Dental Amalgam Controversy: History and Regulations

By David Kennedy, DDS, MIAOMT, Amanda Just, MS, and Jack Kall, DMD, MIAOMT

Dental amalgam controversy: history of debate and growing scientific evidence of harm

amalgam fillingOne of the first reports documenting the dental amalgam controversy and the dangers of using mercury in dentistry dates back to 1841. At that time, dental amalgam mercury fillings had just been brought to the United States, and a committee of the American Society of Dental Surgeons, which was the first U.S. dental group, warned that amalgam was not safe.[1] The same group made its members pledge not to use mercury because of its known toxicity,[2] and meanwhile, the New York Dental Society expelled members or forced them to resign if they would not pledge to be amalgam-free.[3]

This marked the beginning of a time period referred to as the “Amalgam War” due to the many debates and arguments that ensued over dental mercury. Three notable examples of evidence against amalgam from this time period include 1) a report from Dr. Amos Westcott warning that dental mercury could cause issues with the stomach and issues with gold fillings; 2) a case study published in the American Dental Review of a patient whose health improved after amalgam removal, and 3) the recommendation from Dr. Elisha Townsend, formerly a renowned proponent of amalgam, that the use of dental mercury should be avoided.[4]

By 1856, the American Society of Dental Surgeons had disbanded because of the Amalgam War, and in 1859, the American Dental Association (ADA), a group who supported the use of amalgam, became the nation’s new dental society. However, concerns about dental amalgam continued. A July 1873 article in the Chicago Medical Journal warned of the “poisoning of thousands of people all over the world from corrosive sublimate generated in the mouth from amalgam plugs in the teeth; neither cholera, smallpox, or any malarious disease [is] doing more injury in the world than this poison.”[5]

Meanwhile, in 1867, the St. Louis Odontological Society recognized health risks from amalgam fillings and voted not to use them,[6] and in 1878, the Canada Lancet noted that the use of dental mercury “is radically wrong, and should not be ventured upon if the patient’s welfare is to be considered.”[7] Additionally, based on a series of experiments, Dr. E. Talbot warned that “all amalgams will send off the vapor of mercury.”[8] His work was published in the Ohio State Journal of Dental Science in 1882.

Equally important was Dr. J. Tuthill’s research entitled “Mercurial necrosis resulting from amalgam fillings,” which was published in The Brooklyn Medical Journal in 1898. Dr. Tuthill read his work, including a number of case studies, before a medical society, and in it he passionately stated:

In presenting this subject to the society for consideration, I want to show that by the use of amalgam in filling teeth there is a possibility of mercurial poisoning, which seriously affects the nerve centers, impairs locomotion by heaviness of limb and stiffness of joint, gives rise to obstinate diseases of the skin, and makes a mental wreck of its victim, whose imaginations and hallucinations are more than my pen can describe.[9]

Dr. Tuthill and others continued to fight the use of dental mercury, and the dental amalgam controversy continued into the twentieth century, when scientific progress allowed for many more studies to validate that mercury remains a toxic threat when it is amalgamized and placed into teeth.

In one of the first studies to measure the amount of dental mercury vapor emitted from fillings, German chemist Alfred Stock shared evidence that mercury vapor is released from amalgam fillings in amounts significant enough to produce adverse health impacts. Stock himself suffered mercury poisoning, and his research appeared in a series of papers published in German scientific journals. Based on his data and experiences, in The Dangerousness of Mercury Vapor, Dr. Stock declared in 1926 that the introduction of mercury in amalgam fillings was “a nasty sin against humanity.”[10]

Because of new technology and scientific advancements, research conducted in more recent decades has been able to more accurately examine issues related to dental amalgam mercury. Moreover, the increase in the number of published research articles has resulted in the development of science designed to evaluate specific risks related to mercury exposure from dental amalgam. Some of the areas of research addressed in recent scientific literature include

Dental amalgam controversy: worldwide regulations begin in the 21st Century

Awareness of occupational hazards, environmental dangers, and patient risks as a result of dental mercury usage has grown with new science. In fact, by the turn of the millennium, the world slowly began to take action against dental mercury, following the exact same delayed course that occurred with asbestos and lead.

