The Dental Material Commission –– Care and Consideration
Mercury in dental-filling materials
–– an updated risk analysis in environmental medical terms
Maths Berlin
An overview of scientific literature published in 1997–2002 and current knowledge
Contents
1. Background 4
1.1 Data collection 4
2. Summary of the 1997 risk analysis 5
3. New research findings 6
3.1 Studies in molecular biology 6
Modified redox potential 6
Cytoskeleton of the nerve cells 8
Apoptosis in nerve tissue 9
Retinal pigment epithelial cells 9
3.2 The nervous system 9
Data from animal experiments 9
Accumulation in the retina 9
Brain development and toxicokinetics in the foetus and mother 9
Neuropsychological tests 10
Persistent effects of mercury exposure 11
3.3 The immune system and blood cells 12
Data from animal experiments 12
Lichen 13
Occupational exposure 13
Reduced enzyme activity in erythrocytes 14
Autoimmune diseases 14
Mercury-resistant and antibiotic-resistant bacteria 15
3.4 Kidneys 15
3.5 Thyroid and muscular atrophy 15
3.6 Testicles 16
3.7 Polymorphism 16
3.8 Gender differences 17
3.9 Side-effects and their incidence 18
Clinical surveys 18
Provocation tests 19
4. Risk analysis –– definition of three new hazards 20
Scientific support for influence at low concentrations 21
Influence on foetal development 22
Influence on the immune system 22
Risk of kidney disease 23
Varying sensitivity between individuals 23
5 Summary and conclusions 24
6 Environmental medical views of risk management 26
7 Clinical management 26
8 Need for research 27
Bibliography 28
Abbreviations 33
33
The Dental Material Commission –– Care and Consideration
'The Dental Material Commission –– Care and Consideration' assigned Maths Berlin, in autumn 2002, to report on the past five years’ research literature on amalgam and the health hazards, if any, of mercury.
Maths Berlin is a Professor Emeritus with long experience of the effects of mercury on animals and humans. He chaired the WHO Task Group on Environmental Health Criteria for Inorganic Mercury (WHO Environmental Health Criteria 118, 1991) and a similar group with the function of drawing up health criteria for methylmercury.
Professor Berlin compiled the environmental medicine risk analysis of mercury and amalgam issued by the Swedish Council for Planning and Coordination of Research (FRN) in 1998 (FRN, Report 1998:22). This risk analysis was based on literature published between 1993 and November 1997. The present risk analysis builds further on this material, and analyses literature published between November 1997 and November 2002.
Available on order from:
The Dental Material Commission –– Care and Consideration
Kv. Spektern, SE–103 33 Stockholm, Sweden or on the web site, www.dentalmaterial.gov.se
1. Background
In April 2002 the Swedish Government appointed a Special Investigator to propose measures to boost knowledge of health problems relating to amalgam and other dental materials, and to improve care of patients who associate their symptoms with such materials. The directives for the Commission emphasise that the Special Investigator should assess the knowledge situation with respect to such health problems and pinpoint areas on which further studies should focus. The Investigator was also assigned to report on key research in recent years, focusing on the past five-year period.
The author was assigned by the Investigator to summarise and evaluate research findings, regarding the environmental medical aspects of exposure to mercury from amalgam, that were published during the period from November 1997 to November 2002. The summary is to continue and supplement the risk analysis that was carried out for the Swedish Council for Planning and Coordination of Research in 1997.
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