International Journal of Oral Biology

The Korean Academy of Oral Biology (대한구강생물학회)
권호 표지

Association between Amalgam Tooth Fillings and Blood Mercury Levels in Children

  • SaKong, Joon (Department of Preventive Medicine and Public Health, College of Medicine, Yeungnam University) ;
  • Choi, Youn-Hee (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Chung, Sun-Young (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Kwon, Ho-Jang (Department of Preventive Medicine and Public Health, College of Medicine, Dankook University) ;
  • Karmaus, Wilfried (Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina) ;
  • Merchant, Anwar T. (Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina) ;
  • Ha, Mi-Na (Department of Preventive Medicine and Public Health, College of Medicine, Dankook University) ;
  • Hong, Yun-Chul (Institute of Environmental Medicine, College of Medicine, Seoul National University) ;
  • Kang, Dong-Mug (Department of Preventive and Occupational Medicine, Pusan National University) ;
  • Song, Keun-Bae (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University)
  • Received : 2011.05.23
  • Accepted : 2011.08.23
  • Published : 2011.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

The notion that dental amalgam is a potential source of mercury exposure remains a controversial issue. However, there are few epidemiological analyses that have addressed whether this occurs in children. We aimed in our current study to identify the relationship between dental amalgam filling surfaces and the blood mercury levels in a cohort of 711 South Korean children aged between 8-9 years. Oral examinations were conducted to detect the number of amalgam filling surfaces on the teeth of these individuals. Blood samples were also taken from these children to assess the levels of mercury accumulation in the body. The amalgam filling surfaces were classified into four groups based on their number: 0 (n = 368), 1-5 (n = 219), 6-10 (n = 89), and 11+ (n = 35). The blood mercury levels in the children with more than 10 amalgam surfaces was 0.47 ${\mu}g$/L higher on average than those with no amalgam surfaces after adjusting for the frequency of fish or seafood consumption, age, and gender (P < 0.05). We found from our data that a higher number of dental amalgam fillings correlated with a higher blood mercury level in Korean children. Further studies are needed to investigate whether these elevated mercury levels exert neurotoxic or nephrotoxic effects.