Norway banned dental amalgam in 2008,[155] Sweden banned the use of dental amalgam for almost all purposes in 2009,[156] and Denmark, Estonia, Finland, and Italy use it for less than 5% of tooth restorations.[157] Japan and Switzerland have also restricted or almost banned dental amalgam.[158] France has recommended that alternative mercury-free dental materials be used for pregnant women, and Austria, Canada, Finland, and Germany have purposely reduced the use of dental amalgam fillings for pregnant women, children, and/or in patients with kidney problems.[159]

In December of 2016, three EU institutions (the European Parliament, the European Commission and the Council of the European Union) reached a provisional agreement to ban dental amalgam fillings for children under 15 and pregnant and breastfeeding women as of July 1, 2018, and to consider banning dental amalgam completely by 2030.[160] [161]

The United Nations Environment Programme’s Intercessional Negotiating Committee agreed upon the text of a global, legally-binding mercury treaty in 2013, and over 100 nations have since signed the “Minamata Convention on Mercury.” The United States was the first country to give its support for ratification of the international agreement, which entered into force in 2017. Annex A, Part II, includes the following initiatives with regards to dental mercury amalgam:[162]

  1. Setting national objectives aiming at dental caries prevention and health promotion, thereby minimizing the need for dental restoration;
  2. Setting national objectives aiming at minimizing its use;
  3. Promoting the use of cost-effective and clinically effective mercury-free alternatives for dental restoration;
  4. Promoting research and development of quality mercury-free materials for dental restoration;
  5. Encouraging representative professional organizations and dental schools to educate and train dental professionals and students on the use of mercury-free dental restoration alternatives and on promoting best management practices;
  6. Discouraging insurance policies and programmes that favour dental amalgam use over mercury-free dental restoration;
  7. Encouraging insurance policies and programmes that favour the use of quality alternatives to dental amalgam for dental restoration;
  8. Restricting the use of dental amalgam to its encapsulated form;
  9. Promoting the use of best environmental practices in dental facilities to reduce releases of mercury and mercury compounds to water and land.[163]

Dental amalgam controversy: US FDA has not taken action yet

In spite of this international action, the U.S. Food and Drug Administration (FDA) “considers dental amalgam fillings safe for adults and children ages 6 and above.”[164] While the FDA does not claim safety for children under the age of six, there is no regulation for this population. Also, details in the FDA’s public statements about dental amalgam on its website have changed over the years, including information about amalgam’s potentially harmful impact on pregnant women, fetuses, and children under the age of six.

Due in part to concerns about the FDA’s lack of protection, the IAOMT filed a lawsuit in 2014 against the FDA over its classification of dental mercury amalgam.[165] As part of the case, the IAOMT secured an internal document from the FDA that had proposed restricting dental mercury amalgam use in pregnant and nursing women and children under the age of six, as well as individuals with mercury allergies and pre-existing kidney or neurological disease.[166] Yet, allegedly for administrative or political reasons, the FDA communication (dated January 2012) was never released to the public.

Recently, the U.S. Environmental Protection Agency (EPA) utilized measures in the Clean Water Act to develop standards for dental offices/clinics to use amalgam separators so that dental mercury is not flushed down the drain and into the environment.[167] These standards went into effect on July 14, 2017, and the EPA has estimated that it could reduce the discharge of mercury by 5.1 tons annually.

Dental amalgam controversy: when will it end?

The IAOMT has been working to educate dental and medical professionals, policy-makers, and the public about the risks of dental mercury since 1984. While the IAOMT applauds the actions that have been taken against dental mercury over the past two decades, the group warns that it is essential to remember that it is still being used in many countries, and even if the day should come that dental mercury is banned worldwide, it is already in the mouths of millions of patients. For this reason, in addition to encouraging the end of dental mercury, the IAOMT also encourages the use of the Safe Mercury Amalgam Removal Technique (SMART) when amalgam fillings are removed. SMART was developed to mitigate mercury exposures that can occur when the fillings are taken out of people’s mouths, which often occurs due to device failure, hypersensitivity, and/or patient preference.

Meanwhile, some will ignore the warnings and continue to debate the use of amalgam, which they have been doing for over a century. Yet, science will continue to prove that using a toxic material in people’s teeth can have serious health consequences. A famous quote from philosopher Arthur Schopenhauer offers an interesting analogy as to why it is taking so long to end the use of dental mercury: “All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.”

Copyright © 2018 IAOMT. All rights reserved.

