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SAGE Open Medicine 2021Mercury (Hg)-based amalgam is a dental restorative material in common use. This hypothesis-testing study evaluated the relationship between dental amalgam exposure and...
Mercury (Hg)-based amalgam is a dental restorative material in common use. This hypothesis-testing study evaluated the relationship between dental amalgam exposure and the risk of reported asthma diagnoses in American adults. A total of 97,861,577 weighted-persons with one or more dental amalgam surfaces (exposed group) and 31,716,558 weighted-persons with one or more other dental surfaces (no dental amalgams, unexposed group) were examined in the 2015-2016 National Health and Nutrition Examination Survey. All persons were 20-80 years old and with known reported asthma status (only newly diagnosed asthma cases were examined). Survey logistic regression and survey frequency modeling in SAS were employed to evaluate the relative incidence rate of reported asthma diagnoses among those in the exposed group compared to the unexposed group. Covariates of gender, race, socioeconomic status, educational status, country of birth, and tobacco exposure were considered. Survey logistic modeling revealed a significantly increased incidence rate of reported asthma in the exposed group as compared to the unexposed group in unadjusted (4.46-fold) and adjusted (4.84-fold) models. A dose-response relationship was observed for the risk of reported asthma per dental amalgam filling surface in unadjusted (1.073) and adjusted (1.076) models. Survey frequency modeling revealed that the frequency of reported asthma (per 10,000 weighted-person years) was 3.66-fold significantly increased in the exposed group (2.06) as compared to the unexposed group (0.56). Increased dental amalgam exposure was associated with an increased risk of reported asthma diagnoses in American adults, but future studies should further evaluate this relationship.
PubMed: 34691469
DOI: 10.1177/20503121211048677 -
Dentistry Journal Jan 2023Among the pillars of sustainability in health care units is environmental protection. Although an EU-wide dental amalgam phase-out legislation exists, quantities of this...
UNLABELLED
Among the pillars of sustainability in health care units is environmental protection. Although an EU-wide dental amalgam phase-out legislation exists, quantities of this material are still to be found in the market, dental offices or in the mouths of patients. The purpose of this study is to record the views of dentists and dental students in Greece regarding the use and safety of dental amalgam for people and the environment as well as their attitudes towards its restriction and disposal.
MATERIALS AND METHODS
Two different questionnaires, through Google forms, were filled by each group. Descriptive statistics were used to describe the variables. The chi-square test or the chi-square test with Yates correction was used to examine potential differences per group (-value = 0.05). Overall, 564 people participated in this study; 462 (81.9%) dentists (N1) and 102 (18.1%) dental students (N2).
RESULTS
Both groups agreed that they no longer use dental amalgam often. Dentists (39.8%) and students (36.4%) consider amalgam to have a moderate burden on the environment. This answer differed significantly per year of profession and year of undergraduate studies, respectively, with dentists from 6-25 years in the profession and 4th-year students, being the least aware on the environmental footprint of dental amalgam. Further, professionals (70%) and students (60%) believe that dental amalgam has a hazardous impact on patient's health, at all or to a small extent. For staff health, dentists reported at a moderate degree dangerous impact (32.9%) while students (36.4%), respectively. The impact on patients and staff health, were found to differ significantly per region of practicing dentistry for both groups. Finally, there were suggestions made from both groups about the necessity of information sharing on amalgam and mercury safety and the impact on the environment at the level of professional organizations.
CONCLUSIONS
Students, younger dentists and those living in non-urban regions seem to be more sensitive to the environmental impact of amalgam use, disposal, and health of people. Environmental issues should be addressed thoroughly by professional organizations, enhancing relevant activities for all people involved.
