title: Health-related quality of life and symptoms in patients with experiences of health problems related to dental restorative materials.
abstract: OBJECTIVE
  The question of health risks associated with dental materials, especially dental amalgam, has long been controversial and remains unresolved. For the past 10 years, people in Sweden with perceived adverse reactions to dental restorative materials have been entitled to apply to their local county council for subsidized replacement of restorative materials. The aim of the study was to investigate symptoms, perceived health changes over time and health-related quality of life (HRQoL) in this population, comprising subjects with subjective health impairment, allegedly because of dental materials. A further aim was to compare their HRQoL with that of the general population.
  
  
  METHODS
  A comprehensive questionnaire was sent to 515 people who had applied for subsidized replacement of dental restorations. The questionnaire covered general and oral symptoms, HRQoL, health ratings over time and dental restoration replacement.
  
  
  RESULTS
  The response rate was 54.4% (n=280). Most (83.2%) answered that they had undergone replacement of restorative materials because of impaired health, perceived to be related to dental restorative materials. The most common symptoms were musculoskeletal pain (67.5%), sleep disturbance (60.0%) and fatigue (58.6%). The HRQoL of the study subjects was significantly lower than that of the Swedish population in general.
  
  
  CONCLUSIONS
  Subjects who had undergone subsidized dental restoration replacement reported persistent subjective symptoms and low HRQoL. The results indicate that replacement of restorative materials alone is insufficient to achieve improved health in patients with symptoms allegedly attributable to dental restorations.
authors.affiliation: Division of Dental Biomaterials and Cariology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. aron.naimi-akbar@ki.se
authors.forename: Aron
authors.initials: A
authors.lastname: Naimi-Akbar
authors.forename: Pia
authors.initials: P
authors.lastname: Svedberg
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.forename: Bodil
authors.initials: B
authors.lastname: Carlstedt-Duke
authors.forename: Jan
authors.initials: J
authors.lastname: Ekstrand
authors.forename: Gunilla Sandborgh
authors.initials: GS
authors.lastname: Englund
mesh_terms: D000180:Acrylic Resins / Q000009:adverse effects; D000368:Aged; D001294:Attitude to Health; D002516:Ceramics / Q000009:adverse effects; D002858:Chromium Alloys / Q000009:adverse effects; D015331:Cohort Studies; D003188:Composite Resins / Q000009:adverse effects; D003722:Dental Alloys / Q000009:adverse effects; D003723:Dental Amalgam / Q000009:adverse effects; D003764:Dental Materials / Q000009:adverse effects*; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006047:Gold Alloys / Q000009:adverse effects; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D059352:Musculoskeletal Pain / Q000209:etiology; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000209:etiology; D013548:Sweden; D014025:Titanium / Q000009:adverse effects; D014098:Toothache / Q000209:etiology; D014987:Xerostomia / Q000209:etiology
chemical_list: D000180:Acrylic Resins; D002858:Chromium Alloys; D003188:Composite Resins; D003722:Dental Alloys; D003764:Dental Materials; D006047:Gold Alloys; D003723:Dental Amalgam; D014025:Titanium