Amalgam hazards: an assessment of research

Article Abstract:

A review is presented of the health effects of mercury, with particular emphasis on its use in dental amalgam (filling materials made of alloys of mercury and other metals). Studies of dental personnel in the 1970s and 1980s found that urinary levels of mercury were elevated in many cases and that some practitioners with elevated levels also had signs of nerve damage. Better protective measures in dental offices caused a drop in urinary mercury levels among dental professionals by more than 50 percent. Concern over possible patient exposure to mercury from amalgam was heightened by early reports that overestimated the amount of mercury vapor released from fillings during chewing; in fact, the amount is approximately 1 percent of the safe occupational exposure level. Neurological effects from the absorption of elemental mercury directly into the brain are only seen at levels that considerably exceed the levels associated with amalgams. Multiple sclerosis, a progressive, debilitating neurologic disease, is not cured by removal of amalgam. The National Multiple Sclerosis Society has warned people against believing that this is possible. The kidneys are particularly vulnerable to mercury toxicity, but are not affected until mercury levels are at least 25 times higher than in amalgam. A study of dentists found no association between signs of kidney dysfunction and elevated urinary mercury levels. Effects of mercury in amalgam on the immune system have not been documented, and true allergy to mercury is rare. Findings that amalgams could affect pregnancy adversely, resulting in a higher rate of still births, prompted a study of several thousand dentists and assistants. Results showed that miscarriages and non-congenital abnormalities were more common in workers exposed to high levels of mercury at work. Overall, amalgam does not appear to cause kidney impairment, nerve damage, or changes in the immune system. However, epidemiologic studies using large numbers of people are needed to fully satisfy both the dental profession and the public. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Planning, Measurement, Physiological aspects, Dental amalgams, Epidemiological research, Cross sectional studies, Mercury (Metal), Mercury in the body

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Changing dental images - from stone tablets to comic strips

Article Abstract:

The profession of dentistry, like society as a whole, is changing rapidly; change itself has become a constant. The most significant sources of the recent upheaval in dentistry include new concepts about the causes of dental diseases, advances in materials and techniques, and alterations in the financing of patient care. Dentistry seems to be undergoing a type of identity crisis, because it is not clear what the profession will be like in the 21st century. A perspective on the field is supplied by the author, who traces its history through depictions in art and literature. Toothaches were common and severe up until recent history; attempts to control them included prayers, magical incantations, and fasting regimens. Sufferers were most often depicted with the face wrapped in a towel or handkerchief. However, teeth were not only seen as a source of pain, but also as a thing of beauty. Straight, white teeth were compared to pearls in some societies, but others such as the Japanese culture stained them black to improve their appearance, and in Central America, inlays with jade or turquoise were favored. In the past several centuries, preventive dentistry developed gradually with recommendations for various home care regimens. Today, good oral hygiene is accepted to the point that it has reached pop culture - as evidenced by comic strips that regularly mention flossing and brushing. These descriptions of dentistry's past should serve as a mold for its future, in which the profession will be vibrant and excited by change as well as proud of its heritage. (Consumer Summary produced by Reliance Medical Information, Inc.)

History, Dentists, Dentistry, Dental care, Oral hygiene, editorial

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Salivary diagnosis: more than a lick and a promise

Article Abstract:

Examination of saliva and other oral fluids can be used to diagnose different types of oral diseases. Saliva can reflect tissue fluid levels of different types of natural substances or substances introduced for therapeutic or recreational purposes. Saliva can be collected by passive drooling or drooling stimulated using different methods. Different types of collecting devices can be used to collect saliva and other types of oral fluids such as oral mucosal transudate and salivary ultrafiltrates. Different types of oral diseases may be diagnosed in part by examination of secretions from salivary glands. A large number of systemic diseases can also affect the function of the salivary glands. Some of the chemicals that can be detected in saliva include drugs and hormones and antibodies to viruses such as HIV, rubella and hepatitis. Viral and bacterial antigens can also be detected in saliva.

Analysis, Diagnosis, Dental caries, Saliva, Periodontal disease, Periodontal diseases, Mouth diseases

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