Mercury

“Mercury vapor released from one, two and four amalgam restorations in pregnant rats and mercury concentrations in maternal and fetal organs were studied. Dental treatment was given on day 2 of pregnancy. Mercury concentration in air samples drawn from each metabolism chamber with a rat were measured serially for 24 h on days 2, 8 and 15 of pregnancy. On each day of pregnancy, the amount of mercury in 24 h air samples was in proportion to the amalgam surface areas. Linear regression analysis showed relatively high correlation coefficients between the mercury content and amalgam surface areas, and the coefficients were statistically significant. A highly significant correlation was also found between the number of amalgam fillings and their surface areas. Mercury concentrations in major maternal organs with one, two and four amalgam fillings tended to increase with the increasing amalgam surface areas. Spearman’s rank correlation test revealed significant correlations in the brain, liver, kidneys and placenta but not in the lung. Furthermore, significant correlations were also found between the mercury concentrations in all maternal organs and the amount of mercury in 24 h air samples on day 15 of pregnancy. Mercury concentrations in fetal brain, liver and kidneys were much lower than those of the dams but liver and kidneys showed positive correlations between the mercury content and maternal amalgam surface areas. Similar correlations were observed between the mercury concentrations in fetal organs and the amount of mercury in 24 h air samples on day 15 of pregnancy. In fetal brain, no significant correlations were found between either maternal amalgam surface areas or the amount of mercury in 24 h samples on day 15 of pregnancy but significant uptake of mercury was found in the samples from the dams given four amalgam fillings. The results of the present study demonstrated that mercury vapor released from the amalgam fillings in pregnant rats was distributed to maternal and fetal organs in dose-dependent amounts of the amalgam fillings.”

“OBJECTIVES:

The purpose of this study was to evaluate treatment of patients suffering from chronic ill health with a multitude of symptoms associated with metal exposure from dental amalgam and other metal alloys.

SETTING AND DESIGN:

We included 796 patients in a retrospective study using a questionnaire about symptom changes, changes in quality of life as a consequence of treatment and assessment of care taking.

METHODS:

Treatment of the patients by removal of offending dental metals and concomitant antioxidant therapy was implemented according to the Uppsala model based on a close co-operation between physicians and dentists.

RESULTS:

More than 70% of the responders, remaining after exclusion of those who had not begun or completed removal, reported substantial recovery and increased quality of life. Comparison with similar studies showed accordance of the main results. Plasma concentrations of mercury before and after treatment supported the metal exposure to be causative for the ill health.

MAIN FINDINGS:

Treatment according to the Uppsala model proved to be adequate for more than 70% of the patients. Patients with a high probability to respond successfully to current therapy might be detected by symptom profiles before treatment.

CONCLUSIONS:

The hypothesis that metal exposure from dental amalgam can cause ill health in a susceptible part of the exposed population was supported. Further research is warranted to develop laboratory tests to support identification of the group of patients responding to current therapy as well as to find out causes of problems in the group with no or negative results.”

“The three modern ‘faces’ of mercury are our perceptions of risk from the exposure of billions of people to methyl mercury in fish, mercury vapor from amalgam tooth fillings, and ethyl mercury in the form of thimerosal added as an antiseptic to widely used vaccines. In this article I review human exposure to and the toxicology of each of these three species of mercury. Mechanisms of action are discussed where possible. Key gaps in our current knowledge are identified from the points of view both of risk assessment and of mechanisms of action.”

“The overload of the osteoarticular system resulting from standing and stooping position of the body is the main health problem of dentists. This may cause vertebral pain, symptoms of sciatica and foot valgo-planus. Symptoms of carpal tunnel syndrome are induced by repeated carpus movements. Frequent numbness associated with the peripheral nerves changes result from using drills by dentists. Menstruation disturbances observed in dental assistants could be related to the increased levels of mercury in serum and urine. Allergy is also a frequent medical problem, particularly allergy to latex manifested by contact eczema or allergic urticaria, asthma and shock. There also is an increased risk for infectious diseases through the contact with biological material, mostly saliva and blood.”

“The concentration of total mercury in stimulated saliva was studied in humans with dental amalgam fillings and in 2 nonamalgam groups. The probability of exceeding the limits of mercury permitted in wastewater increased proportionally as the number of amalgam-filled surfaces increased. The mercury limit for sewage is 0.05 mg/l (= 250 nmol/l) effluent, according to the Council of European Communities directive 84/156/EEC. In neither of the nonamalgam groups was this limit exceeded, but 20.5% in the amalgam group exceeded the limit (p < .001). The risk of exceeding the limit increased 2-fold for every 10 additional amalgam-filled surfaces (odds ratio = 2.0; 95% confidence interval = 1.3, 3.3). These results demonstrate that humans, especially in populated areas, can be a significant source of mercury pollutants. As a consequence of mercury release, bacteria may acquire mercury resistance, as well as resistance to other antimicrobial agents, thus resulting in failure of antibiotic treatment.”

“OBJECTIVE AND METHODS:

In 1993, a special Amalgam Clinic was established at Huddinge University Hospital. Residents in the Stockholm County area with morbidity attributed to dental fillings (‘amalgam disease’), were referred to this clinic. Patients were examined by a dentist (n 428), a physician (n 379), and a psychologist (n 360). Sixty-nine per cent were women and 31% men; the mean patient age was 46 years.