  1. Hyson Jr, JM. Amalgam: its history and perils. CDA. JOURNAL. 2006; 34(3):215-229.
  2. Health Canada. The Safety of Dental Amalgam. Minister of Supply and Services Canada; 1996: 3. Available from Health Canada Web site: http://www.hc-sc.gc.ca/dhp-mps/alt_formats/hpfb-dgpsa/pdf/md-im/dent_amalgam-eng.pdf. Accessed December 22, 2015.
  3. Tuthill, JY. “Mercurial necrosis resulting from amalgam fillings.” The Brooklyn Medical Journal. 1898; XII:725-742.
  4. Hyson Jr, JM. Amalgam: its history and perils. CDA. JOURNAL. 2006; 34(3):215-229.
  5. Quoted in Tuthill, JY. “Mercurial necrosis resulting from amalgam fillings.” The Brooklyn Medical Journal. 1898; XII: 12:740.
  6. Hyson Jr, JM. Amalgam: its history and perils. CDA. JOURNAL. 2006; 34(3):215-229.
  7. Quoted in Hyson Jr, JM. Amalgam: its history and perils. CDA. JOURNAL. 2006; 34(3):215-229.
  8. Talbot ES. The chemistry and physiological action of mercury as used in amalgam fillings. The Ohio State J. Dent.Sci. 1882; 2(1): 1-12.
  9. Tuthill, JY. “Mercurial necrosis resulting from amalgam fillings.” The Brooklyn Medical Journal. 1898; XII:740.
  10. Stock A. [Zeitschrift fuer angewandte Chemie, 29. Jahrgang, 15. April 1926, Nr. 15, S. 461-466, Die Gefaehrlichkeit des Quecksilberdampfes, von Alfred Stock (1926).] The Dangerousness of Mercury Vapor. Translated by Birgit Calhoun. http://www.stanford.edu/~bcalhoun/AStock.htm.
  11. Moen BE, Hollund BE, Riise T. Neurological symptoms among dental assistants: a cross-sectional study. Journal of Occupational Medicine and Toxicology. 2008: 3(1):10.
  12. Nylander M, Friberg L, Eggleston D, Bjorkman L. Mercury accumulation in tissues from dental staff and controls in relation to exposure. Swed Dent J. 1989; 13(6): 235-236.
  13. Herber RF, de Gee AJ, Wibowo AA. Exposure of dentists and assistants to mercury: mercury levels in urine and hair related to conditions of practice. Community Dent Oral Epidemiol. 1988; 16(3): 153-158.
  14. Echeverria D, Heyer N, Martin MD, Naleway CA, Woods JS, Bittner AC. Behavioral effects of low-level exposure to Hg0 among dentists. Neurotoxicol Teratol. 1995; 17(2):161-8.
  15. Rowland AS, Baird DD, Weinberg CR, Shore DL, Shy CM, Wilcox AJ. The effect of occupational exposure to mercury vapour on the fertility of female dental assistants. Occupat Environ Med. 1994; 51:28-34.
  16. Shapiro IM, Cornblath DR, Sumner AJ, Sptiz LK, Uzzell B, Ship II, Bloch P. Neurophysiological and neuro-psychological function in mercury-exposed dentists. Lancet. 1982; 319(8282): 1447-1150.
  17. Richardson GM, Brecher RW, Scobie H, Hamblen J, Samuelian J, Smith C. Mercury vapour (Hg(0)): Continuing toxicological uncertainties, and establishing a Canadian reference exposure level. Regul Toxicol Pharmicol. February 2009; 53(1):32-38.
  18. Mutter J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. Journal of Occupational Medicine and Toxicology. 2011; 6:2.
  19. Ngim CH, Foo SC, Boey KW, Jeyaratnem J. Chronic neurobehavioural effects of elemental mercury in dentists.Br J Ind Med. 1992; 49(11):782-790.
  20. Cook TA, Yates PO. Fatal mercury intoxication in a dental surgery assistant. British Dental Journal. 1969; 127(12):553-5.
  21. Sikorski R, Juszkiewicz T, Paszkowski T, Szprengier-Juszkiewicz T. Women in dental surgeries: reproductive hazards in exposure to metallic mercury. International Archives of Occupational and Environmental Health. September 1987; 59(6): 551-557.
  22. White RR, Brandt RL. Development of mercury hypersensitivity among dental students. JADA. 1976; 92(6):1204-7.
  23. Nimmo A, Werley MS, Martin JS, Tansy MF. Particulate inhalation during the removal of amalgam restorations. J Prosth Dent. 1990; 63(2):228-33.
  24. Cooper GS, Parks CG, Treadwell EL, St Clair EW, Gilkeson GS, Dooley MA. Occupational risk factors for the development of systemic lupus erythematosus. J Rheumatol. 2004; 31(10): 1928-1933.
