Below are some fairly old references with abstracts demonstrating the effects of removing amalgam. Just because the studies are old does not invalidate them. IT does however demonstrate how long it has been known, compared to the current teaching and propaganda.
BUT FIRST:
There’s nothing like a bit of history to put things in perspective. A very official document was published in 1992, which found no significant detrimental effects for the mercury released from amalgam fillings. It is responded to below.
Potential Biological Consequences of Mercury Released from Dental Amalgam. A State of the Art Document. [MFR-panel (Swedish Medical Research Council)] A State of the Art Conference in Stockholm 9-10 April 1992.
“- Mercury released from dental amalgam does not, according to available data, contribute to systemic disease or systemic toxicological effects.
– No significant effects on the immune system have been demonstrated with the amounts of mercury which may be released from dental amalgam fillings.
– Allergic reactions to mercury from amalgam have been demonstrated, but are extremely rare.
– In very few individuals local reactions such as lichenoid reactions of the mucosa, may occur adjacent to amalgam restorations as well as adjacent to dental restorations made of other materials.
– There are no data supporting that mercury released from dental amalgam give rise to teratological effects.
– The possible environmental consequences of mercury from handling dental amalgam can be controlled by proper waste management, including the installation of efficient amalgam separators in dental offices.
– Available data do not justify discontinuing the use of silver-containing dental amalgam fillings or recommending their replacement.”
In the panel: Bergman B (chairman), Boström H, Larsson K S, Löe H
Response to the above:
Prof. Murray Vimy. Professor of Medicine in Dentistry.
The University of Calgary Health Sciences Centre 3330 Hospital Drive N.W., Calgary December 15, 1992
An open letter to Sekreterare Tore Scherstén Medicinska Forskningsrådet Swedish Medical Research Council Box 6713 S-113 85 Stockholm, Sweden
Re: Potential Biological Consequences of Mercury Released from Dental Amalgam. A Swedish state of the Art Conference, April 9, 1992.
Dear Secretary Scherstén:
By now you must have felt the pressure of a number of groups who have criticized your “conference”. In fairness to you, it is apparent that trust was misplaced in an organizing committee, which had no intention of convening an objective academic scientific forum. Rather, these individuals had a predetermined agenda, as demonstrated by their public positions on the issue of amalgam safety taken on many occasions prior to this meeting.
Drs. Larsson, Löe and Bergman are all on the record as defenders of the status quo. Dr. Bergman’s objectivity is tainted by his wife’s involvement in the issue; while Dr. Larsson is on the record as a strong supporter of amalgam. Indeed, it was incredible to see this person act as both presenter and “judge”, especially since he has no scientific experimental track record of his own to demonstrate his expertise in this area. Finally, Dr. Löe, politically, administratively and economically affiliated with the American dental establishment, is apparently more concerned with preventing litigation in the U.S.A. than he is with determining scientific truth. His opening biased remarks made it obvious why he was chosen as moderator. Dr. Boström was red herring – a physician “yes”-man with absolutely no research expertise in this area.
The conference presenters showed a general lack of expertise. Most have poor research records, and many had not published research papers on either mercury or dental amalgam. This is easily determined by reviewing the bibliographies to their written presentations. They have few if any research papers of their own to cite! The penultimate example was Dr. Petr Skrabanek, a self appointed “quack catcher”. This individual, who has no scientific expertise of amalgam, is one of a growing group of self-appointed watch-dog “experts”. In North America, we have an organization called the National Council Against Health Fraud which purports to be expert in everything. Dr. Skrabanek’s mere presence at the meeting totally discredited the scientific purpose of the conference. Sweden, a country of many noted scientists, was better represented by the quality of the expertise in the audience than by the quality of many conference speakers.
Finally, I understand that my invitation to present a paper at this conference was extended reluctantly by the organizing committee, and only after political pressure for a more balanced meeting. If you review the list of speakers chosen it will be obvious that the intention of the organizers was to “whitewash” the conclusions. The conclusions of the conference were drawn by the organizing committee and do not represent a consensus view of all the participants or the audience. Since the results were apparently preordained, as I have just described, they are not credible.
I have enclosed for your information a reprint of a recent medical scientific forum on the same issue (Goering et. al., 1992). As you can see, there is now international scientific concurrence on a number of points related to the amalgam mercury issue and its potential effects on human health; a concurrence which is in marked contrast to the “massaged” conclusions of the Swedish Medical Research Council’s biased organizing committee.
Respectfully yours,
signed
Murray J. Vimy BA, DMD, FAGD, FIAOMT Clinical Associate Professor Department of Medicine (also Private Practice of Dental Medicine)
Idiosyncrasy to metallic mercury, with special reference to amalgam fillings in the Teeth. Bass M HJ Pediat 23:215-218 (1943)
ABSTRACT “Three cases of idiosyncrasy to metallic mercury are described. All occurred in children and all showed symptoms referable to the skin. In two instances metallic mercury applied to the skin was the active agent. In two, amalgam fillings were the etiologic factor. In one of these, symptoms of severe urticaria continued until the removal of the fillings. This cause of urticaria may be more common than is ordinarily supposed.”
