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Epicutaneous patch testing of a battery of 35 dental test substances was carried out in 24 patients with visible lichenoid oral mucosal lesions and in 24 patients with burning mouth syndrome (BMS) without any visible lesions. Reactions to mercury ammonium chloride were found in 33% (8/24) of the patients with visible lesions compared to 0% (0/24) of the patients with BMS. The difference was statistically significant. In 7 of the 8 patients who reacted to mercury, total or partial regression of the lesions was observed after removal of dental amalgam. Reactions to nickel sulfate were found in 21% (5/24) of the patients with BMS compared to 3% (1/24) of the patients with lichenoid lesions. This difference was also statistically significant. Nickel is a rare component in dental restorations, but the oral mucosa is daily exposed to nickel through food and water intake. Removal of nickel from the environment of the patient can therefore be hard to accomplish.

The findings presented here suggest that mercury from dental amalgam may play a role in the etiology of oral cavity health. Comparisons between subjects with and without amalgam showed significant differences of diseases of the mouth. Subjects who had amalgams removed reported that symptoms of diminished oral health were improved or eliminated after removal. The data suggest that inorganic mercury from dental amalgam does affect the oral cavity.

The findings presented here suggest that mercury poisoning from dental amalgam may play a role in the etiology of many health disorders. A comparison of 125 health symptoms was made between a group of subjects with amalgams and a control group without amalgams. The 47 amalgam subjects reported a total of 45% (P = .0001) more health symptoms per subject compared to an age and sex matched control group of 48 nonamalgam subjects. Symptoms that were exhibited significantly more by the amalgam group were less happiness, less peace of mind, poorer reading ability, foul breath, tremors, colds and respiratory infections, heart or chest pains, heartburn, menstrual difficulties, sudden anger, depression, irritability, tiring easily, tiring in the morning, hay fever, trouble with night vision, and a metallic taste in mouth. Most of these symptoms can be explained by mercury toxicity. The data suggest that inorganic mercury poisoning from dental amalgam does affect health.

There has been much publicity about the harmful effects of mercury from dental amalgam which has resulted in a number of individuals having their amalgams removed. This paper reports on the research done on some of these people as well as presenting hypotheses on how amalgam mercury may be affecting health.

The cumulative survival rate (retention of both cusps) and the fracture pattern of 1639 endodontically treated posterior teeth were assessed in a retrospective study. All teeth had an MO/DO or an MOD cavity restored with amalgam without cuspal overlays. The 20-year survival rate of teeth with an MO/DO cavity was markedly higher than that of teeth with an MOD cavity. The lowest survival rate was found for the upper premolars with an MOD cavity: 28% of these teeth fractured within 3 years after endodontic therapy, 57% were lost after 10 years, and 73% after 20 years. Generally, the cusp most prone to fracture was the lingual one, and lingual fractures caused significantly more damage to the periodontal tissues than did facial or total crown fractures. The severity of periodontal damage increased with posterior location of the tooth. By far the most serious failures, irrespective of the cavity type, were found for the upper second molar, as 10 of 29 fractures led to extraction. It is concluded that amalgam, especially in MOD cavities, is an unacceptable material for restoration of endodontically treated posterior teeth if used without cuspal overlays.