Characterization of health complaints before and after removal of amalgam fillings — 3-year follow-up

Lygre, Gunvor Bentung; Sjursen, Therese Thornton; Svahn, Johanna; Helland, Vigdis; Lundekvam, Birgitte Fos; Dalen, Knut; Björkman, Lars

doi:10.3109/00016357.2012.697577

Cited by 11 publications

(11 citation statements)

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“…The most commonly reported single symptoms in this study were tendency to rapid exhaustion followed by tiredness , concentration disturbance , and pain in joints and limps . This finding is in line with other Scandinavian studies in similar populations [ 12 , 13 , 24 ]. Lygre et al [ 12 ] found that the most reported complaints were local symptoms around the mouth and general complaints such as pain from muscles and joints, fatigue and memory disturbance - a symptom pattern, which is confirmed in the present study.…”

Section: Discussionsupporting

confidence: 94%

Health Complaints Attributed to Dental Amalgam: A Retrospective Survey Exploring Perceived Health Changes Related to Amalgam Removal

Kristoffersen

Alræk

Hamre

et al. 2016

TODENTJ

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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.Conclusion: 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.

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Section: Discussionsupporting

confidence: 94%

Health Complaints Attributed to Dental Amalgam: A Retrospective Survey Exploring Perceived Health Changes Related to Amalgam Removal

Kristoffersen

Alræk

Hamre

et al. 2016

TODENTJ

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“…Our results add to the body of evidence that there is reduced likelihood of health complaints after removal of the amalgam fillings, consisting of either a decrease of subjective symptom burden overall or subtle effects on symptoms, mood, motor function (hand steadiness) and cognition [ 42 , 45 – 50 ]. Our findings suggest that there remains increased risk of health deterioration in study participants even with mercury levels below the established HBM-I no risk urine mercury value.…”

Section: Discussionmentioning

confidence: 51%

“…The possible dose–response relationship between low-level mercury vapor exposure and subclinical neurological and psychological effects has been characterized previously as preclinical symptoms (predominantly in dentists and dental assistants) [ 17 , 51 , 56 ]. Symptom changes associated with amalgam removal have been seen in other studies and include a diverse range of adverse effects including decreased motor functioning (e.g., losses in hand steadiness and manual dexterity, progressing to incoordination, imbalance and tremor in muscles that perform fine motor control) and loss of mental capacity (e.g., memory, confusion, diminished logical reasoning and concentration) [ 42 , 45 , 47 , 50 ]. Most of these studies are limited by their small sample size (amalgam removal group sample sizes of 20, 20, 60 and 796 respectively with the latter being a retrospective study).…”

Section: Discussionmentioning

confidence: 99%

“…It is possible that a longer follow-up period would provide different symptom effects. A recent study characterized a reduction of health complaints in persons 3 years after replacement of dental amalgams in comparison to complaints from the general population [ 45 ]. This emphasizes the magnitude of health complaints attributed to dental amalgams that can be reduced simply by removal of amalgam fillings.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal analysis of the association between removal of dental amalgam, urine mercury and 14 self-reported health symptoms

