Mercury

“Mercury is a toxic and bioaccumulative metal. It exists in elemental, inorganic and organic forms. The use of mercury by the dental profession represents approximately 6 percent of the total annual domestic consumption and is estimated to contribute significantly to the discharge of mercury (14 percent in one study) to waste-water streams. Publicly owned treatment works (POTW) must obtain and comply with a National Pollutant Discharge Elimination System waste-water discharge permit. When minimal mercury discharge limits into surface waters are exceeded, an upstream search for contributors of mercury to the waste stream may result. Given the present sociopolitical environment, mercury discharge from dental offices will increasingly receive scrutiny. Strategies to minimize discharge of mercury/amalgam waste include engineering controls such as changes in the discharge process, changes in the composition of commercial products, and changes in control equipment. Governmental strategies include an outright ban, the setting of discharge standards, and educational efforts. Study of these strategies with evaluation of effectiveness is needed.”

“The solubilized partially purified Ins(1,4,5)P3-sensitive Ca2+ channel from rat cerebellum has been reconstituted into planar lipid bilayer membranes by the ‘tip-dip’ method [Ehrlich (1992) Methods Enzymol. 207, 463-471] allowing low noise current records. Single-channel events have been recorded. In the presence of 10 microM Ins(1,4,5)P3, 50 microM ATP, and 0.2 microM Ca2+ the Ins(1,4,5)P3 receptor channel opens to a conductance level of 53 pS. In the presence of 100 microM thimerosal (TMS), a sulphydryl-oxidizing agent, three subconductance levels (60 pS, 80 pS and 120 pS) were observed. More than one population of mean open times was found, both in the absence and presence of TMS, although TMS affected the length of the open time by decreasing the short opening significantly from 4.05 ms to 2.78 ms and increasing the longer open time from 27.8 ms to 94.8 ms. The results indicate that TMS enhances Ins(1,4,5)P3-induced Ca2+ release by both altering the open times of the channel significantly and causing a shift to higher subconductance levels.”

“In animals, inorganic mercury can bypass the blood brain barrier and enter motor neurons. We sought to determine the lowest injected dose of mercury that could be detected in mouse motor neurons. Mice were injected intraperitoneally with mercuric chloride in doses from 0.05 to 2 micrograms/g body weight and studied between 5 days and 18 months after injection. After formalin fixation, 7 microns sections of cerebrum, cerebellum, brain stem, spinal cord and kidney were stained with silver nitrate autometallography. Five days after injection, mercury granules were detected at doses from 0.2 microgram/g upwards in the cell bodies of spinal and brain stem motor neurons, more granules being seen at the higher doses. Mercury granules were also seen in 5% of posterior root ganglion neurons. At doses from 0.05 microgram/g upwards mercury was detected 5 days later in renal tubule cells. Mercury was still present in motor neurons 6-11 months after injection, but by this time mercury had been cleared from the kidneys. Low doses of inorganic mercury are therefore selectively taken up and retained by motor neurons, making this neurotoxin a good candidate for a cause of sporadic motor neuron disease.”

Dental amalgam continuously releases mercury. Studies of sheep [Boyd et al., Am. J. Physiol. 261 (Regulatory Integrative Comp. Physiol. 30): R1010-R1014, 1991] showed decreased renal function after placement of amalgam fillings. In this study, renal function was investigated in 10 healthy volunteers before and after amalgam removal. The subjects had an average of 18 tooth surfaces filled with amalgam, which was removed during one dental session. One week before and sixty days after removal, the glomerular filtration rate (GFR) was determined by 51Cr-EDTA clearance technique. Blood and urine samples were collected for analysis of mercury, creatinine, beta 2-microglobulin, N-acetyl-beta-glucosaminidase (NAG), and albumin 1 wk before and 1, 2, and 60 days after amalgam removal. The plasma mercury concentration increased significantly 1 day after removal. Sixty days later, significantly lower mercury levels were found in blood, plasma, and urine. The GFR values were similar before and after mercury exposure (mean 94 and 94 ml/min per 1.73 m2, respectively). No detectable effects occurred on excretion of NAG, beta 2-microglobulin, or albumin. It is concluded that no signs of renal toxicity could be found in conjunction with mercury released from amalgam fillings.

“Changes in urinary porphyrin excretion patterns (porphyrin profiles) have been described in response to a variety of drugs and chemicals. The present studies were conducted to define the specific changes in the urinary porphyrin profile associated with prolonged exposure to mercury and mercury compounds. In rats, exposure for a prolonged period to mercury as methyl mercury hydroxide was associated with urinary porphyrin changes, which were uniquely characterized by highly elevated levels of 4- and 5-carboxyl porphyrins and by the expression of an atypical porphyrin (“precoproporphyrin”) not found in urine of unexposed animals. These distinct changes in urinary porphyrin concentrations were observed as early as 1-2 weeks after initiation of mercury exposure, and increased in a dose- and time-related fashion with the concentration of mercury in the kidney, a principal target organ of mercury compounds. Following cessation of mercury exposure, urinary porphyrin concentrations reverted to normal levels, consistent with renal mercury clearance. In human studies, a comparable change in the urinary porphyrin profile was observed among subjects with occupational exposure to mercury as mercury vapor sufficient to elicit urinary mercury levels greater than 20 micrograms/L. Urinary porphyrin profiles were also shown to correlate significantly with mercury body burden and with specific neurobehavioral deficits associated with low level mercury exposure. These findings support the utility of urinary porphyrin profiles as a useful biomarker of mercury exposure and potential health effects in human subjects.”