RESULTS:

Oral symptoms included tender or aching teeth (60%), metallic taste (54%), sore mouth (43%) and dry mouth (43%). Signs of moderate or severe temporomandibular joint dysfunction were found in 81 cases, glossitis in 30 and oral lichen in 26 cases. Common general symptoms included diffuse pain (78%), general weakness (75%), extreme fatigue (68%) and dizziness (68%). Seven per cent of the patients suffered from previously undiagnosed medical conditions (thyroid dysfunction, anaemia, cardiopathy, renal disease, cancer). In 26 subjects, skin patch testing revealed allergy to mercury, gold or palladium. The median concentration of mercury was 10 nmol L-1 in whole blood, 3 nmol L-1 in plasma and 10 nmol L-1 in urine, i.e. normal levels. Earlier mental trauma was common, and in the psychological questionnaire SCL-90, clear tendencies to somatization were found. Only a few cases of severe psychiatric illness were observed. No positive correlation was found between the amount of amalgam and somatic symptoms or psychological effect parameters.

CONCLUSIONS:

The results do not support the hypothesis that release of mercury from amalgam fillings is the cause of ‘amalgam disease’, but suggest that there may be various explanations for the patient’s complaints.”

“Silver amalgam alloy has been used as a dental restorative material since the beginnings of restorative dentistry. It rose as an easily manipulated and low cost material in comparison to other restorative techniques of the time, but it had poor dimensional stability and clinical behavior. Successive research led to the standardization of both its composition and some aspects of its mechanical properties, which have contributed to its widespread acceptance. Nevertheless, the risk of environmental toxicity generated by mercury and its poor esthetics have given rise to the search for alternative and more promising materials. This article endeavors to give a brief historical description of the main events which have led to development of modern silver amalgam alloys.

SIGNIFICANCE:

It is concluded that extensive knowledge of the use of silver amalgam alloy has made it the most widely used restorative material for the posterior oral cavity. However, in recent years its preponderance has been brought into question even though some innovative ideas have been suggested which could help improve this material in the future.”

“OBJECTIVE:

The objective of this investigation was to carry out residual mercury (Hg) determinations and toxicity characteristic leaching procedure (TCLP) analysis of used amalgam capsules.

METHODS:

For residual Hg analysis, 25 capsules (20 capsules for one brand) from each of 10 different brands of amalgam were analyzed. Total residual Hg levels per capsule were determined using United States Environmental Protection Agency (USEPA) Method 7471. For TCLP analysis, 25 amalgam capsules for each of 10 brands were extracted using a modification of USEPA Method 1311. Hg analysis of the TCLP extracts was done with USEPA Method 7470A. Analysis of silver (Ag) concentrations in the TCLP extract was done with USEPA Method 6010B.

RESULTS:

Analysis of the residual Hg data resulted in the segregation of brands into three groups: Dispersalloy capsules, Group A, retained the most Hg (1.225 mg/capsule). These capsules were the only ones to include a pestle. Group B capsules, Valliant PhD, Optaloy II, Megalloy and Valliant Snap Set, retained the next highest amount of Hg (0.534-0.770 mg/capsule), and were characterized by a groove in the inside of the capsule. Group C, Tytin regular set double-spill, Tytin FC, Contour, Sybraloy regular set, and Tytin regular set single-spill retained the least amount of Hg (0.125-0.266 mg/capsule). TCLP analysis of the triturated capsules showed Sybraloy and Contour leached Hg at greater than the 0.2 mg/l Resource Conservation and Recovery Act (RCRA) limit.

SIGNIFICANCE:

This study demonstrated that residual mercury may be related to capsule design features and that TCLP extracts from these capsules could, in some brands, exceed RCRA Hg limits, making their disposal problematic. At current RCRA limits, the leaching of Ag is not a problem.”

“We determined levels of inorganic mercury (I-Hg) and methylmercury in placentas from 119 Swedish women, not selected with respect to high exposure of mercury. Our objective was to relate placental Hg species with maternal and fetal blood concentrations and to evaluate possible associations with selenium. We performed the analyses using automated alkaline solubilization/reduction and cold-vapor atomic fluorescence spectrophotometry. I-Hg levels in placenta increased with an increasing number of maternal dental amalgam fillings (p < 0.001). Despite placental accumulation (median, 1.3 microg/kg; range, 0.18-6.7 microg/kg wet weight), a substantial fraction of maternal blood I-Hg, probably as Hg(0), reached the fetus. Although MeHg transferred easily to the fetus, it also accumulated in the placenta. On average, 60% of placental Hg was in the form of MeHg. The median concentration was 1.8 microg/kg (range, 0-6.2 microg/kg wet weight), more than twice the maternal blood concentration. We found significant associations between MeHg and selenium in both maternal and umbilical cord blood but not in the placenta. The associations were particularly obvious in freshwater fish consumers, probably reflecting that fish is a source of both MeHg and selenium. We found no correlations between I-Hg and selenium. This study increases the understanding of Hg, in its different forms, in human placenta and how they are related to maternal and fetal exposure.”

BACKGROUND:
Amalgam tattoos result from deposition of metallic particles (eg, silver, mercury, copper, zinc, and tin) into the oral mucosa. Their clinical and histologic appearance is similar to that of decorative tattoos.

OBJECTIVE:
To describe the successful use of a Q-switched alexandrite laser for removal of an amalgam tattoo.

MATERIALS AND METHODS:
An amalgam tattoo on the buccal mucosa and gingiva was treated with a QS 755 nm alexandrite laser. Three treatments were delivered at 8-week time intervals (average fluence = 6.8 J/cm2).

RESULTS:
Significant lightening of the tattoo was achieved after each of the three treatments without adverse sequelae.

CONCLUSION:
Q-switched alexandrite laser irradiation can safely and effectively eradicate amalgam tattoos.