“Their observations and astute comment prompt me to submit this report of my own recent exacerbation, associated with a poorly defined and easily overlooked dental trigger, an altogether different process from the initial attack 40 years ago and my own recollection of it.”
“To measure the effects of chronic low-level exposure to inorganic mercury, the neuropsychological performances of 13 female dental auxiliary workers with elevated head mercury levels (as measured by an X-ray fluorescence technique) were compared with 13 workers with no measurable mercury levels. Workers with elevated mercury levels scored significantly less well on the Recurrent Figures, and SCL-90-R, but not on the WAIS, Rey’s AVL, PASAT, BGT, Grooved Pegboard, and Finger Tapping tests. Chronic subtoxic levels of inorganic mercury appear to produce mild changes in short-term nonverbal recall and heightened distress generally, and particularly in categories of obsessive compulsion, anxiety and psychoticism, without alterations in general intellectual functioning, attention, verbal recall, and motor skills.”
“Samples from the central nervous system (occipital lobe cortex, cerebellar cortex and ganglia semilunare) and kidney cortex were collected from autopsies and analysed for total mercury content using neutron activation analyses. Results from 34 individuals showed a statistically significant regression between the number of tooth surfaces containing amalgam and concentration of mercury in the occipital lobe cortex (mean 10.9, range 2.4-28.7 ng Hg/g wet weight). The regression equation y = 7.2 + 0.24x has a 95% confidence interval for the regression coefficient of 0.11-0.37. In 9 cases with suspected alcohol abuse mercury levels in the occipital lobe were, in most cases, somewhat lower than expected based on the regression line. The observations may be explained by an inhibition of oxidation of mercury vapour. The regression between amalgams and mercury levels remained after exclusion of these cases. The kidney cortex from 7 amalgam carriers (mean 433, range 48-810 ng Hg/g wet weight) showed on average a significantly higher mercury level than those of 5 amalgam-free individuals (mean 49, range 21-105 ng Hg/g wet weight). In 6 cases analysis of both inorganic and total mercury was carried out. A high proportion (mean 77% SD 17%) of inorganic mercury was found. It is concluded that the cause of the association between amalgam load and accumulation of mercury in tissues is the release of mercury vapour from amalgam fillings.”
“This paper discusses metal exposure in the male, the nonpregnant female, and the maternal-offspring unit. In the first two situations, the primary targets are the gonads. In the mother-offspring unit, consideration must be given to effects on the fertilized ovum, the growth of the embryo, and, finally, to the fetal and perinatal stages. The central nervous system may be especially vulnerable during development. The placenta also undergoes development, and either the placenta or the fetus may be the primary target. In humans, certain metals may cause abortion or other effects on the conceptus. Effects may also be produced by metal exposure both in utero and in the suckling infant. For example, methylmercury gives rise to a range of effects on the central nervous system at doses lower than those producing damage to the mature nervous system. Effects of lead and arsenic are associated mainly with postnatal exposures during infancy and early childhood, but there is reason to believe from animal experiments that some effects may occur from prenatal exposures to certain metal compounds.”
“A group of dentists had their offices monitored for mercury vapour and content. Low values were found compared to other surveys, but a variety of locations of a reservoir of mercury-rich materials was identified.”
“Summary: The cases cited in the literature indicate that the potential for toxicity or poisoning with mercury exists as an occupational hazard to the dentist and dental personnel. The cause is the elemental form of mercury resulting from vaporization due to an accidental spill of mercury. Undetected or unreported spills produced chronic and low level exposures. When exposure to mercury affected the dental patient, it was during the placement of the amalgam restoration that an allergic reaction was precipitated. When allowed, the reaction was self-limiting, resolving by its own processes. For patients who are particularly allergic to mercury and not amenable to antihistamine therapy, removal of the newly placed amalgam restoration is recommended.”
“The maximum content of mercury forming intermetallic compounds has been determined in dental amalgams prepared from alloys with different copper contents. In amalgams made from alloys with silver contents less than about 42% there is a risk of occurrence of free mercury if an effective condensation technique has not been used.”
“Intra-oral air was analyzed for mercury (Hg) vapor concentration in 46 subjects, 35 of whom had dental amalgam restorations. Measurements were made with a Jerome Hg detector both before and ten min after chewing stimulation. Subjects with dental amalgams had unstimulated Hg vapor concentrations that were nine times greater than basal levels in control subjects with no amalgams. Chewing stimulation in subjects with amalgams increased their Hg concentration six-fold over unstimulated Hg levels, or a 54-fold increase over levels observed in control subjects. Concentrations of Hg measured in intra-oral air larger than those reported in expired air were attributed to the rate and direction of air passage across amalgam surfaces. There were significant correlations between Hg vapor released into intra-oral air after chewing stimulation and the numbers and types of amalgam restorations. It is concluded that intraoral air is a reliable physiological indicator of Hg released from dental amalgam that may reflect a major source of chronic Hg exposure.”
“Serial measurements of Hg concentration in intra-oral air were made during and after chewing stimulation in 35 subjects with occlusal amalgam restorations. Hg concentrations remained elevated during 30 min of continuous chewing and declined slowly over 90 min after cessation of chewing. By curve-fitting and integration analysis of data during these time periods (including corrections for respiratory volume, retention rate of inspired Hg, oral-to-nasal breathing ratios, and consumption of three meals and three snacks per day), we calculated that all subjects received an average daily Hg dose of approximately 20 micrograms. Subjects with 12 or more occlusal amalgam surfaces were estimated to receive a daily Hg dose of 29 micrograms, whereas in subjects with four or fewer occlusal amalgam surfaces, the dose was 8 micrograms. These Hg dosages from dental amalgam were as much as 18-fold the allowable daily limits established by some countries for Hg exposure from all sources in the environment. The results demonstrate that the amount of elemental Hg released from dental amalgam exceeds or comprises a major percentage of internationally accepted threshold limit values for environmental Hg exposure. It is concluded that dental amalgam Hg makes a major contribution to total daily dose.”