  25. de Oliveira MT, Pereira JR, Ghizoni JS, Bittencourt ST, Molina GO. Effects from exposure to dental amalgam on systemic mercury levels in patients and dental school students. Photomed Laser Surg. 2010; 28(S2): S-111.
  26. Fabrizio E, Vanacore N, Valente M, Rubino A, Meco G. High prevalence of extrapyramidal signs and symptoms in a group of Italian dental technicians. BMC Neurol. 2007; 7(1): 24.
  27. Goodrich JM, Wang Y, Gillespie B, Werner R, Franzblau A, Basu N. Methylmercury and elemental mercury differentially associate with blood pressure among dental professionals. Int J Hyg Environ Health. 2013; 216(2): 195-201.
  28. Hilt B, Svendsen K, Syversen T, Aas O, Qvenild T, Sletvold H, Melø I. Occurrence of cognitive symptoms in dental assistants with previous occupational exposure to metallic mercury. Neurotoxicology. 2009; 30(6): 1202-1206.
  29. Kanerva L, Lahtinen A, Toikkanen J, Forss H, Estlander T, Susitaival P, Jolanki R. Increase in occupational skin diseases of dental personnel. Contact Dermatitis. 1999; 40(2): 104-108.
  30. Karahalil B, Rahravi H, Ertas N. Examination of urinary mercury levels in dentists in Turkey. Hum Exp Toxicol. 2005; 24(8): 383-388.
  31. Lönnroth EC, Shahnavaz H. Amalgam in dentistry. A survey of methods used at dental clinics in Norrbotten to decrease exposure to mercury vapour. Swed Dent J. 1995; 19(1-2): 55.
  32. Lee JY, Yoo JM, Cho BK, Kim HO. Contact dermatitis in Korean dental technicians. Contact Dermatitis. 2001; 45(1), 13-16.
  33. Martin MD, Naleway C, Chou HN. Factors contributing to mercury exposure in dentists. J Am Dent Assoc. 1995; 126(11): 1502-1511.
  34. Mumtaz R, Khan AA, Noor N, Humayun S. Amalgam use and waste management by Pakistani dentists: an environmental perspective. East Mediterr Health J. 2010; 16(3).
  35. Olfert SM. Reproductive outcomes among dental personnel: a review of selected exposures. J Can Dent Assoc. 2006; 72(9): 821.
  36. Pérez-Gómez B, Aragonés N, Gustavsson P, Plato N, López-Abente G, Pollán, M. Cutaneous melanoma in Swedish women: occupational risks by anatomic site. Am J Ind Med. 2005; 48(4): 270-281.
  37. Parsell DE, Karns L, Buchanan WT, Johnson RB. Mercury release during autoclave sterilization of amalgam. J Dent Educ. 1996; 60(5): 453-458.
  38. Roberts HW, Leonard D, Osborne J. Potential health and environmental issues of mercury-contaminated amalgamators. J Am Dent Assoc. 2001; 132(1): 58-64.
  39. Zahir F, Rizwi SJ, Haq SK, Khan RH. Low dose mercury toxicity and human health. Environ Toxicol Pharmacol. 2005; 20(2): 351-360.
  40. Rowland AS, Baird DD, Weinberg CR, Shore DL, Shy CM, Wilcox AJ. The effect of occupational exposure to mercury vapour on the fertility of female dental assistants. Occupat Environ Med. 1994; 51:28-34.
  41. Sikorski R, Juszkiewicz T, Paszkowski T, Szprengier-Juszkiewicz T. Women in dental surgeries: reproductive hazards in exposure to metallic mercury. International Archives of Occupational and Environmental Health. 1987; 59(6): 551-557.
  42. Richardson GM, Brecher RW, Scobie H, Hamblen J, Samuelian J, Smith C. Mercury vapour (Hg(0)): Continuing toxicological uncertainties, and establishing a Canadian reference exposure level. Regul Toxicol Pharmicol. February 2009; 53(1):32-38.
  43. Al-Saleh I, Al-Sedairi A. Mercury (Hg) burden in children: The impact of dental amalgam. Sci Total Environ. 2011; 409(16):3003-3015.
  44. Nylander M, Friberg L, Lind B. Mercury concentrations in the human brain and kidneys in relation to exposure from dental amalgam fillings. Swed Dent J. 1987; 11(5): 179-187.
  45. Mortada WL, Sobh MA, El-Defrawi, MM, Farahat SE. Mercury in dental restoration: is there a risk of nephrotoxity? J Nephrol. 2002; 15(2): 171-176.