PubMed: 36661558
DOI: 10.3390/dj11010021 -
Journal of Dental Research Nov 2012Resin-based composite dental restoration materials may release bisphenol-A, an endocrine-disrupting chemical. Using secondary analysis of a randomized clinical safety... (Comparative Study)
Comparative Study Randomized Controlled Trial
Resin-based composite dental restoration materials may release bisphenol-A, an endocrine-disrupting chemical. Using secondary analysis of a randomized clinical safety trial of amalgam vs. composites, we tested the hypothesis that dental restoration materials affect children's growth. Children (N = 218 boys, N = 256 girls) aged 6 to 10 yrs at baseline with ≥ 2 decayed posterior teeth were randomized to amalgam or composites (bisphenol-A-diglycidyl-dimethacrylate composite for permanent teeth, urethane-dimethacrylate compomer for primary teeth) for treatment of posterior caries throughout follow-up. Primary outcomes for this analysis were 5-year changes in BMI-for-age z-scores, body fat percentage (BF%), and height velocity; exploratory analyses (n = 113) examined age at menarche. Results showed no significant differences between treatment assignment and changes in physical development in boys [(composites vs. amalgam) BF%, 4.9 vs. 5.7, p = 0.49; (BMI-z-score) 0.13 vs. 0.25, p = 0.36] or girls (8.8 vs. 7.7, p = 0.95; 0.36 vs. 0.21, p = 0.49). Children with more treatment on primary teeth had greater increases in BF% regardless of material type. Girls assigned to composites had lower risk of menarche during follow-up (hazard ratio = 0.57, 95% CI 0.35-0.95). Overall, there were no significant differences in physical development over 5 years in children treated with composites or amalgam. Additional studies examining these restoration materials in relation to age at menarche are warranted (clinicaltrials.gov number NCT00065988).
Topics: Adipose Tissue; Analysis of Variance; Benzhydryl Compounds; Body Height; Body Mass Index; Child; Child Development; Composite Resins; Dental Amalgam; Dental Restoration, Permanent; Estrogens, Non-Steroidal; Female; Humans; Linear Models; Male; Menarche; Methacrylates; Phenols; Polyurethanes; Sex Factors
PubMed: 22972857
DOI: 10.1177/0022034512458691 -
European Oral Research May 2023The popularity of dental amalgam arises from its excellent long-term performance, ease of use, and low cost. However, there is a concern about the potential adverse... (Review)
Review
PURPOSE
The popularity of dental amalgam arises from its excellent long-term performance, ease of use, and low cost. However, there is a concern about the potential adverse health effects arising from exposure to mercury in amalgam. This review article critically discusses the safety of dental amalgam as a restorative material and our preparedness for a mercury-free road ahead.
MATERIALS AND METHODS
A database search was performed on PubMed and Google scholar using the keywords: "mercury-free dentistry", "mercury toxicity", "amalgam substitutes", "amalgam mercury toxicity". Inclusion and exclusion criteria were specified clearly. Relevant literature was also searched in the dental textbooks.
RESULTS
Around 40 articles, highlighting mercury exposure among dental professionals and patients were included. Despite the overwhelming body of scientific evidence demonstrating amalgam to be a safe restorative material, concerns about the toxic effects of mercury persist.
CONCLUSION
The real challenge is to find a suitable amalgam substitute and to follow the mercury hygiene measures closely.
PubMed: 37525858
DOI: 10.26650/eor.20231050091 -
Australian Dental Journal Dec 2000Mercury in dentistry has re-emerged as a contentious issue in public health, predominantly because so many people are inadvertently exposed to mercury in order to obtain... (Review)
Review
Mercury in dentistry has re-emerged as a contentious issue in public health, predominantly because so many people are inadvertently exposed to mercury in order to obtain the benefits of dental amalgam fillings, and the risks remain difficult to interpret. This commentary aims to examine the issues involved in public policy assessment of the continued use of dental amalgam in dentistry. More than 30 per cent of Australian adults are concerned about mercury from dental amalgam fillings but only a small percentage report having their amalgam fillings removed. The placement of dental fillings nearly halved between 1983 and 1997, but many millions of dental amalgam fillings exist in the Australian community. These fillings release mercury (mercury vapour or inorganic ions) at a low level (about 2-5 micrograms/day in an adult). Evidence on the health effect of dental amalgams comes from studies of the association between their presence and signs or symptoms of adverse effects or health changes after removal of dental amalgam fillings. More formal risk assessment studies focus on occupational exposure to mercury and health effects. Numerous methodological issues make their interpretation difficult but new research will continue to challenge policymakers. Policy will also reflect prudent and cautious approaches, encouraging minimization of exposure to mercury in potentially more sensitive population groups. Wider environmental concerns and decreasing tolerance of exposure to other mercury compounds (for example, methylmercury in seafoods) will ensure the use of mercury in dentistry remains an issue, necessitating dentists keep their patients informed of health risks and respect their choices.