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Thrombocytopenia in two children after placement of amalgam fillings in primary teeth).Berglund F, Elinder G Program, Sammanfattningar, Svenska Läkarsällskapets Riksstämma 27-29 nov 1991 ABSTRACT
“A 9 year old girl in Oskarshamn went ill 2 months after inseration of one amalgam filling into a primary tooth, having petechiae on her legs and bleeding gums. Trombocytes initially 15×19(9)/l rapidly decreasing to 2,1×10(9)/l. Microscopy of bone marrow displayed small and immature megakaryocytes. Prednisolone 60 mg per os was administered for four days, then 20 mg/day. Prednisolone was finished after 3 weeks. Trombocytes then rose within 3 months from 43 up to ca 200×10(9)/l. During this time the girl had lost her decidious tooth with the amalgam filling. The mother had 16 amalgam fillings of varying size and 4 gold crowns. She suffered from aching joints, fatigue, and frozenness, and she fully breast-fed the girl for 7 months. A boy born 1979 had an amalgam filling inserated in a primary tooth in 1982, in dec-83 bruises, and trombocytes 23×10(9)/l. Strongly positive Coombs test. Initially treated with Cortison and Imurel. After a couple of months only Imurel was given with short intermissions until 1991. The tooth started to loosen in nov-90, and was lost in jan-91, and have been analyzed. The boy is now well. The mother has amalgams in all molars and premolars, metallic taste since around 1986. She breast-fed the boy for 2 months. Mice exposed to mercury vapour enrich mercury also in bone marrow (Khayat, Dencker 1983). Tooth history for mother and child should be part of anamnestic assessment.” [Transl. BW]
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Mercury allergy resulting from amalgam restorations. Engelman M A J Amer Dent Assoc 66:122-123 (1963)
ABSTRACT
“A patient was studied who had an allergy to the mercury used in silver amalgam restorations. Although uncommon, this problem could be encountered in any dental office. If the patient is found to be allergic to mercury, no mercurials should come into contact with the patient. These preparations include calomel, merbromin, thimerosal, nitromersol and mercurial ointments. The use of an antihistamine has been found to reduce the patient’s post-operative discomfort and should be considered as adjunctive therapy in similar instances.”
Dermatitis due to mercury in amalgam dental fillings. Feuerman E Contact Dermatitis l:191 (1975) ABSTRACT “30-year-old metal worker was admitted with a clinical picture of acute dermatitis of the face, neck and upper thorax which had been present for one week. Examination revealed edema and erythema, with a papulo-vesicular rash, which was particularly pronounced on the face, where oozing and crust formation could also be seen. A similar rash had appeared several times during the past ten years, disappearing each time after approximately two weeks. In the hospital, the rash disappeared after four days of corticosteroid treatment. He was hospitalized again four years later in a similar condition, patch tests gave a strongly positive vesicular reaction to mercury which lasted for more than two weeks. In 1969, the patient was re-admitted in a much worse state, with pronounced edema of the eyelid. A silver amalgam dental filling had been inserted in two teeth the day before. Examination revealed only a slight edema of the gingiva which was not located at the exact site of the filling. In 1970, he once more appeared in a similar condition, in spite of the fact that no contact with mercury other than the amalgam fillings could be discovered. After all signs of the disease had disappeared, the amalgam fillings were removed. This was followed by a new outbreak of severe dermatitis, but during the four years which have passed since it disappeared, there has been no new recurrence. The appearance of the rash in 1970 one year after the amalgam fillings were made, and the fact that during the four years after their removal there has been no recurrence of the rash, indicate that dermatitis may be caused by the mercury in old fillings and not only by that in new dental fillings.”
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Chronic illness in association with dental amalgam: Report of two cases. Godfrey M E J Adv Med 3:247-255 (1990)
ABSTRACT
“Two case studies, involving multiple symptomatology, are presented. A casual relationship with dental amalgam is proposed, with remission of symptoms and signs following removal of the source.”
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Amalgam-related chronic ulceration of oral mucosa. Jolly M, Moule A J, Freeman S Br Dent J 160:434-437 (1986)
ABSTRACT
“A case is presented in which long-standing chronic ulceration in the mouth healed rapidly following the removal of old amalgam restorations from several teeth. Electron microprobe analysis of the amalgam revealed evidence of extensive corrosion which had probably resulted in prolonged release of mercury on to the surface of the restoration. The patient exhibited a positive patch test to mercury and to dental amalgam. It is evident that mercury may be the etiological agent in the development of some oral lichenoid lesions.”