Keywords

References

  1. Abraham JE, Svare CW, Frank CW. The effect of dental amalgam restorations on blood mercury levels. J Dent Res. 1984;63:71-3. https://doi.org/10.1177/00220345840630011801
  2. Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological profile for mercury Department of Public Health Service. 1999.
  3. Bates MN. Mercury amalgam dental fillings: an epidemiologic assessment. Int J Hyg Environ Health. 2006;209:309-16. https://doi.org/10.1016/j.ijheh.2005.11.006
  4. Bergdahl IA, Schutz A, Ahlqwist M, Bengtsson C, Lapidus L, Lissner L, Hulten B. Methylmercury and inorganic mercury in serum--correlation to fish consumption and dental amalgam in a cohort of women born in 1922. Environ Res. 1998;77:20-4. https://doi.org/10.1006/enrs.1997.3820
  5. Bjorkman L, Lundekvam BF, Laegreid T, Bertelsen BI, Morild I, Lilleng P, Lind B, Palm B, Vahter M. Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study. Environ Health. 2007;6:30. https://doi.org/10.1186/1476-069X-6-30
  6. Clarkson TW, Magos L, Myers GJ. The toxicology of mercury-- current exposures and clinical manifestations. N Engl J Med. 2003;349:1731-7. https://doi.org/10.1056/NEJMra022471
  7. Clarkson TW, Vyas JB, Ballatori N. Mechanisms of mercury disposition in the body. Am J Ind Med. 2007;50:757-64. https://doi.org/10.1002/ajim.20476
  8. Counter SA, Buchanan LH. Mercury exposure in children: a review. Toxicol Appl Pharmacol. 2004;198:209-30. https://doi.org/10.1016/j.taap.2003.11.032
  9. DeRouen TA, Martin MD, Leroux BG, Townes BD, Woods JS, Leitao J, Castro-Caldas A, Luis H, Bernardo M, Rosenbaum G, Martins IP. Neurobehavioral effects of dental amalgam in children: a randomized clinical trial. JAMA. 2006;295:1784- 92. https://doi.org/10.1001/jama.295.15.1784
  10. Dodes JE. The amalgam controversy. An evidence-based analysis. J Am Dent Assoc. 2001;132:348-56. https://doi.org/10.14219/jada.archive.2001.0178
  11. Dye BA, Schober SE, Dillon CF, Jones RL, Fryar C, McDowell M, Sinks TH. Urinary mercury concentrations associated with dental restorations in adult women aged 16-49 years: United States, 1999-2000. Occup Environ Med. 2005;62:368-75. https://doi.org/10.1136/oem.2004.016832
  12. Factor-Litvak P, Hasselgren G, Jacobs D, Begg M, Kline J, Geier J, Mervish N, Schoenholtz S, Graziano J. Mercury derived from dental amalgams and neuropsychologic function. Environ Health Perspect. 2003;111:719-23.
  13. Ganss C, Gottwald B, Traenckner I, Kupfer J, Eis D, Monch J, Gieler U, Klimek J. Relation between mercury concentrations in saliva, blood, and urine in subjects with amalgam restorations. Clin Oral Investig. 2000;4:206-11. https://doi.org/10.1007/s007840000089
  14. Ha M, Kwon HJ, Lim MH, Jee YK, Hong YC, Leem JH, Sakong J, Bae JM, Hong SJ, Roh YM, Jo SJ. Low blood levels of lead and mercury and symptoms of attention deficit hyperactivity in children: a report of the children's health and environment research (CHEER). Neurotoxicology. 2009;30: 31-6. https://doi.org/10.1016/j.neuro.2008.11.011
  15. Halbach S, Vogt S, Kohler W, Felgenhauer N, Welzl G, Kremers L, Zilker T, Melchart D. Blood and urine mercury levels in adult amalgam patients of a randomized controlled trial: interaction of Hg species in erythrocytes. Environ Res. 2008;107:69-78. https://doi.org/10.1016/j.envres.2007.07.005
  16. Innis SM, Palaty J, Vaghri Z, Lockitch G. Increased levels of mercury associated with high fish intakes among children from Vancouver, Canada. J Pediatr. 2006;148:759-63. https://doi.org/10.1016/j.jpeds.2006.02.001
  17. Kingman A, Albertini T, Brown LJ. Mercury concentrations in urine and whole blood associated with amalgam exposure in a US military population. J Dent Res. 1998;77:461-71. https://doi.org/10.1177/00220345980770030501
  18. MacIntyre CR. Hepatitis B vaccine: Risks and benefits of universal neonatal vaccination. J Paediatr Child Health. 2001; 37:215-17. https://doi.org/10.1046/j.1440-1754.2001.00639.x
  19. MacIntyre CR, Leask J. Immunization myths and realities: responding to arguments against immunization. J Paediatr Child Health. 2003;39:487-91. https://doi.org/10.1046/j.1440-1754.2003.t01-1-00200.x
  20. Maserejian NN, Trachtenberg FL, Assmann SF, Barregard L. Dental amalgam exposure and urinary mercury levels in children: the New England Children's Amalgam Trial. Environ Health Perspect. 2008;116:256-62.
  21. Melchart D, Vogt S, Kohler W, Streng A, Weidenhammer W, Kremers L, Hickel R, Felgenhauer N, Zilker T, Wuhr E, Halbach S. Treatment of health complaints attributed to amalgam. J Dent Res. 2008;87:349-53. https://doi.org/10.1177/154405910808700410
  22. Minoia C, Ronchi A, Pigatto PD, Guzzi G. Measuring mercury exposure in children. Pediatr Int. 2008;50:839-40. https://doi.org/10.1111/j.1442-200X.2008.02749.x
  23. Murata K, Weihe P, Budtz-Jorgensen E, Jorgensen PJ, Grandjean P. Delayed brainstem auditory evoked potential latencies in 14- year-old children exposed to methylmercury. J Pediatr. 2004; 144:177-83. https://doi.org/10.1016/j.jpeds.2003.10.059
  24. Olstad ML, Holland RI, Wandel N, Pettersen AH. Correlation between amalgam restorations and mercury concentrations in urine. J Dent Res. 1987;66:1179-82. https://doi.org/10.1177/00220345870660061701
  25. Scott A, Egner W, Gawkrodger DJ, Hatton PV, Sherriff M, van Noort R, Yeoman C, Grummitt J. The national survey of adverse reactions to dental materials in the UK: a preliminary study by the UK Adverse Reactions Reporting Project. Br Dent J. 2004;196:471-7. https://doi.org/10.1038/sj.bdj.4811176
  26. Shenker BJ, Maserejian NN, Zhang A, McKinlay S. Immune function effects of dental amalgam in children: a randomized clinical trial. J Am Dent Assoc. 2008;139:1496-505. https://doi.org/10.14219/jada.archive.2008.0076
  27. Tsuji JS, Williams PR, Edwards MR, Allamneni KP, Kelsh MA, Paustenbach DJ, Sheehan PJ. Evaluation of mercury in urine as an indicator of exposure to low levels of mercury vapor. Environ Health Perspect. 2003;111:623-30.
  28. Vahter M, Akesson A, Lind B, Bjors U, Schutz A, Berglund M. Longitudinal study of methylmercury and inorganic mercury in blood and urine of pregnant and lactating women, as well as in umbilical cord blood. Environ Res. 2000;84:186-94. https://doi.org/10.1006/enrs.2000.4098
  29. Woods JS, Martin MD, Leroux BG, DeRouen TA, Leitao JG, Bernardo MF, Luis HS, Simmonds PL, Kushleika JV, Huang Y. The contribution of dental amalgam to urinary mercury excretion in children. Environ Health Perspect. 2007;115: 1527-31.
  30. World Health Organization. Oral Health Surveys; Basic Methods. 4th ed. WHO. 1997.