Topics: Adult; Australia; Dental Amalgam; Dental Restoration, Permanent; Dentists; Environmental Exposure; Food Contamination; Humans; Mercury; Occupational Exposure; Policy Making; Public Health; Public Opinion; Risk Assessment
PubMed: 11225523
DOI: 10.1111/j.1834-7819.2000.tb00256.x -
Safety and Health At Work Mar 2017Considerable effort has been made to address the issue of occupational health and environmental exposure to mercury. This review reports on the current literature of... (Review)
Review
Considerable effort has been made to address the issue of occupational health and environmental exposure to mercury. This review reports on the current literature of mercury exposure and health impacts on dental personnel. Citations were searched using four comprehensive electronic databases for articles published between 2002 and 2015. All original articles that evaluated an association between the use of dental amalgam and occupational mercury exposure in dental personnel were included. Fifteen publications from nine different countries met the selection criteria. The design and quality of the studies showed significant variation, particularly in the choice of biomarkers as an indicator of mercury exposure. In several countries, dental personnel had higher mercury levels in biological fluids and tissues than in control groups; some work practices increased mercury exposure but the exposure levels remained below recommended guidelines. Dental personnel reported more health conditions, often involving the central nervous system, than the control groups. Clinical symptoms reported by dental professionals may be associated with low-level, long-term exposure to occupational mercury, but may also be due to the effects of aging, occupational overuse, and stress. It is important that dental personnel, researchers, and educators continue to encourage and monitor good work practices by dental professionals.
PubMed: 28344835
DOI: 10.1016/j.shaw.2016.05.007 -
BMC Research Notes Nov 2016Studies investigating the attitudes of Saudi dentists to the use of amalgam for restorations are relatively rare. Considering the goals set forth by the Minamata...
BACKGROUND
Studies investigating the attitudes of Saudi dentists to the use of amalgam for restorations are relatively rare. Considering the goals set forth by the Minamata Convention on Mercury, it appears prudent to investigate the attitudes of experienced dentists and fresh dental graduates to the use of amalgam. The aim of this study was to assess the attitudes of Saudi dentists and interns working in Riyadh, Saudi Arabia to the use of amalgam. Using a convenience sampling methodology, a total of 400 Saudi dentists and interns were contacted to request their participation in this cross-sectional questionnaire-based study. The questionnaire consisted of socio-demographic and practice characteristics such as gender, type of practice, as well as their service sector and questions related to the use of dental amalgam. The data obtained was analyzed using Chi square tests to compare differences in distribution between groups. P values of less than 0.05 were considered statistically significant.
RESULTS
The overall response rate was 84% (336 of 400 potential participants). The majority of the participants (80.7%) did not use dental amalgam for restorations in their clinical practice frequently. A significantly higher number of participants working in private sector did not use amalgam frequently (P = 0.004), agreed on replacing good amalgam restoration with composite resin (P < 0.000) and on stopping the use of amalgam as a final restoration (P = 0.017) compared to participants working in public sector. A significantly higher number of interns did not use amalgam in their clinical practice frequently (P < 0.000), agreed on replacing good amalgam restoration with composite resin (P = 0.002) and on stopping the use of amalgam as a final restoration (P < 0.000) compared to dentists.
CONCLUSIONS
Within the limitations of this study, dental amalgam seems to be less frequently used among the surveyed Saudi dentists and interns working in Riyadh. Fresh dental graduates used amalgam less frequently compared to experienced dentists. Furthermore, private dental practitioners showed a propensity to replace existing well-placed amalgam restorations with resin composite which reinforces their market-oriented attitude reported in earlier studies.
Topics: Adult; Attitude of Health Personnel; Composite Resins; Cross-Sectional Studies; Dental Amalgam; Dental Caries; Dental Restoration, Permanent; Dentists; Female; Humans; Internship and Residency; Male; Middle Aged; Private Practice; Public Sector; Saudi Arabia; Sex Factors; Surveys and Questionnaires; Workforce
PubMed: 27855718
DOI: 10.1186/s13104-016-2294-x -
International Journal of Environmental... Jan 2020Essential tremor (ET) is a common neurological disorder and the most common movement disorder. Low-level occupational exposure to mercury vapor is known to be a crucial...