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Exercise-induced anaphylaxis: improvement after removal of amalgam in dental caries. Katsununa T, Iikura Y, Nagakura T, Saitoh H, Akimoto K, Akasawa A, Kindaichi S Ann Allergy 64:472-475 (1990)
ABSTRACT
“We present a case of exercise-induced anaphylaxis with improvement following the removal of dental amalgam. Although her symptoms were unresponsive to various kinds of therapy until removal of the amalgam, her symptoms related to exercise improved remarkably after the removal. The increase in plasma histamine levels for exercise provokation test also improved. This suggests that sensitivity to metals might cause exercise-induced asthma in som patients…. The patient, a 9-year-old girl, was admitted to our hospital because of urticaria and fainting induced by exercise. She had been suffering from atopic dermatitis since the age of 1 year. Two years prior to being seen, when she was 7 years old, urticaria developed over her extremities when she was exposed to rain. Urticaria and erythema after exercises were observed 3 months before admission. Two months before admission, urticaria, chest tightness, transient loss of consciouness, and rigidity of extremities were recognized after running gymnastic exercises in school. She recovered spontaneously, but such symptoms induced by exercise were increasing in frequency and severity. One month before admission an abnormal EEG was noted…. During admission, we were told by her mother that a cavity in her tooth had been filled with amalgam about 3 years before admission (when she was 6 years old), and that the local gingiva swelled on the next day. She was examined by 48 hours patch test… At the site of the amalgam. erythema and small papules were recognized… Two months after the removal of amalgam, she underwent an exercise provocation again… This time only mild itch and erythema were observed… Approximately 1 year after the removal, she enjoys a normal daily life, including gymnastic exercise in school without any medication.
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A Case of High Mercury exposure from Dental Amalgam. Langworth S, Strömberg R European Journal of Oral Sciences. Jun 1996; 104(3):320-321. ISSN: 0909-8836
ABSTRACT
“This report describes a patient who suffered from several complaints, which by herself were attributed to her amalgam fillings. Analysis of mercury in plasma and urine showed unexpectedly high concentrations, 63 and 223 nmol/l, respectively. Following removal of the amalgam fillings, the urinary excretion of mercury became gradually normalized, and her symptoms declined.”
Comment: In the article is also told that recovery was lasting, which would not likely be the case if it was a placebo effect (authors’ statement). BW
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Urticaria following a dental silver filling – case report. Markow H New York State J Med 43:1648-1652 (1943)
ABSTRACT
“The onset of urticaria with local buccal and tongue edema and paresthesia followed shortly after the introduction of a mercury filling into a tooth and, repeatedly, exacerbations were induced by the removal of such fillings and by the use of a similar filling placed against the hard palate as a provocative procedure. Although several such fillings were in the mouth for many years, the out break of this attack came on only after the last filling. In all probability, sensitivity was induced by contact with the previous fillings, and the allergic response occurred following the last filling.”
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Three cases of linear lichen planus cused by dental metal compounds. : Sasaki G, Yokozeki H, Katayama I, Nishioka K: J Dermatol 1996 Dec 23:12 890-2
ABSTRACT
Three cases of linear lichen planus on the lower extremities unaccompanied by mucous lesions are described. Dental metal compounds were thought to be the precipitating factor in all cases. Skin lesions did not respond to topical steroid ointment or antihistamines. Two cases showed a positive patch test reaction to gold (HAuCl4) and a positive lymphocyte stimulation test to gold compound (Gold sodium thiomalate). One case showed a positive patch test reaction to mercury (HgCl2), but a negative lymphocyte stimulation test. Suspected metal compounds were demonstrated in their dental materials. Removal of gold materials in one case gradually improved the lesions within 6 months with a transient erythematous swelling of the face shortly after removal of the metal. Both of these cases responded to oral disodium chromoglycate therapy. These results suggest that metal compound specific T cells might be responsible for the development of linear lichen planus.
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Generalized allergic reaction from silver amalgam fillings Strassburg M, Schubel R : Dtsche Zahnarztliche Zeit 22:3-9 (1967)
ABSTRACT
“Silver amalgam fillings, having been in the mouth of a 45 year old female patient over several years, suddenly produced recurrent and generalized allergic reactions which subsided completely after removal of these fillings. The preceding epidermal test with silver amalgam, taken from the old fillings, was positive. A later, unintentional exposure to organic mercury-compounds led to recurrence of the disease and thus once more confirmed the diagnosis of allergy to mercury.”
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A case of hypersensitivity to mercury released from amalgam fillings. Witek E Source: Czas Stomat 22:311-315, (?)
ABSTRACT
“The author discusses the toxic and allergic effects of mercury present in amalgam fillings on the organism. A case of acute allergic reaction to presence of mercury released from an extensive amalgam filling is reported. The symptoms included itching, burning edema and reddening of the oral mucosa and appearance of itching eruptions on the face 15 hours after insertion of filling. After removal of the filling and appropriate treatment improvement appeared on the following day and complete disappearance of symptoms occurred after 6 days of treatment.”
