PREVENTION PLUS CLINIC
Doing our best to keep you healthy.

Alzheimer's disease, dental amalgam and mercury.

Saxe SR, Wekstein MW, Kryscio RJ, Henry RG, Cornett CR, Snowdon DA, Grant FT, Schmitt FA, Donegan SJ, Wekstein DR, Ehmann WD, Markesbery WR

Geriatric Oral Health Program, College of Dentistry, University of Kentucky, Lexington, USA.

BACKGROUND: Mercury, or Hg, is a neurotoxin that has been speculated to play a role in the pathogenesis of Alzheimer's disease, or AD. Dental amalgam releases low levels of Hg vapor and is a potential source of Hg for a large segment of the adult population. METHODS: The authors studied 68 subjects with AD and 33 control subjects without AD to determine Hg levels in multiple brain regions at autopsy and to ascertain the subjects' dental amalgam status and history. The subjects were from central Kentucky and Elm Grove, Wis. The authors conducted dental amalgam assessments during the lives of the majority of subjects and in some subjects at the time of autopsy only. The authors also determined three dental amalgam index scores--Event (placement, repair or removal of amalgam), Location and Time In Mouth--in addition to the numbers of and surface area of occlusal amalgam restorations. The authors determined Hg levels in multiple brain regions and performed full neuropathologic evaluations to confirm the normal status of the brain or the presence of AD. RESULTS: The authors found no significant association of AD with the number, surface area or history of having dental amalgam restorations. They also found no statistically significant differences in brain Hg level between subjects with AD and control subjects. CONCLUSIONS: Hg in dental amalgam restorations does not appear to be a neurotoxic factor in the pathogenesis of AD. The authors found that brain Hg levels are not associated with dental amalgam, either from existing amalgam restorations or according to subjects' dental amalgam restoration history. CLINICAL IMPLICATIONS: Dental amalgam restorations, regardless of number, occlusal surface area or time, do not relate to brain Hg levels.

MeSH Terms:

Correlation of dental amalgam with mercury in brain tissue.

Eggleston DW, Nylander M

Department of Restorative Dentistry, University of Southern California, School of Dentistry, Los Angeles.

Data from this project demonstrate a positive correlation between the number of occlusal surfaces of dental amalgam and mercury levels in the brain (p less than .0025 in white matter). This is indirect evidence suggesting that mercury from dental amalgam fillings may contribute to the body burden of mercury in the brain. The toxic levels of mercury in human tissues have not been sufficiently investigated and the amount of mercury in human brain tissue from dental amalgam may or may not be clinically significant. Nevertheless, dental amalgam exposure should be considered in monitoring sources of mercury accumulation in human brain tissue.

J Dent Res 1984 Jan;63(1):71-3

The effect of dental amalgam restorations on blood mercury levels.

Abraham JE, Svare CW, Frank CW

Mercury levels in blood and in mouth air before and after chewing were measured in 47 persons with and 14 persons without dental amalgam restorations. Questionnaires relating to exogenous sources of mercury exposure were administered to both groups. Differences in the mouth air mercury levels before and after chewing were statistically significant in the group with amalgams, but not in the group without amalgams. Analysis of the data from the questionnaires indicated that little or no exogenous exposure to mercury occurred among the two groups. Blood mercury concentrations were positively correlated with the number and surface area of amalgam restorations and were significantly lower in the group without dental amalgams.

Dent Res 1985 Aug;64(8):1069-71

Intra-oral air mercury released from dental amalgam.

Vimy MJ, Lorscheider FL

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.

MeSH

Neurotoxicology 1983 Fall;4(3):201-4

Mercury toxicity and dental amalgam.

Wolff M, Osborne JW, Hanson AL

There is adequate evidence that dental amalgam restorations, during and after placement, results in the release of Hg into the patient's body. Whether the Hg released from amalgam is due to placement procedures, surface abrasion, or later corrosion breakdown, there is evidence that a low level Hg release continues for years. It is generally agreed that if amalgam was introduced today as a restorative material, they would never pass F.D.A. approval. With new and more accurate techniques of measuring Hg levels, especially in tissue and blood, additional studies are necessary to relate blood-Hg levels with dental amalgam restorations. Studies must relate existing restorations as well as the placement of new restorations to body-Hg levels. It is possible that we have accepted a potentially dangerous material as being safe.

Pharmacol Toxicol 1992 Apr;70(4):308-13

Dental amalgam and mercury.

Jokstad A, Thomassen Y, Bye E, Clench-Aas J, Aaseth J

Department of Anatomy, Dental Faculty, University of Oslo, Norway.