Essential tremor (ET) is a common neurological disorder and the most common movement disorder. Low-level occupational exposure to mercury vapor is known to be a crucial factor that increases the risk of tremor. Dental amalgam is one of the main sources of mercury in those who possess amalgam restorations. However, the relationship between ET and amalgam filling (AMF) is not quite clear. The purpose of this study was to investigate the association between AMF and the risk of ET using a population-based administrative databank. The data for this study were sourced from the Taiwanese National Health Insurance Research Database (NHIRD). A retrospective case-control study was conducted using this databank from 2000 to 2013. Case and control groups were matched by sex, age, urbanization level, monthly income, and Charlson comorbidity index using the propensity score method with a 1:1 ratio. In this study, 3008 cases and 3008 controls were included. The results from this nationwide population-based case-control study did not indicate any association between ET and AMF in Taiwan. Although the results were not significantly statistical, the findings may be worthy to be valued.
Topics: Adult; Aged; Aged, 80 and over; Case-Control Studies; Dental Amalgam; Dental Restoration, Permanent; Essential Tremor; Female; Humans; Male; Mercury; Middle Aged; Retrospective Studies; Risk; Taiwan
PubMed: 32012693
DOI: 10.3390/ijerph17030780 -
Parkinson's Disease 2023Environmental toxicants are thought to play a major role in the pathogenesis of Parkinson's disease. In reviewing the literature on heavy metals known to be toxicants,... (Review)
Review
Environmental toxicants are thought to play a major role in the pathogenesis of Parkinson's disease. In reviewing the literature on heavy metals known to be toxicants, we noted several recent studies on mercury suggesting a possible role in the etiology of some cases of this disease. We therefore undertook a review of this association, focusing especially on peer-reviewed articles to avoid the bias inherent in much of the literature regarding mercury. For most people, our contemporary exposure to mercury comes from dental amalgam tooth restorations and from eating fish contaminated with mercury. In both cases, mercury is known to get into the brain in utero and at all ages. It remains in the brain for many years and is known to produce permanent neuropsychological deficits. Mercury toxicity can produce tremors and other Parkinsonian clinical symptoms. It can also produce neurochemical and neuropathological changes similar to those found in Parkinson's disease, including the loss of dopamine neurons, degeneration of tubulin and axons, dysfunction of mitochondria, and the aggregation of alpha-synuclein. Relatively few studies have assessed mercury in parkinsonian patients, but almost all reported a statistically significant association. Published studies suggest some promising leads in the relationship between mercury exposure and Parkinson's disease. However, studies of patients are relatively few, and the need for research is clear. A search of Parkinsonian research studies currently funded by the US National Institutes of Health, Parkinson's Foundation, and the Michael J Fox Foundation yielded no studies on mercury. We believe such studies should be supported.
PubMed: 37744289
DOI: 10.1155/2023/4709322 -
International Journal of Dentistry 2011Objective. The purpose of this review paper is to review the literature regarding the toxicology of mercury from dental amalgam and evaluate current statements on dental...
Objective. The purpose of this review paper is to review the literature regarding the toxicology of mercury from dental amalgam and evaluate current statements on dental amalgam. Materials and Methods. Two key-words "dental amalgam" and "toxicity" were used to search publications on dental amalgam biocompatibility published in peer-reviewed journals written in English. Manual search was also conducted. The most recent declarations and statements were evaluated using information available on the internet. Case reports were excluded from the study. Results. The literature show that mercury released from dental amalgam restorations does not contribute to systemic disease or systemic toxicological effects. No significant effects on the immune system have been demonstrated with the amounts of mercury released from dental amalgam restorations. Only very rarely have there been reported allergic reactions to mercury from amalgam restorations. No evidence supports a relationship between mercury released from dental amalgam and neurological diseases. Almost all of the declarations accessed by the internet stated by official organizations concluded that current data are not sufficient to relate various complaints and mercury release from dental amalgam. Conclusions. Available scientific data do not justify the discontinuation of amalgam use from dental practice or replacement with alternative restorative dental materials.
PubMed: 22145006
DOI: 10.1155/2011/981595