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Allergic reaction to mercury after dental treatment. Wright F A C New Zealand Dent J 67:25l-252 (1971)
ABSTRACT
“A 13-year-old girl was sensitized to mercury at the age of 13 months and since 9 years of age, she has had an allergic reaction following the placement of amalgam restorations. No reaction followed her treatment in a mercury-free area. Rubber dam and towel drapes ensured that she had no contact with mercury during the removal of inadequate amalgam restorations, and composite resin was used for new restorations. Satisfactory amalgam restorations were not replaced.”
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Description of persons with symptoms presumed to be caused by electricity or visual display units–oral aspects. Bergdahl J, Anneroth G, Stenman E Scand J Dent Res. 1994 Feb; 102(1): 41-5
ABSTRACT
A questionnaire containing 20 questions was sent to 127 members of the Association for Those Injured by Electricity and Visual Display Units in northern Sweden, of whom 103 (81%) answered. The questionnaire consisted of questions about age, sex, and place of work. Furthermore, the members were asked to state: 1) their general and oral symptoms; 2) whether they thought that dental amalgam and other types of dental filling materials had affected their symptoms; 3) whether they were replacing or had replaced their amalgam fillings and, if so, what effect it had had on their symptoms; 4) whether they had been medically examined; and 5) whether they were or had been sick-listed for their complaints. Of those who answered the questionnaire, 79% were women (mean age 45 yr) and 21% men (mean age 42 yr). Sixty percent worked in offices. In 82%, the symptoms had started at work. The mean duration of the symptoms was 5.2 yr. The symptoms were aggravated mostly in “electric environment in general” and in “office with computers”. Skin complaints, fatigue, and eye symptoms were the most common general symptoms. Sixty-five percent mentioned that they had oral symptoms. Gustatory disturbances, burning mouth, and temporomandibular joint (TMJ) dysfunction were the most common oral symptoms. Fifty-six percent considered that dental amalgam and 24% that other dental materials affected the symptoms. Twenty-one percent were in the process ofreplacing the amalgam fillings; 40% had already done so. After replacement, 37% had noticed a decrease of symptoms…
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Long-term mercury excretion in urine after removal of amalgam fillings Begerow J, Zander D, Freier I, Dunemann L Int Arch Occup Environ Health 1994 66:3 209-12
ABSTRACT
The long-term urinary mercury excretion was determined in 17 28- to 55-year-old persons before and at varying times (up to 14 months) after removal of all (4-24) dental amalgam fillings. Before removal the urinary mercury excretion correlated with the number of amalgam fillings. In the immediate post-removal phase (up to 6 days after removal) a mean increase of 30% was observed. Within 12 months the geometric mean of the mercury excretion was reduced by a factor of 5 from 1.44 micrograms/g (range: 0.57-4.38 micrograms/g) to 0.36 microgram/g (range: 0.13-0.88 microgram/g). After cessation of exposure to dental amalgam the mean half-life was 95 days. These results show that the release of mercury from dental amalgam contributes predominantly to the mercury exposure of non-occupationally exposed persons. The exposure from amalgam fillings thus exceeds the exposure from food, air and beverages. Within 12 months after removal of all amalgam fillings the participants showed substantially lower urinary mercury levels which were comparable to those found in subjects who have never had dental amalgam fillings. A relationship between the urinary mercury excretion and adverse effects was not found. Differences in the frequency of effects between the pre- and the post-removal phase were not observed.
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Effect of Replacement of Dental Amalgam on Oral Lichenoid Reactions. Bratel J, Hakeberg M, Jontell M: Journal of Dentistry. Jan-Mar 1996; 24(1-2):41-45
Objectives: The objectives of this study were to investigate (i) healing of oral lichenoid reactions (OLR) following the selective replacement of restorations of dental amalgam, (ii) whether there were differences in healing between contact lesions (CL) and oral lichen planus (OLP), and (iii) whether there was a difference in healing potential when different materials were selected as a substitute for dental amalgam. Methods: Patients included in the study presented with OLR confined to areas of the oral mucosa in close contact with amalgam restorations (CL; n = 142) or with OLR which involved other parts of the oral mucosa as well (OLP; n = 19). After examination, restorations of dental amalgam which were in contact with OLR in both patient groups were replaced. The effect of replacement was evaluated at a follow up after 6-12 months. Results: In the CL group, the lesions showed a considerable improvement or had totally disappeared in 95% of the patients after replacement of the restorations of dental amalgam (n = 474). This effect was paralleled by a disappearance of symptoms, in contrast to patients with persisting CL (5%) who did not report any significant improvement. The healing response was not found to correlate with age, gender, smoking habits, subjective dryness of the mouth or current medication. However, the healing effect in patients who received gold crowns was superior compared to that of patients treated with metal ceramic crowns (MC; P < 0.05). In the OLP group (n = 19), 63% of the patients with amalgam associated erosive and atrophic lesions showed an improvement following selective replacement. OLP lesions in sites not in contact with amalgams were not affected. Most of the patients (53%) with OLP reported symptoms also after replacement. Conclusion: From these data it can be concluded that the vast majority of CL resolve following selective replacement of restorations of dental amalgam, provided that a correct clinical diagnosis is established. It is also noteworthy that MC crowns did not facilitate healing of CL to the same extent as gold crowns.