The mercury concentrations in blood (HgB) and urine (HgU) samples, and in exhaled air (HgAir) were measured in 147 individuals from an urban Norwegian population, using cold vapour atomic absorption spectrometry. The study aimed to estimate the mercury exposure from the dental restorations, by correlating the data to the presence of amalgam restorations. Mean values were HgB = 24.8 nmol/l, HgU = 17.5 nmol/l and HgAir = 0.8 micrograms/m3. HgU correlated with HgAir, and both HgU and HgAir with the number of amalgam restorations, amalgam restored surfaces and amalgam restored occlusal surfaces. HgB showed poor correlation to HgU and HgAir and the presence of amalgam restorations. A differentiation of the mercury absorption due to exposure from dental amalgams and from the dietary intake, necessitates measurements of both organic and inorganic mercury in the plasma, and in the erythrocytes. The results suggest that individuals with many amalgam restorations, i.e., more than 36 restored surfaces, absorb 10-12 micrograms Hg/day.

MeSH Terms

J Dent Res 1989 May;68(5):780-5

The contribution of dental amalgam to mercury in blood.

Snapp KR, Boyer DB, Peterson LC, Svare CW

Department of Prosthodontics, College of Dentistry, University of Iowa, Iowa City 52242.

We determined the exposure to mercury from dental amalgam by comparison of blood levels of mercury before and after removal of all amalgams from ten subjects. Baseline concentrations of mercury in whole blood were measured weekly for four to 18 weeks (median = 6.6 weeks) prior to removal. All amalgams were removed in a single appointment. The subjects had an average of 14 surfaces of amalgam, seven of which were occlusal surfaces. Weekly blood sampling was continued for five to 18 weeks (median = 7.6 weeks) after the amalgams were removed. The mean baseline concentration of total mercury in whole blood of the ten subjects was 2.18 (SD = 0.90) ng Hg/mL before the amalgams were removed. The baseline mercury levels were related to the number of amalgam surfaces. The linear correlation coefficient was 0.724 with number of occlusal surfaces, and 0.433 with total number of surfaces. After removal of the amalgams, nine of the ten subjects exhibited a statistically significant decrease in blood mercury at the 95% level of confidence. The mean decrease in mercury was 1.13 (SD = 0.60) ng Hg/mL. The half-time for elimination of mercury from blood after amalgam removal was 30.2 (SD = 5.8) days. Removal of the amalgams provided an additional exposure of 1.46 (SD = 1.17) ng Hg/mL that was rapidly cleared from the blood with a half-time of 2.9 days. The daily intake of mercury from amalgam in the subjects was estimated to be at least 1.3 micrograms

Arch Environ Health 1991 Mar-Apr;46(2):102-9

Status of mercury and selenium in dental personnel: impact of amalgam work and own fillings.

Akesson I, Schutz A, Attewell R, Skerfving S, Glantz PO

Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.

Urinary mercury (U-Hg) and plasma mercury (P-Hg) levels were higher in 244 dental personnel than in 81 matched referents (U-Hg: 1.8 and 1.1 mumol/mol creatinine, respectively; p less than .001; P-Hg: 6.7 and 6.2 nmol/l, respectively; p = .03). The amalgam in the mouth influenced mercury levels in whole blood (B-Hg), plasma, and urine. The association was nonlinear: the more amalgam, the larger the relative increase in mercury levels. The number of amalgam surfaces accounted for more of the variance in blood and urine mercury levels than did the number of fillings (e.g., U-Hg: 44% and 36%, respectively). The estimated increases in mercury level with rising amalgam load were 3.0%, 2.0%, and 0.8% per filled surface for U-Hg, P-Hg, and B-Hg, respectively (p less than .0001 in all cases). The impact of occupational exposure on U-Hg in the dental personnel corresponded to approximately 19 amalgam surfaces. Ceramo metallic restorations were associated with higher (31%) U-Hg.

MeSH

J Nihon Univ Sch Dent 1994 Dec;36(4):266-8

Effect of mercury from dental amalgams on mercury concentration in urine.

Ulukapi I, Cengiz S, Sandalli N

Department of Pedodontics, Faculty of Dentistry, University of Istanbul, Turkey.

A study was conducted to determine the mercury concentration in urine after placement of dental amalgam restorations. The 24-h urine mercury levels in 10 children with a mean age of 8 years were determined before the amalgam restorations had been placed, and after placement. The urinary mercury content was measured by the cold vapor atomic fluorescence method. Mercury levels in the urine samples before placement of the amalgam restorations were below the detection limit, and the values obtained after placement, although detectable, were far below the limits stipulated by the World Health Organization. Under the conditions of this study, it is considered that the mercury levels released from dental amalgams are not high enough to cause any systemic toxic effect.

MeSH Terms