  46. Molin M, Bergman B, Marklund SL, Schutz A, Skerfving S. Mercury, selenium, and glutathione peroxidase before and after amalgam removal in man. Acta Odontol Scand. 1990; 48(3): 189-202.
  47. Redhe O, Pleva J. Recovery of amyotrophic lateral sclerosis and from allergy after removal of dental amalgam fillings. Int J Risk & Safety in Med. 1994; 4(3): 229-236.
  48. Godfrey ME, Wojcik DP, Krone CA. Apolipoprotein E genotyping as a potential biomarker for mercury toxicity. Journal of Alzheimer’s Disease. 2003; 5(3): 189-195.
  49. Summers AO, Wireman J, Vimy MJ, Lorscheider FL, Marshall B, Levy SB, Bennet S, Billard L. Mercury released from dental ‘silver’ fillings provokes an increase in mercury- and antibiotic- resistant bacteria in oral and intestinal flora of primates. Antimicrob Agents and Chemother. 1993; 37(4): 825-834.
  50. Fredin B. The distribution of mercury in various tissues of guinea-pigs after application of dental amalgam fillings (a pilot study). Sci Total Environ. 1987; 66: 263-268.
  51. Danscher G, Horsted-Bindslev P, Rungby J. Traces of mercury in organs from primates with amalgam fillings. Ex Mol Pathol. June 1990; 52(3): 291-299.
  52. Snapp KR, Boyer DB, Peterson LC, Svare CW. The contribution of dental amalgam to mercury in blood. J Dent Res. 1989; 68(5):780–5.
  53. Vimy MJ, Lorscheider FL.  Intra-oral air mercury released from dental amalgam.  J Den Res. 1985; 64(8):1069-71.
  54. Vimy MJ, Lorscheider FL:  Serial measurements of intra-oral air mercury; Estimation of daily dose from dental amalgam.  J Dent Res. 1985; 64(8):1072-5.
  55. Vimy MJ, Luft AJ, Lorscheider FL. Estimation of mercury body burden from dental amalgam computer simulation of a metabolic compartment model. J. Dent. Res. 1986; 65(12):1415-1419.
  56. Hahn LJ, Kloiber R, Leininger RW, Vimy MJ, Lorscheider FL.  Whole-body imaging of the distribution of mercury released from dental fillings into monkey tissues.  FASEB J. 1990; 4(14): 3256-3260.
  57. Boyd ND, Benediktsson H, Vimy MJ, Hooper DE, Lorscheider FL.  Mercury from dental “silver” tooth fillings impairs sheep kidney function. Am J Physiol. 1991; 261(4 Pt 2):R1010-4.
  58. Hanson M, Pleva J. The dental amalgam issue: a review. Experientia. 1991; 47(1): 9-22.
  59. Apostoli P, Cortesi I, Mangili A, Elia G, Drago I, Gagliardi T, Soleo L, Valente T, Sciarra GF, Aprea C, Ronchi A, Minoia C. Assessment of reference values for mercury in urine: the results of an Italian polycentric study. Sci Total Environ. 2002; 289(1): 13-24.
  60. Barregård L. Biological monitoring of exposure to mercury vapor. Scand J Work Environ Health. 1993: 45-49.
  61. Fredin B, Krabisch L. In vitro investigation of the possible influence of inorganic mercury and hydrogen peroxide on the formation of peroxides in a polyunsaturated fatty acid system (linoleic acid). Int J Risk Saf Med. 1993; 4(1): 19-25.
  62. Martin MD, Naleway C, Chou HN. Factors contributing to mercury exposure in dentists. J Am Dent Assoc. 1995; 126(11): 1502-1511.
  63. Mutter J, Naumann J. Mercury and the risk of myocardial infarction. N Engl J Med. 2003; 348(21):2151-4.
  64. Vimy MJ, Lorscheider FL.  Intra-oral air mercury released from dental amalgam.  J Den Res. 1985; 64(8):1069-71.
  65. Vimy MJ, Lorscheider FL:  Serial measurements of intra-oral air mercury;  Estimation of daily dose from dental amalgam.  J Dent Res. 1985; 64(8):1072-5.
  66. Gay DD, Cox RD, Reinhardt JW.  Chewing releases mercury from fillings.  Lancet. 1979; 313(8123):985-6.
  67. Abraham JE, Svare CW, Frank CW. The effect of dental amalgam restorations on blood mercury levels. J Dent Res. 1984; 63(1):71-3.
  68. Nimmo A, Werley MS, Martin JS, Tansy MF. Particulate inhalation during the removal of amalgam restorations. J Prosth Dent. 1990; 63:228-33.