2014

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BackgroundMercury vapor poses a known health risk with no clearly established safe level of exposure. Consequently there is debate over whether the level of prolonged exposure to mercury vapor from dental amalgam fillings, combining approximately 50% mercury with other metals, is sufficiently high to represent a risk to health. The objective of our study is to determine if mercury exposure from amalgam fillings is associated with risk of adverse health effects.MethodsIn a large longitudinal non-blind sample of participants from a preventative health program in Calgary, Canada we compared number of amalgam fillings, urine mercury measures and changes in 14 self-reported health symptoms, proposed to be mercury dependent sub-clinical measures of mental and physical health. The likelihood of change over one year in a sample of persons who had their fillings removed was compared to a sample of persons who had not had their fillings removed. We use non-parametric statistical tests to determine if differences in urine mercury were statistically significant between sample groups. Logistic regression models were used to estimate the likelihood of observing symptom improvement or worsening in the sample groups.ResultsAt baseline, individuals with dental amalgam fillings have double the measured urine mercury compared to a control group of persons who have never had amalgam fillings. Removal of amalgam fillings decreases measured urine mercury to levels in persons without amalgam fillings. Although urine mercury levels in our sample are considered by Health Canada to be too low to pose health risks, removal of amalgam fillings reduced the likelihood of self-reported symptom deterioration and increased the likelihood of symptom improvement in comparison to people who retained their amalgam fillings.ConclusionsOur findings suggest that mercury exposure from amalgam fillings adversely impact health and therefore are a health risk. The use of safer alternative materials for dental fillings should be encouraged to avoid the increased risk of health deterioration associated with unnecessary exposure to mercury.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-95) contains supplementary material, which is available to authorized users.

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“…A study protocol was developed by a task group appointed by the Amalgam-attributed health complaints are heterogeneous and a variety of symptoms has been attributed to amalgam. [13][14][15][16][17] Since the symptom pattern is unspecific, amalgam-attributed health complaints are difficult to validate and are, for the most part, quantified using symptom scales. Notably, amalgam-attributed health complaints are largely similar to complaints experienced by patients with so-called 'medically unexplained physical symptoms' (MUPS) 18,19 or 'medically unexplained symptoms' (MUS).…”

Section: Introductionmentioning

confidence: 99%

Removal of dental amalgam restorations in patients with health complaints attributed to amalgam: A prospective cohort study

Björkman

Alræk

Werner

et al. 2020

J of Oral Rehabilitation

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Summary Background The Norwegian Ministry of Health and Care Services initiated a project including experimental treatment for patients with health complaints attributed to amalgam restorations. Objective The aim was to evaluate changes of general health complaints in patients who participated in the project and had all amalgam restorations removed. Methods The project was designed as a prospective cohort study and organised by the Dental Biomaterials Adverse Reaction Unit in Bergen, Norway. The dental treatment was provided by the patient's local dentist. The main target group consisted of patients with medically unexplained physical symptoms, attributed to dental amalgam restorations (Amalgam cohort). The primary comparison group consisted of patients with medically unexplained physical symptoms without attribution to dental amalgam restorations (MUPS cohort). Primary outcome was self‐reported general health complaints (GHC index) at follow‐up 12‐months after completed amalgam removal. Results In the Amalgam cohort, a significant reduction of GHC index from 43.3 (SD 17.8) at baseline to 30.5 (SD 14.4) at follow‐up (mean reduction 12.8, SD 15.9; n = 32; P < .001) was observed. The change scores for GHC index indicated that the reduction of complaints was significantly higher (P = .004) in the Amalgam cohort compared with the MUPS cohort (mean reduction 1.2, SD 12.3, n = 28). After adjustment for age, gender, education and baseline GHC index, the mean adjusted difference was −8.0 (95% confidence interval from −15.4 to −0.5; P = .036). Conclusion In a group of patients with medically unexplained physical symptoms, which they attributed to dental amalgam restorations, removal of amalgam restorations was followed by a significant reduction of health complaints.

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Characterization of health complaints before and after removal of amalgam fillings — 3-year follow-up

Abstract: The inter-individual variation of intensities of health complaints was considerable and the reduction of health complaints varied for the different complaints. Several factors may be of importance for the observed reduction of complaint intensity.

Cited by 11 publications

References 25 publications

Health Complaints Attributed to Dental Amalgam: A Retrospective Survey Exploring Perceived Health Changes Related to Amalgam Removal

Health Complaints Attributed to Dental Amalgam: A Retrospective Survey Exploring Perceived Health Changes Related to Amalgam Removal

Longitudinal analysis of the association between removal of dental amalgam, urine mercury and 14 self-reported health symptoms

Removal of dental amalgam restorations in patients with health complaints attributed to amalgam: A prospective cohort study

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