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Mercury sensitization in amalgam fillings. Assessment from a dermatologic viewpoint Brehler R, Panzer B, Forck G, Bertram H P Dtsch Med Wochenschr 1993 Apr 2 118:13 451-6
ABSTRACT
“Epicutaneous tests were performed on 88 patients (27 men, 61 women; mean age 36.8 [18-68] years) thought to have an allergy against amalgam or mercury. In addition their oral mucosa was assessed clinically. The epicutaneous test was positive for mercury sensitization in seven patients, five of them reporting oral mucosa symptoms. Such symptoms also occurred, although less frequently, in non-sensitized patients (30 of 81). In three sensitized patients there was evidence of perioral dermatitis which in two of them cleared up after removal of the amalgam fillings. Two further patients had no further complaints, such as burning sensation on the oral mucosa, recurrent aphthous ulcers or gingivitis, after removal of amalgam fillings. In one patient each peroral eczema and diarrhoea aggravated after amalgam fillings had been taken out. These observations indicate that responses to mercury allergy are not uniform and show considerable individual variations. There is no reason to advise against or prohibit the use of amalgam fillings. Their substitutions by other materials may well bring about other types of allergy.”
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Healing of Lichenoid Reactions Following Removal of Amalgam – a Clinical Follow-up Henriksson E, Mattsson U, Håkansson J:. J Clin Periodont 22(4):287-294 (1995)
131 patients who made complete or partial amalgam removal, and amalgam removal in 10 patients with negative patch tests for mercury.
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The Relevance and Effect of Amalgam Replacement in Subjects with Oral Lichenoid Reactions Ibbotson S H, Speight E L, Macleod R I, Smart E R, Lawrence C M British Journal of Dermatology. Mar 1996; 134 (3):420-423. ISSN: 0007-0963
ABSTRACT
In this study we examined the prevalence of mercury hypersensitivity in patients with oral lichenoid reactions (OLR) and the effect of amalgam replacement in subjects with amalgams adjacent to OLR irrespective of their mercury sensitivity status. One hundred and ninety seven patients with oral problems were examined: 109 with OLR, 22 with oral and generalized lichen planus, and 66 with other oral diagnoses. including aphthous ulcers and orofacial granulomatosis. Nineteen per cent of patients with OLR reacted to mercury on patch testing, significantly more than in those with generalized lichen planus (0%) and in those with other oral diagnoses (3%). Twenty two patients with OLR and adjacent amalgams had amalgam replacement and, in 16 of 17 mercury positive subjects and three of four mercury negative subjects, the OLR resolved after amalgam removal. In conclusion, we found a significantly increased prevalence of mercury hypersensitivity in patients with localized OLR in comparison to subjects with other oral problems. Amalgam replacement resulted in resolution of OLR in the majority of patients with amalgams adjacent to OLR irrespective of their mercury sensitivity status.
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Resolution of oral lichenoid lesions after replacement of amalgam restorations in patients allergic to mercury compounds.: Laine J, Kalimo K, Forssell H, Happonen R P Br J Dermatol 126(1):10-15 (1992) ABSTRACT
“The significance of contact allergy in patients with various oral symptoms was studied. Positive patch-test reactions to mercury compounds were found in 21/91 patients. Of these, 18 had lichenoid lesions in oral mucosa in close contact to amalgam fillings, and three patients with contact allergy had neither amalgam fillings in their teeth nor visible oral lesions. Amalgam replacement was carried out in 15/18 symptomatic patients. The fillings were replaced with gold in three cases, composite resin fillings in six, glass ionomer in three and both gold and composite materials in three cases. In 10 patients there was complete replacement and in five it was restricted to the fillings adjacent to the mucosal lesions. After a mean follow-up period of 3.2 years a complete cure was seen in seven patients, each of whom had had all their fillings changed. A marked improvement occurred in six patients, and there was no change in two.”
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Symptoms before and after proper amalgam removal in relation to serum-globulin reaction to metals. Lichtenberg H Journal of Orthomolecular Medicine Vol 11 No.4. pp 195-203 1996.
ABSTRACT
The results of this study indicate that proper amalgam removal – and in some cases removal of all the other metals – and replacement with biocompatible composites – can eliminate or reduce 80% of the classic symptoms of chronic mercury poisoning.
These results also show that the strength of an individual’s serum-globulin reaction, to many metals used in dentistry, especially the five metals present in amalgam, has important implications for recovery.
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Effects of Removing Amalgam Fillings from Patients with Diseases Affecting the Immune SystemLindqvist B, Mörnstad H Medical Science Research. May 1996; 24(5):355-356
ABSTRACT
53 patients with complaints which they attributed to their amalgam fillings, and with pathological tests indicating abnormality of the immune system, were followed for 1-3 years after the removal of all, part of, or none of their amalgam fillings. Within the group of 34 individuals who had all their amalgam fillings replaced, there was a significant number of decreased antibody titres, but only two had normalised their laboratory tests after 1-3 years. A significant improvement in subjective symptoms occurred in 20 (59%) of cases. In the group of patients who still had amalgam fillings, there were no statistically significant changes in the antibody titres. It thus seems that mercury released from amalgam fillings may initiate or support an ongoing immune disease. However. this study group was rather heterogeneous, and had received various pharmacological treatments. Further studies, are, therefore, needed to confirm, or refute, the results.