  69. Dunn JE, Trachtenberg FL, Barregard L, Bellinger D, McKinlay S. Scalp hair and urine mercury content of children in the northeast United States: the New England children’s amalgam trial. Environ Res. 2008; 107(1):79–88.
  70. Isacsson G, Barregard L, Selden A, Bodin L. Impact of nocturnal bruxism on mercury uptake from dental amalgams. Eur J Oral Sci. 1997; 105(3):251–7.
  71. Sallsten G, Thoren J, Barregard L, Schutz A, Skarping G. Long-term use of nicotine chewing gum and mercury exposure from dental amalgam fillings. J Dent Res. 1996; 75(1):594–8.
  72. Bjorkman L, Lind B. Factors influencing mercury evaporation rate from dental amalgam fillings. Scand J Dent Res. 1992; 100(6):354–60.
  73. Fredin B. Mercury release from dental amalgam fillings. Int J Risk Saf Med. 1994; 4(3): 197-208.
  74. Richardson, GM, Brecher RW, Scobie H, Hamblen J, Samuelian J, Smith C. Mercury vapour (Hg(0)): Continuing toxicological uncertainties, and establishing a Canadian reference exposure level. Regul Toxicol Pharmicol. 2009; 53(1):32-38.
  75. Godfrey ME, Wojcik DP, Krone CA. Apolipoprotein E genotyping as a potential biomarker for mercury toxicity. Journal of Alzheimer’s Disease. 2003; 5(3): 189-195.
  76. Wojcik DP, Godfrey ME, Christie D, Haley BE. Mercury toxicity presenting as chronic fatigue, memory impairment and depression: diagnosis, treatment, susceptibility, and outcomes in a New Zealand general practice setting: 1994-2006. Neuro Endocrinol Lett. 2006; 27(4): 415-423.
  77. Weiner JA, Nylander M, Berglund F. Does mercury from amalgam restorations constitute a health hazard? Sci Total Environ. 1990; 99(1-2):1-22.
  78. Echeverria D, Woods JS, Heyer NJ, Rohlman D, Farin F, Li T, Garabedian CE. The association between a genetic polymorphism of coproporphyrinogen oxidase, dental mercury exposure and neurobehavioral response in humans. Neurotoxicol Teratol. 2006; 28(1):39-48.
  79. Mutter J, Naumann J, Sadaghiani C, Schneider R, Walach H. Alzheimer disease: mercury as pathogenetic factor and apolipoprotein E as a moderator. Neuro Endocrinol Lett. 2004; 25(5): 331-339.
  80. Woods JS, Heyer NJ, Echeverria D, Russo JE, Martin MD, Bernardo MF, Luis HS, Vaz L, Farin FM. Modification of neurobehavioral effects of mercury by a genetic polymorphism of coproporphyrinogen oxidase in children. Neurotoxicol Teratol. 2012; 34(5):513-21.
  81. Palkovicova L, Ursinyova M, Masanova V, Yu Z, Hertz-Picciotto I. Maternal amalgam dental fillings as the source of mercury exposure in developing fetus and newborn. J Expo Sci Environ Epidemiol. 2008;18(3):326–31.
  82. Ask-Björnberg K, Vahter M, Petersson-Grawé K, Glynn A, Cnattingius S, Darnerud PO, et al. Methyl mercury and inorganic mercury in Swedish pregnant women and in cord blood: influence of fish consumption. Environ Health Perspect. 2003; 111(4): 637–41.
  83. Lindow SW, Knight R, Batty J, Haswell SJ. Maternal and neonatal hair mercury concentrations: the effect of dental amalgam. Journal of Obstetrics and Gynecology. 2003; 23(S1):S48-S49.
  84. Lutz E, Lind B, Herin P, Krakau I, Bui TH, Vahter M. Concentrations of mercury, cadmium and lead in brain and kidney of second trimester fetuses and infants. J Trace Elem Med Biol. 1996; 10(2):61–7.
  85. da Costa SL, Malm O, Dorea JG. Breast-milk mercury concentrations and amalgam surface in mothers from Brazilia, Brazil. Biol Trace Elem Res. 2005; 106(2): 145–51.
  86. Geier DA, Kern JK, Geier MR. A prospective study of prenatal mercury exposure from dental amalgams and autism severity. Neurobiolgiae Experimentals Polish Neuroscience Society. 2009; 69(2): 189-197.
  87. Ask K, Akesson A, Berglund M, Vahter M. Inorganic mercury and methylmercury in placentas of Swedish women. Environ Health Perspect 2002; 110(5):523-6.
  88. 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(2):186-94.
