoluble precipitates, but that didn't save the Romans.

Cheers!

33 posted on 02/27/2008 7:34:41 PM PST by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: Patriotic Thunder

btt


34 posted on 02/27/2008 7:43:58 PM PST by FreeInWV
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To: spectre

They could be. My boyfriend’s dentist talked him into choosing porcelain bonded to gold, saying that the regular metals aren’t good for teeth! I have to investigate this claim. I just laughed at him when he told me.


35 posted on 02/27/2008 7:49:57 PM PST by CaliGirl-R (I miss my Hunter "pings")
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To: Patriotic Thunder

If you ever need a crown go to a dentist who makes his own. You get your crown the same day. It is wonderful. They also look and fit better.


36 posted on 02/27/2008 7:56:15 PM PST by therut
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To: Patriotic Thunder

You would think someone would have come up with a titanium crown by now. Coat it with titanium dioxide and it stays white forever ... and it will never get sunburned, either.


37 posted on 02/27/2008 7:57:09 PM PST by LiberConservative
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To: tacticalogic
Let's think about that. How long will it take that crown to "leach" that 210 parts per million? How long does it take a crown to dissolve in your mouth? Is this really a lead poisoning hazard, or just a lot of innuendo that creates the perception. Public service, or fearmongering sensationalism? What happened ot Rome after they built lead lined aqaducts? They went crazy, having sex orgies, going on eating binges, and they fell. They fell. Lead makes one crazy.
38 posted on 02/27/2008 7:58:41 PM PST by LoneRangerMassachusetts (<I>)
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To: grey_whiskers
What is the mass of a crown in grams?

Quarter ounce max - 7 grams?

What proportion of that is lead?

210 ppm = .21mg/g x 7 = 1.47mg, assuming you can leach all of it out before it gets replace once the core is exposed.

Allowed occupational exposure = 40ug/dl.

Average adult blood volume = 6L (600dl)x40ug/dl = 24000ug/1000 = 2.4mg.

39 posted on 02/27/2008 8:00:52 PM PST by tacticalogic ("Oh bother!" said Pooh, as he chambered his last round.)
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To: tacticalogic
Let me fix this.

Let's think about that. How long will it take that crown to "leach" that 210 parts per million? How long does it take a crown to dissolve in your mouth? Is this really a lead poisoning hazard, or just a lot of innuendo that creates the perception. Public service, or fearmongering sensationalism?

What happened ot Rome after they built lead lined aqaducts? They went crazy, having sex orgies, going on eating binges, and they fell. They fell. Lead makes one crazy.

40 posted on 02/27/2008 8:01:20 PM PST by LoneRangerMassachusetts (<I>)
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To: Patriotic Thunder

bump


41 posted on 02/27/2008 8:02:20 PM PST by AnimalLover ( ((Are there special rules and regulations for the big guys?)))
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To: Patriotic Thunder
I'm in need of a root canal and a new crown - its either that or allow the infection to spread and incur worse damage to the healthier teeth. Sometimes one does need to avail oneself of the dentist.
42 posted on 02/27/2008 8:03:38 PM PST by goldstategop (In Memory Of A Dearly Beloved Friend Who Lives In My Heart Forever)
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To: LoneRangerMassachusetts
What happened ot Rome after they built lead lined aqaducts? They went crazy, having sex orgies, going on eating binges, and they fell. They fell. Lead makes one crazy.

That's one theory of what happened to Rome. Do you think there's any basis for basing the estimated risk on the actual amount of lead involved, or is that just foolishness?

43 posted on 02/27/2008 8:05:36 PM PST by tacticalogic ("Oh bother!" said Pooh, as he chambered his last round.)
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To: tongass kid

They didn’t know any better.


44 posted on 02/27/2008 8:08:37 PM PST by DManA
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To: Responsibility2nd

If i find out my new crown was made in Leadsville china, I am punching someone’s teeth out!


45 posted on 02/27/2008 8:12:20 PM PST by redstateconfidential (If you are the smartest person in the room,you are hanging out with the wrong people.)
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To: tacticalogic

“Kind of odd that people can walk around with bullets (990,000 ppm?) in them for years and not have that happen.”

I’m still walking around with a fair amount of a bullet in my left leg. Been there for about thirty years. No problem.

Elemental lead is not dangerous: It’s the oxides of lead (and other lead compounds)that are dangerous as the body can easily absorb them.


46 posted on 02/27/2008 8:15:37 PM PST by EEDUDE
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To: tacticalogic
Very good, except for a quibbling type point.

Isn't occupational exposure based on external levels?

...and then that would be affected by the possibility of breathing in lead-laden dust, etc. depending on circumstances.

Here's a related question. There is still epidemiological evidence on toxicity of lead-based paint, on inner-city children who eat chipping paint.

Would it be possible to back into a toxicologically significant dose (crowns and paint chips both are inside the mouth...) from that data?

Cheers!

47 posted on 02/27/2008 8:17:05 PM PST by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: grey_whiskers

Check out the video

http://www.10tv.com/vplayer.php?clip=2008_02_27_Denist_Work_To_Test.wmv&showpromo=adsrv.dispatch.com/RealMedia/ads/adstream_lx.ads/www.10tv.com/video/L18/662454528/Top3/CDispatch/10tv_osumc_break_vv/10tv_break6_vv_video/544e49676645664536436b4144537278


48 posted on 02/27/2008 8:20:28 PM PST by Patriotic Thunder
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To: EEDUDE
Elemental lead is not dangerous: It’s the oxides of lead (and other lead compounds)that are dangerous as the body can easily absorb them.

In this case, the body has to separate it from an amalgam/alloy (at 210 ppm) first. I'm just not seeing the potential to get enough lead exposure from one of these to cause the problems that are being attributed to it.

49 posted on 02/27/2008 8:20:49 PM PST by tacticalogic ("Oh bother!" said Pooh, as he chambered his last round.)
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To: Patriotic Thunder
I could reach the link but my browser would not play the video.

I'll try again tomorrow...

Thanks, and
Cheers!

50 posted on 02/27/2008 8:22:42 PM PST by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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