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Allergy and corrosion of dental materials in patients with oral lichen planus. Lundström I M C Int J Oral Surg 13:16-24 (1984)
ABSTRACT
“Patients with histologically verified oral lichen planus (OLP) were studied regarding allergic reactions to substances in dental materials, presence of clinical corrosion orally and factors influencing corrosion, such as mixed gold and amalgam therapy, non-precious pin-constructions or complete dentures. The material consisted of 48 OLP patients (33 female, 15 male) and the results were compared with those of a control group (40 patients) and/or general population samples. When patch tested, 39% of the OLP patients reacted to one or more components in dental materials. Reaction to mercury was most common, being noted in 26%. Clinical signs of corrosion were significantly more frequent in the OLP group (72%) than in the control cases (28%). Patients with atrophic-erosive OLP exhibited a significantly higher frequency of corrosion (83%) than those with reticular type (46%). Mixed gold and amalgam therapy and screwposts were equally present in both the OLP and control group and the frequency of complete dentures corresponded to that reported for general populations. A change of dental materials in 8 patients with positive patch tests led to marked oral improvement in 6 cases, 2 of which became completely cured. The frequencies recorded for allergic reactions and corrosion as well as the result of treatment indicate that substances in dental materials may be of significance in cases of OLP.”
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Amalgam Associated Oral Lichenoid Reactions: Clinical and Histologic Changes After Removal of Amalgam Fillings. Östman P O, Anneroth G, Skoglund A Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics. Apr 1996; 81 (4):459-465.
ABSTRACT
Objective and study design. Forty nine consecutive patients with clinically diagnosed oral lichenoid reactions in contact with amalgam fillings were studied clinically and histologically. The long term effect of replacement of these fillings was also examined. Results. Seventeen (35%) patients showed positive reactions to mercury at the epicutaneous patch test that was carried out before treatment. After treatment, total regression of the lesions was found clinically in 33 (69%) and histologically in 26 (55%) patients. Most of the remaining lesions changed clinically and histologically to a less pronounced tissue reaction. Lesions in direct contact with amalgam fillings (group I) showed significantly better healing results than lesions that exceeded the contact area (group II). No difference in healing capacity was noted in the two groups between patients with positive patch reactions to mercury compared with those with negative reactions. Lesions that histologically were classified as benign oral keratosis showed a similar healing pattern as those classified as oral lichen planus. Conclusion. In group I all lesions changed histologically and clinically to a normal mucosa or to a less affected tissue reaction. In group II this change was less pronounced, which suggests that the fillings themselves were not the only factor involved in the cause of these lesions. The results suggest that various etiologic factors are involved in lichenoid reactions and that the effect of removal of amalgam fillings cannot be predicted by epicutaneous patch testing and biopsies.
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No Evidence of Renal Toxicity from Amalgam Fillings. Sandborgh-Englund G, Nygren A T, Ekstrand J, Elinder American Journal of Physiology Regulatory Integrative and Comparative Physiology. Oct 1996; 40 (4) : R941-R945
ABSTRACT
Dental amalgam continuously releases mercury. Studies of sheep [Boyd et al., Am. J. Physiol. 261 (Regulatory Integrative Comp. Physiol. 30): R1010 R1014, 1991] showed decreased renal function after placement of amalgam fillings. In this study, renal function was investigated in 10 healthy volunteers before and after amalgam removal. The subjects had an average of 18 tooth surfaces filled with amalgam, which was removed during one dental session. One week before sind sixty days after removal, the glomerular filtration rate (GFR) was determined by Cr 51 EDTA clearance technique. Blood and urine samples were collected for analysis of mercury, creatinine, beta(2) microglobulin, N acetyl beta glucosaminidase (NAG), and albumin 1 wk before and 1, 2, and 60 days after amalgam removal. The plasma mercury concentration increased significantly 1 day after removal. Sixty days later, significantly lower mercury levels were found in blood, plasma, and urine. The GFR values were similar before and after mercury exposure (mean 94 and 94 ml/min per 1.73 m(2), respectively). No detectable effects occurred on excretion of NAG, beta(2) microglobulin, or albumin. It is concluded that no signs of renal toxicity could be found in conjunction with mercury released from amalgam fillings.
