title: The potential adverse health effects of dental amalgam.
abstract: There is significant public concern about the potential health effects of exposure to mercury vapour (Hg(0)) released from dental amalgam restorations. The purpose of this article is to provide information about the toxicokinetics of Hg(0), evaluate the findings from the recent scientific and medical literature, and identify research gaps that when filled may definitively support or refute the hypothesis that dental amalgam causes adverse health effects. Dental amalgam is a widely used restorative dental material that was introduced over 150 years ago. Most standard dental amalgam formulations contain approximately 50% elemental mercury. Experimental evidence consistently demonstrates that Hg(0) is released from dental amalgam restorations and is absorbed by the human body. Numerous studies report positive correlations between the number of dental amalgam restorations or surfaces and urine mercury concentrations in non-occupationally exposed individuals. Although of public concern, it is currently unclear what adverse health effects are caused by the levels of Hg(0) released from this restoration material. Historically, studies of occupationally exposed individuals have provided consistent information about the relationship between exposure to Hg(0) and adverse effects reflecting both nervous system and renal dysfunction. Workers are usually exposed to substantially higher Hg(0) levels than individuals with dental amalgam restorations and are typically exposed 8 hours per day for 20-30 years, whereas persons with dental amalgam restorations are exposed 24 hours per day over some portion of a lifetime. This review has uncovered no convincing evidence pointing to any adverse health effects that are attributable to dental amalgam restorations besides hypersensitivity in some individuals.
authors.affiliation: Life Sciences Research Office, Bethesda, Maryland 20814-3998, USA. LSRO@LSRO.org
authors.forename: Amy M
authors.initials: AM
authors.lastname: Brownawell
authors.forename: Stanley
authors.initials: S
authors.lastname: Berent
authors.forename: Robert L
authors.initials: RL
authors.lastname: Brent
authors.forename: James V
authors.initials: JV
authors.lastname: Bruckner
authors.forename: John
authors.initials: J
authors.lastname: Doull
authors.forename: Eric M
authors.initials: EM
authors.lastname: Gershwin
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Hood
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Matanoski
authors.forename: Raphael
authors.initials: R
authors.lastname: Rubin
authors.forename: Bernard
authors.initials: B
authors.lastname: Weiss
authors.forename: Meryl H
authors.initials: MH
authors.lastname: Karol
mesh_terms: D003723:Dental Amalgam / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D006801:Humans; D008628:Mercury / Q000009:adverse effects* / Q000493:pharmacokinetics*; D008767:Methylmercury Compounds / Q000009:adverse effects
chemical_list: D008767:Methylmercury Compounds; D003723:Dental Amalgam; D008628:Mercury