  89. Mutter J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. Journal of Occupational Medicine and Toxicology. 2011; 6:2.
  90. Norouzi E, Bahramifar N, Ghasempouri SM. Effect of teeth amalgam on mercury levels in the colostrums human milk in Lenjan. Environ Monit Access. 2012; 184(1):375-380.
  91. Vimy MJ, Hooper DE, King WW, Lorscheider FL. Mercury from maternal “silver” tooth fillings in sheep and human breast milk. Biological Trace Element Research. 1997; 56(2): 143-152.
  92. Richardson GM, Wilson R, Allard D, Purtill C, Douma S, Gravière J. Mercury exposure and risks from dental amalgam in the US population, post-2000. Science of the Total Environment. 2011; 409(20): 4257-4268.
  93. Vimy MJ, Takahashi Y, Lorscheider FL. Maternal-fetal distribution of mercury (203 Hg) released from dental amalgam fillings. American Physiology Society. 1990; 258(4): R939-945.
  94. Oskarsson A, Schutz A, Schkerving S, Hallen IP, Ohlin B, Lagerkvist BJ. Total and inorganic mercury in breast milk in relation to fish consumption and amalgam in lactating women. Arch Environ Health. 1996; 51(3):234-51.
  95. Geier DA, Kern JK, Geier MR. The biological basis of autism spectrum disorders: Understanding causation and treatment by clinical geneticists. Acta Neurobiol Exp (Wars). 2010; 70(2): 209-226.
  96. Mutter J, Naumann J, Schneider R, Walach H, Haley B. Mercury and autism: accelerating evidence. Neuro Endocrinol Lett. 2005: 26(5): 439-446.
  97. Ask-Björnberg K, Vahter M, Petersson-Grawé K, Glynn A, Cnattingius S, Darnerud PO, et al. Methyl mercury and inorganic mercury in Swedish pregnant women and in cord blood: influence of fish consumption. Environ Health Perspect. 2003;111(4): 637–41.
  98. da Costa SL, Malm O, Dorea JG. Breast-milk mercury concentrations and amalgam surface in mothers from Brazilia, Brazil. Biol Trace Elem Res. 2005; 106(2): 145–51.
  99. Oskarsson A, Schutz A, Schkerving S, Hallen IP, Ohlin B, Lagerkvist BJ. Total and inorganic mercury in breast milk in relation to fish consumption and amalgam in lactating women. Arch Environ Health. 1996; 51(3):234-51.
  100. Norouzi E, Bahramifar N, Ghasempouri SM. Effect of teeth amalgam on mercury levels in the colostrums human milk in Lenjan. Environ Monit Access. 2012; 184(1): 375-380.
  101. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A significant dose-dependent relationship between mercury exposure from dental amalgams and kidney integrity biomarkers A further assessment of the Casa Pia children’s dental amalgam trial. Human & Experimental Toxicology. 2013; 32(4):434-440.
  102. Guzzi, G; Pigatto, PD. Urinary mercury levels in children with amalgam fillings. Environ Health Perspect. 2008; 116(7):A286-7.
  103. Geier DA, Carmody T, Kern JK, King PG, Geier MR. A significant relationship between mercury exposure from dental amalgams and urinary porphyrins: a further assessment of the Casa Pia children’s dental amalgam trial. Biometals. 2011; 24, (2):215-224.
  104. Al-Saleh I, Al-Sedairi A. Mercury (Hg) burden in children: The impact of dental amalgam. Sci Total Environ. 2011; 409(16):3003-3015.
  105. Ask K, Akesson A, Berglund M, Vahter M. Inorganic mercury and methylmercury in placentas of Swedish women. Environ Health Perspect. 2002; 110(5):523-6.
  106. 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(2):186-94.
  107. Holmes, AS, Blaxill, MF, Haley, BE. Reduced levels of mercury in first baby haircuts of autistic children. Int J Toxicol. 2003. 22 (4): 277-85.
  108. Haley BE. Mercury toxicity: genetic susceptibility and synergistic effects. Medical Vertias. 2005; 2(2): 535-542.
  109. Woods JS, Heyer NJ, Echeverria D, Russo JE, Martin MD, Bernardo MF, Luis HS, Vaz L, Farin FM. Modification of neurobehavioral effects of mercury by a genetic polymorphism of coproporphyrinogen oxidase in children. Neurotoxicol Teratol. 2012; 34(5):513-21.