This piece is interesting from many points of view. In the full text of the article something is revealed, which is not mentioned in the abstract. The experiment was removing amalgam fillings from 10 healthy individuals to see if this produced any tokens of kidney damage. If this would have been shown from this number of cases it would have been a sensation, so you could say that it was a very safe experiment to perform if your object was to show nothing! However, one of the subjects of this experiment went temporary ill after the amalgam removal. A discussion of this unexpected event of a side effect is in the full text, and the conclusion is that this healthy person reacted adversly to the elevated mercury levels from the one-session removal process without any protection due to unusual heavy exercise the day of the removal, viz. riding a bicycle 10 km (daily ride to and from the job?). Questions: There is a Swedish register for side effects from dental amalgams. Is this event reported? There is a regulated duty to protect subjects on experimental trials from risk. Obviously the ethical board permitting the experiment said nothing about the procedure in advance, so: have this incident been reported to the ethical board to avoid future risks of similar experimentation? Comment: It is an observation that in a sample of 10 healthy subjects one reacted adversly to amalgam removal. This is a significant observation, but it is not presented in the abstract, which is the main source for communicating significant observations. Obviously this case slipped the eyes of the WHO expert group.
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Resolution of lichen planus following removal of amalgam restorations in patients with proven allergy to mercury salts: a pilot study. Smart E R, Macleod R I, Lawrence C M Br Dent J 178(3):108-112 (1995)
ABSTRACT
“Thirteen patients with symptomatic oral lichen planus had been shown by patch testing to be allergic to ammoniated mercuric chloride. Replacement of amalgam restorations in these patients effected an improvement in all but one case. In some cases the resolution of symptoms was dramatic following the replacement of one or two fillings. The authors feel that the removal of all amalgam fillings need not be necessary except in the most intractable case.”
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The contribution of dental amalgam to mercury in blood. Snapp K R, Boyer D B, Peterson L C, Svare C W J Dent Res. 1989 May; 68(5):780-5
ABSTRACT
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.
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Studies of individuals with orofacial discomfort complaints. An investigation of a group of patients who related their sufferings to effects of dental materials and constructions. Yontchev E A Swed Dent J Supplement 38 (1986)
ABSTRACT
“This thesis is based on seven studies. The aim of these studies were to investigate a series of consecutive patients with orofacial and general sensations and complaints of discomfort, which the patients assumed to be caused by galvanic currents created by metallic dental fillings and restorations, as well as contact allergy to both metallic and non-metallic substances in dental materials. Studies I and II described the patients’ symptoms and complaints, as well as the clinical findings of many odontological and medical examinations. A widely vatying symptom panorama and numerous clinical findings, both oral and general, have been found which could not be explained by a single etiological factor. A combination of many factors, such as general health problems, side effects of medication, psychosocial problems, including stressful life events and complications due to the chronicity of the pain formed the background to the oral and general complaints of these patients. The salivary and microbiological conditions and patch test results were presented in studies III and IV. The salivary flow rate, pH and cariogenic bacteria level as well as contact allergy to metallic and non-metallic substances known as allergens, were not significantly different, but buffer capacity and saliva conductance did differ. A laboratory investigation of the corrosion behaviour of dental amalgams and gold alloys in natural saliva and saline solutions was performed (Study V) and the corrosion state of dental amalgam fillings and construction was examined (Study VI). Special laboratory and clinical methods and apparatus were constructed and used. No differences between electrode potentials of the amalgam fillings and constructions in patients with and without orofacial discomfort complaints were measured. Study VII presentaed an analysis of the outcome of the treatments applied. The treatment was based on each patient’s symptoms and signs and probable diagnosis. Besides conventional dental, stomatognathic and medical treatment, metallic constructions were removed in 54% of the patients. The initial treatment result was favourable in 80% but recurrences were frequent. It was concluded that these patients need a careful oral examination and dental treatment of observed local pathosis and defects of dental constructions, but removal of metallic fillings and constructions should be avoided when not indicated. Many of these patients require medical consultation and treatment, and collaboration between the dentist and the physician is recommended
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Removal of Dental Mercury: Often an Effective Treatment for the Very Sensitive Patient Zamm A F J Orthomolecular Med 5(53):138-142 (1990
ABSTRACT
“This study covers 22 patients who had multiple severe sensitivities in that they were extremely intolerant to inhalants (particles and vapours), ingestants (food and chemicals) and their own endogenous, normally occurring yeast (Candida albicans). The removal of dental mercury (“amalgam”) fillings was the single most effective method of improving the health of these patients after other methods were instituted, i.e., avoidance, hyposensitization and nutritional improvement.”
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Elimination of symptoms by removal of dental amalgam from mercury poisoned patients, as compared with a control group of average patients. Lichtenberg H J J Orthomol Med 8:145-148 (1993)
ABSTRACT
“The findings presented here suggest a correlation between many health complaints and mercury amalgam fillings. Removal of amalgam fillings results in significant improvement of these symptoms. These same symptoms which are improved or eliminated in amalgam-removal patients are present but undiagnosed in the general population.”
