Patients’ experiences of changes in health complaints before, during, and after removal of dental amalgam

Sjursen, Therese Thornton; Binder, Per‐Einar; Lygre, Gunvor Bentung; Helland, Vigdis; Dalen, Knut; Björkman, Lars

doi:10.3402/qhw.v10.28157

Cited by 8 publications

(3 citation statements)

References 23 publications

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“…A study from a referral institution found that patients reporting health deteriorations had altered mercury concentrations in erythrocytes and plasma, compared to patients who reported improvement of health status after amalgam removal [ 29 ]. Sjursen et al [ 30 ] concluded in a qualitative study that: “The dental amalgam was certainly important to get rid of, but it is uncertain how important the removal was for the experienced changes in health complaints”. Also Nerdrum et al [ 13 ], who reported improvement of health after amalgam removal, state that the amalgam might not have been the main cause of the patient’s subjective health complaints.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…Definitions of illness, disease, and sickness, and what they represent, are not immutable, but they change over time (Johanisson, 1997). Sjursen et al (2015) suggested that the most important aspects of the amalgam controversy were found in the difference between the rational understanding of multifactorial explanations of health and the emotions around the questions about dental amalgam. This underscores the importance of health care professionals learning more about how patients think, act, and feel regarding illness attributed to dental restorations.…”

Section: Discussionmentioning

confidence: 99%

“Struggle to obtain redress”: Women’s experiences of living with symptoms attributed to dental restorative materials and/or electromagnetic fields

Mårell

Lindgren

Nyhlin

et al. 2016

International Journal of Qualitative Studies on Health and Well

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The aim of this study was to explore the experiences of illness and the encounters with health care professionals among women who attributed their symptoms and illness to either dental restorative materials and/or electromagnetic fields, despite the fact that research on health effects from dental fillings or electricity has failed to substantiate the reported symptoms. Thirteen women (aged 37–63 years) were invited to the study and a qualitative approach was chosen as the study design, and data were collected using semi-structured interviews. The analysis was conducted with a constant comparative method, according to Grounded Theory. The analysis of the results can be described with the core category, “Struggle to obtain redress,” the two categories, “Stricken with illness” and “A blot in the protocol,” and five subcategories. The core category represents the women's fight for approval and arose in the conflict between their experience of developing a severe illness and the doctors’ or dentists’ rejection of the symptoms as a disease, which made the women feel like malingerers. The informants experienced better support and confirmation from alternative medicine practitioners. However, sick-leave certificates from alternative medicine practitioners were not approved and this led to a continuous cycle of visits in the health care system. To avoid conflicting encounters, it is important for caregivers to listen to the patient's explanatory models and experience of illness, even if a medical answer cannot be given.

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“…However, a proportion of people experience health complaints, which they attribute to amalgam [2][3][4]. Moreover, for some of these patients the health complains persist even after removal of amalgam fillings.…”

Section: Introductionmentioning

confidence: 99%

Use of complementary and alternative medicine in patients with health complaints attributed to former dental amalgam fillings

Kristoffersen

Hamre

Björkman

et al. 2016

European Journal of Integrative Medicine

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Background: The dental filling material amalgam is generally well tolerated. However, a small proportion of dental patients experience health complaints which they attribute to amalgam. The symptom pattern is often similar to patients with medically unexplained physical symptoms (MUPS) and the health complaints may persist after amalgam removal. Among patients with MUPS, the use of complementary and alternative medicine (CAM) seems to be high. The aim of this survey was to describe the prevalence and range of CAM use among people with health complaints attributed to dental amalgam fillings in which the health problems persist after the removal of all amalgam fillings. Specific attention was paid to (1) self-reported effects of CAM, (2) differences in CAM use dependent on self-reported health, and (3) gender differences in self-reported CAM use. Methods: A survey was distributed to all members of The Norwegian dental patient association (NDPA) (n = 999), the response rate was 36.4 %. The anonymous questionnaire asked for socio-demographic data, health complaints related to former amalgam fillings, subjectively perceived health status, symptoms, and experience with therapeutic interventions, mostly from the spectrum of CAM. Only participants who had all their fillings removed, which was the vast majority, were analysed. Results: A total of 88.9 % of included respondents had used at least one CAM modality, with a higher proportion of men (95.7 %) compared to women (86.2 %, p = 0.015). The most frequently used therapies were dietary supplements, vitamins and minerals recommended by a therapist (used by 66.7 %) followed by self-prescribed dietary supplements, vitamins and minerals (59.0 %), homeopathy (54.0 %), acupuncture (48.8 %) and special diets (47.5 %). Use of CAM was similar for participants reporting normal to good health compared to participants reporting poor health. For all but two CAM modalities, the self-reported treatment effect was better in the group reporting normal to good health compared to the group reporting poor health. Conclusions: CAM was widely used by participants in our study, a finding similar to findings from studies of MUPS patients. To date, health problems associated with the use of dental amalgam is not an accepted diagnosis in the healthcare system. Consequently, people suffering from such complaints experience a lack of adequate treatment and support within conventional health care, which might have contributed to the high number of CAM users in this study.

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Patients’ experiences of changes in health complaints before, during, and after removal of dental amalgam

Cited by 8 publications

References 23 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

“Struggle to obtain redress”: Women’s experiences of living with symptoms attributed to dental restorative materials and/or electromagnetic fields

Use of complementary and alternative medicine in patients with health complaints attributed to former dental amalgam fillings

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