“The effects of the sulfhydryl group inhibitor thimerosal on serotonin (5-HT) transport activity into rabbit blood platelets were investigated, along with its effects on the intracellular concentration of Ca2+ ([Ca2+]i). 3H-5-HT transport activity into rabbit blood platelets was inhibited by treatment with 10(-5) M thimerosal for 30 min, which did not cause 5-HT release from platelets. The thimerosal-induced inhibition of 5-HT transport was antagonized by dithiotheritol. It was suggested that the thimerosal acts as a sulfhydryl inhibitor and inhibits 5-HT transport activity independently of the 5-HT release reaction in our experiment using rabbit blood platelets. As aspirin did not affect thimerosal-induced 5-HT transport inhibition, it was suggested that the thromboxane A2-generating system does not operate in the effect of thimerosal on 5-HT transport into blood platelets. Furthermore, thimerosal induced a transient elevation of [Ca2+]i, which was followed by a sustained increase. In the absence of extracellular Ca2+, thimerosal caused only a transient increase in [Ca2+]i. It was suggested that the elevation of [Ca2+]i consisted of two phases, e.g. a transient phase induced by Ca2+ mobilization from the intracellular store sites and a sustained phase which might be explained by Ca2+ influx from the extracellular environment. In conclusion, thimerosal inhibited 5-HT transport into blood platelets at a concentration which did not induce 5-HT release, and intracellular Ca2+ mobilization might mediate the inhibitory effect of thimerosal on 5-HT transport.”

The concentrations of mercury in saliva and feces and the resistance pattern of the gastrointestinal microflora were investigated for 20 subjects. Ten patients, with a mean number of 19 amalgam surfaces, had all amalgam fillings removed during one dental session. Ten subjects without amalgam fillings served as a control group. Saliva and fecal samples were collected before amalgam removal and 2, 7, 14, and 60 days afterward. Mercury levels in saliva and feces correlated significantly with the number of amalgam surfaces. No differences in the resistance pattern of the oral microflora were detected between the two groups. In the amalgam group there was an increase in the relative number of intestinal microorganisms resistant to mercury, ampicillin, cefoxitin, erythromycin, and clindamycin on days 7-14. This was not statistically significant in light of the normal variations of the control group. A significant correlation between the prevalence of mercury resistance and multiple antimicrobial resistance in intestinal bacterial strains was observed.

However, these mercury deposits, which commonly occur in such cases, were successfully eliminated by the oral intake of 100 mg tablet of Chinese parsley (Cilantro) 4 times a day (for average weight adults) with a number of drug-uptake enhancement methods developed by the 1st author, including different stimulation methods on the accurate organ representation areas of the hands (which have been mapped using the Bi-Digital O-Ring Test), without injections of chelating agents. Ingestion of Chinese parsley, accompanied by drug-uptake enhancement methods, was initiated before the amalgam removal procedure and continued for about 2 to 3 weeks afterwards, and ECGs became almost normal. During the use of strong bluish curing light to create a photo-polymerization reaction to solidify the synthetic filling material, the adjacent gingiva and the side of the tongue were inadvertently exposed. This exposure to the strong bluish light was found to produce pre-cancerous conditions in the gingiva, the exposed areas of the tongue, as well as in the corresponding organs represented on those areas of the tongue, and abnormally increased enzyme levels in the liver. These abnormalities were also successfully reversed by the oral intake of a mixture of EPA with DHA and Chinese parsley, augmented by one of the non-invasive drug-uptake enhancement methods previously described by the 1st author, repeated 4 times each day for 2 weeks.

OBJECTIVE AND STUDY DESIGN:
Forty-nine consecutive patients with clinically diagnosed oral lichenoid reactions in contact with amalgam fillings were studied clinically and histologically. The long-term effect of replacement of these fillings was also examined.

RESULTS:
Seventeen (35%) patients showed positive reactions to mercury at the epicutaneous patch test that was carried out before treatment. After treatment, total regression of the lesions was found clinically in 33 (69%) and histologically in 26 (55%) patients. Most of the remaining lesions changed clinically and histologically to a less pronounced tissue reaction. Lesions in direct contact with amalgam fillings (group I) showed significantly better healing results than lesions that exceeded the contact area (group II). No difference in healing capacity was noted in the two groups between patients with positive patch reactions to mercury compared with those with negative reactions. Lesions that histologically were classified as benign oral keratosis showed a similar healing pattern as those classified as oral lichen planus.

CONCLUSION:
In group I all lesions changed histologically and clinically to a normal mucosa or to a less affected tissue reaction. In group II this change was less pronounced, which suggests that the fillings themselves were not the only factor involved in the cause of these lesions. The results suggest that various etiologic factors are involved in lichenoid reactions and that the effect of removal of amalgam fillings cannot be predicted by epicutaneous patch testing and biopsies.

“In this study, 18 patients with oral lichen planus (OLP), adjacent to amalgam fillings, were tested in vitro with an optimized lymphocyte proliferation test, MELISA (memory lymphocyte immunostimulation assay) and with a patch test. Twenty subjects with amalgam fillings but without oral discomfort and 12 amalgam-free subjects served as controls.”