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Mercury, selenium, and glutathione peroxidase before and after amalgam removal in man. Molin M, Bergman B, Marklund S L, Schütz A, Skerfving Acta Odontol Scand. 1990 Jun; 48(3): 189-202
In 10 healthy persons all amalgam fillings were replaced with gold inlays. Blood and urinary levels were measured on 10 occasions during a 4-month period before and a 12-month period after amalgam removal. These variables were also measured three times in 10 healthy controls. A strong statistically significant relation was found between plasma mercury values and both the total number of amalgam surfaces (r = 0.71, p = 0.0006) and the total surface area of the fillings (r = 0.73, p = 0.0004). In the immediate postremoval phase plasma mercury rose three- to four-fold, whereas the urinary and erythrocyte mercury rose about 50%. These peak values declined to the preremoval level at about 1 month. Twelve months after the removal the plasma and urinary mercury levels were significantly reduced to 50% and 25%, respectively, of the initial values for the experimental group. Apart from the significantly lower plasma selenium values 5 and 10 days after removal no significant differences were found with regard to plasma selenium or erythrocyte glutathione peroxidase either within or between the experimental and the control groups. A large number of supplementary biochemical analyses did not show any influence on organ functions or any differences between the groups before or after the amalgam removal. Amalgam fillings considerably contributed to the plasma and urinary mercury levels.
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The relationship between mercury from dental amalgam and oral cavity health. Siblerud R LAnn Dent 49(2):6-10 (1990)
ABSTRACT
“The findings presented here suggest that mercury from dental amalgam may play a role in the etiology of oral cavity health. Comparisons between subjects with and without amalgam showed significant differences of diseases of the mouth. Subjects who had amalgams removed reported that symptoms of diminished oral health were improved or eliminated after removal. The data suggest that inorganic mercury from dental amalgam does affect the oral cavity.”
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A comparison of mental health of multiple sclerosis patients with silver/mercury dental fillings and those with fillings removed. Siblerud R L Psychol Rep. 1992 Jun; 70(3 Pt 2): 1139-51
ABSTRACT
In this study was compared the mental health status of 47 multiple sclerosis patients with silver/mercury tooth fillings (amalgams) to that of 50 patients with their fillings removed. On the Beck Depression Inventory the multiple sclerosis subjects with amalgams suffered significantly more depression while their scores on the State-Trait Anger Expression Inventory indicated the former group also exhibited significantly more anger. On the SCL-90 Revised, subjects with amalgam fillings had significantly more symptoms of depression, hostility, psychotism, and were more obsessive-compulsive than the patients with such fillings removed. On a questionnaire containing 18 mental health symptoms multiple sclerosis subjects with amalgam fillings reported a history of 43% more symptoms than those without amalgam fillings over the past 12 months. These data suggested that the poorer mental health status exhibited by multiple sclerosis subjects with dental amalgam fillings may be associated with mercury toxicity from the amalgam.
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Evidence that mercury from silver dental fillings may be an etiological factor in multiple sclerosis. Siblerud R L, Kienholz E Sci Total Environ. 1994 Mar 15; 142(3):191-205
ABSTRACT
This paper investigates the hypothesis that mercury from silver dental fillings (amalgam) may be related to multiple sclerosis (MS). It compares blood findings between MS subjects who had their amalgams removed to MS subjects with amalgams. MS subjects with amalgams were found to have significantly lower levels of red blood cells, hemoglobin and hematocrit compared to MS subjects with amalgam removal. Thyroxine levels were also significantly lower in the MS amalgam group and they had significantly lower levels of total T Lymphocytes and T-8 (CD8) suppressor cells. The MS amalgam group had significantly higher blood urea nitrogen and lower serum IgG. Hair mercury was significantly higher in the MS subjects compared to the non-MS control group. A health questionnaire found that MS subjects with amalgams had significantly more (33.7%) exacerbations during the past 12 months compared to the MS volunteers with amalgam removal. The paper also examines epidemiological correlations between dental caries and MS; as well as how mercury could be causing the pathological and physiological changes found in multiple sclerosis. _________________-
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Mercury-Specific Lymphocytes: An Indication of Mercury Allergy in Man. Stejskal V, Forsbeck M, Cederbrant K E, Asteman O J of Clin Immun, Vol. 16, No.1, 1996, pp. 31-40.
ABSTRACT
In this study, 18 patients with oral lichen planus (OLP), adjacent to amalgam fillings, were tested in vitro with an optimized lymphocyte proliferation test, MELISA (memory lymphocyte immunostimulation assay) and with a patch test. Twenty subjects with amalgam fillings but without oral discomfort and 12 amalgam-free subjects served as controls. The results show that patients with OLP have significantly higher lymphocyte reactivity to inorganic mercury, a corrosion product of amalgam, compared to control groups. Removal of amalgam fillings resulted in the disappearance of oral mucosal changes, thus indicating a causal relationship. Positive responses to phenylmercury (phenyl-Hg), a bactericidal agent in rootfillings and in pharmaceutical preparations, were also noted in the oral lichen group but not in the control groups. Thus, low-grade chronic exposure to mercury may induce a state of systemic sensitization as verified by Hg-specific lymphocyte reactivity in vitro.