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Dental amalgam is 50% metallic mercury (Hg) by weight and Hg vapour continuously evolves from in-place dental amalgam, causing increased Hg content with increasing amalgam load in urine, faeces, exhaled breath, saliva, blood, and various organs and tissues including the kidney, pituitary gland, liver, and brain. The Hg content also increases with maternal amalgam load in amniotic fluid, placenta, cord blood, meconium, various foetal tissues including liver, kidney and brain, in colostrum and breast milk. Based on 2001 to 2004 population statistics, 181.1 million Americans carry a grand total of 1.46 billion restored teeth. Children as young as 26 months were recorded as having restored teeth. Past dental practice and recently available data indicate that the majority of these restorations are composed of dental amalgam. Employing recent US population-based statistics on body weight and the frequency of dentally restored tooth surfaces, and recent research on the incremental increase in urinary Hg concentration per amalgam-filled tooth surface, estimates of Hg exposure from amalgam fillings were determined for 5 age groups of the US population. Three specific exposure scenarios were considered, each scenario incrementally reducing the number of tooth surfaces assumed to be restored with amalgam. Based on the least conservative of the scenarios evaluated, it was estimated that some 67.2 million Americans would exceed the Hg dose associated with the reference exposure level (REL) of 0.3 μg/m(3) established by the US Environmental Protection Agency; and 122.3 million Americans would exceed the dose associated with the REL of 0.03 μg/m(3) established by the California Environmental Protection Agency. Exposure estimates are consistent with previous estimates presented by Health Canada in 1995, and amount to 0.2 to 0.4 μg/day per amalgam-filled tooth surface, or 0.5 to 1 μg/day/amalgam-filled tooth, depending on age and other factors.

The ADA Laboratories purchased and evaluated nine amalgam separators available in the United States to determine their efficiency of amalgam removal. Table 1 lists all amalgam separators tested with product information provided by each manufacturer.

Children’s blood-lead concentration (B-Pb) is well studied, but little is known about cadmium (B-Cd) and mercury (B-Hg), in particular for central Europe. Such information is necessary for risk assessment and management. Therefore, we here describe and compare B-Pb, B-Cd and B-Hg in children in six European, and three non-European cities, and identify determinants of these exposures. About 50 school children (7-14 years) from each city were recruited (totally 433) in 2007-2008. Interview and questionnaire data were obtained. A blood sample was analyzed: only two laboratories with strict quality control were used. The European cities showed only minor differences for B-Cd (geometric means 0.11-0.17 μg/L) and B-Pb (14-20 μg/L), but larger for B-Hg (0.12-0.94 μg/L). Corresponding means for the non-European countries were 0.21-0.26, 32-71, and 0.3-3.2 μg/L, respectively. For B-Cd in European samples, traffic intensity close to home was a statistically significant determinant, for B-Hg fish consumption and amalgam fillings, and for B-Pb sex (boys higher). This study shows that European city children’s B-Cd and B-Pb vary only little between countries; B-Hg differs considerably, due to varying tooth restoration practices and fish intake. Traffic intensity seemed to be a determinant for B-Cd. The metal concentrations were low from a risk perspective but the chosen non-European cities showed higher concentrations than the cities in Europe.

OBJECTIVE:
The objective of this study is to evaluate the awareness of patients with dental fillings about the toxicity of mercury in dental amalgam.

MATERIALS AND METHODS:
Adult patients having at least one amalgam filling in their mouth were recruited in the Oral Diagnosis Department of OAUTHC, Ile-Ife Dental Hospital. Participants were recruited consecutively as they report in the clinic. Data were collected using a structured questionnaire developed based on standard questions from relevant publications. They were asked to indicate the type of filling material in their mouth, ingredients of the material, previous knowledge of mercury in dental amalgam and ailments due to mercury. They were to indicate their level of agreement with filling their cavities with dental amalgam despite prior information about its mercury content.

RESULTS:
There were about 446 respondents analyzed; male, 194 (43.5%); female 252 (56.5%). Six (1.4%) and 21 (4.7%) respondents were primary and secondary schools students respectively; 15(3.4%) had no formal education while about 410 (91.9%) were either undergraduate or graduate. All of them had at least one amalgam filling. 249 (55%) participants know the type of filling on their teeth; 156 (34.5%) had the knowledge of the presence of mercury in dental amalgam while 26.1% believed mercury can cause problems in human beings. About 90 (19.9%) participants claimed to have heard about adverse reactions to dental amalgams and 34 (7.5%) of them have heard about people recovering from an illness after removal of their filling. The level of agreement with filling their cavities with amalgam despite prior knowledge of its mercury content was 74% while 60% was observed for allowing just any material to be placed on their teeth.

CONCLUSION:
Awareness of toxicity of mercury in dental amalgam was slightly low among the respondents studied. This may be suggested to be a reflection of nonexistent of global amalgam controversy in Nigeria.

OVERVIEW:
The authors review factors related to office infrastructure and operation that dentists should consider when investing in an amalgam separator. They also provide a cost-analysis worksheet and checklist that may be useful to dentists who are considering purchasing a separator.

CONCLUSIONS AND CLINICAL IMPLICATIONS:
Before purchasing or installing an amalgam separator, dentists should consider factors specific to the available models, including size and maintenance requirements. In addition, office-specific actors should be considered (such as the plumbing configuration, available space for installation and subsequent access to that space for equipment replacement and maintenance). Dentists also should research whether any local or state regulations exist that might influence product selection or installation. Dentists should consider the effect an amalgam separator could have on existing suction equipment. Finally, dentists will want to consider the short- and long-term costs (including maintenance and parts replacement) of the available options.