title: Health Complaints Attributed to Dental Amalgam: A Retrospective Survey Exploring Perceived Health Changes Related to Amalgam Removal.
abstract: BACKGROUND
  Many patients have complex health complaints they attribute to dental amalgam. There is some evidence of symptom relief after removal of amalgam.
  
  
  OBJECTIVE
  The aims of this study were to assess the total symptom load in patients with all their amalgam fillings removed, and to investigate the self-reported improvement of health with regard to precautions taken under amalgam removal and time since removal.
  
  
  METHODS
  The survey was distributed to all members (n=999) of the Norwegian Dental patients association in 2011. The study participants returned the questionnaires anonymously by means of a pre-stamped envelope. The questionnaire asked for sociodemographic data, subjectively perceived health status, complaints persisting after amalgam removal and self-reported changes in symptoms after amalgam removal.
  
  
  RESULTS
  A total of 324 participants were included in the study. The majority of the participants reported improved health after amalgam removal, even though the mean degree of severity of complaints was still high. Exhaustion and musculoskeletal complaints were most severe, and reflects the fact that 38% of the participants reported poor to very poor current health. With regard to amalgam removal, associations between improved health, number of precautions applied, and time since removal were found.
  
  
  CONCLUSIONS
  Most of the participants in this study reported improvement of health after amalgam removal even though they still suffered a high complaint load. Since absolute symptom load is a robust predictor for general health outcome and socioeconomic burden for society, a possible intervention, which enables patients to further improve their health status is desirable.
authors.affiliation: The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Agnete Egilsdatter
authors.initials: AE
authors.lastname: Kristoffersen
authors.affiliation: The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Terje
authors.initials: T
authors.lastname: Alræk
authors.affiliation: The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Trine
authors.initials: T
authors.lastname: Stub
authors.affiliation: Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany.
authors.forename: Harald Johan
authors.initials: HJ
authors.lastname: Hamre
authors.affiliation: Dental Biomaterials Adverse Reaction Unit, Uni Research Health, Bergen, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Björkman
authors.affiliation: The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Frauke
authors.initials: F
authors.lastname: Musial
keywords: Dental amalgam; Health complaints; Mercury; Restoration