  110. Dunn JE, Trachtenberg FL, Barregard L, Bellinger D, McKinlay S. Scalp hair and urine mercury content of children in the northeast United States: the New England children’s amalgam trial. Environ Res. 2008; 107(1):79–88.
  111. Djerassi E, Berova N. The possibilities of allergic reactions from silver amalgam restorations. Internat Dent J, 1969, 19(4):481-8, 1969.
  112. Finne K, Goransson K, Winckler L. Oral lichen planus and contact allergy to mercury. Int J Oral Surg. 1982; 11(4):236-9.
  113. Miller, EG, Perry WL, Wagner MJ. Prevalence of mercury hypersensitivity in dental students. J Dent Res. 1985; 64: Special Issue, p. 338, Abstract #1472.
  114. Sterzl I, Procházková J, Hrdá P, Bártová J, Matucha P, Stejskal VD. Mercury and nickel allergy: risk factors in fatigue and autoimmunity. Neuro Endocrinol Lett. 1999; 20: 221-228.
  115. Prochazkova J, Sterzl I, Kucerova H, Bartova J, Stejskal VD. The beneficial effect of amalgam replacement on health in patients with autoimmunity. Neuro Endocrinol Lett. 2004; 25(3): 211-218.
  116. Tomka M, Machovkova A, Pelclova D, Petanova J, Arenbergerova M, Prochazkova J. Orofacial granulomatosis associated with hypersensitivity to dental amalgam. Science Direct. 2011; 112(3):335-341.
  117. Lundstrom, IM. Allergy and corrosion of dental materials in patients with oral lichen planus. Int J Oral Surg. 1984; 13(1):16.
  118. Laine, J, Kalimo K, Forssell H, Happonen R. Resolution of oral lichenoid lesions after replacement ofamalgam restorations in patients allergic to mercury compounds. JAMA. 3 June 1992; 267(21):2880.
  119. Lind PO, Hurlen B, Lyberg T, Aas E. Amalgam-related oral lichenoid reaction. Scand J Dent Res. 1986; 94(5):448-51.
  120. Pang BK, Freeman S. Oral lichenoid lesions caused by allergy to mercury in amalgam fillings. Contact Dermatitis. 1995; 33(6):423-7.
  121. Athavale PN, Shum KW, Yeoman CM, Gawkrodger DJ. Oral lichenoid lesions and contact allergy to dental mercury and gold. Contact Dermatitis. 2003; 49(5): 264-265.
  122. Hougeir FG, Yiannias JA, Hinni ML, Hentz JG, el-Azhary RA. Oral metal contact allergy: a pilot study on the cause of oral squamous cell carcinoma. Int J Dermatol. 2006; 45(3): 265-271.
  123. Kaaber S. Allergy to dental materials with special reference to the use of amalgam and polymethylmethacrylate. Int Dent J. 1990; 40(6): 359.
  124. Lee JY, Yoo JM, Cho BK, Kim HO. Contact dermatitis in Korean dental technicians. Contact Dermatitis. 2001; 45(1), 13-16.
  125. Venclikova Z, Benada O, Bartova J, Joska L, Mrklas L, Prochazkova J, Stejskal V, Podzimek S. In vivo effects of dental casting alloys. Neuro Endocrinol Lett. 2006; 27: 61.
  126. Weber ME, Yiannias JA, Hougeir FG, Kyle A, Noble BN, Landry AM, Hinni ML. Intraoral metal contact allergy as a possible risk factor for oral squamous cell carcinoma. Ann Otol Rhinol Laryngol. 2012; 121(6):389-94.
  127. White RR, Brandt RL. Development of mercury hypersensitivity among dental students. JADA. 1976; 92(6):1204-7.
  128. Finne KAJ, Göransson K, Winckler L. Oral lichen planus and contact allergy to mercury. International Journal of Oral Surgery. 1982; 11(4):236-239.
  129. Mutter J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. Journal of Occupational Medicine and Toxicology. 2011; 6:2.  
  130. Bartova J, Prochazkova J, Kratka Z, Benetkova K, Venclikova C, Sterzl I. Dental amalgam as one of the risk factors in autoimmune disease. Neuro Endocrinol Lett. 2003; 24(1-2): 65-67.
  131. Hultman P, Johansson U, Turley SJ, Lindh U, Enestrom S, Pollard KM. Adverse immunological effects and autoimmunity induced by dental amalgam and alloy in mice. FASEB J. 1994; 8(14):1183-90.
  132. Weiner JA, Nylander M, Berglund F. Does mercury from amalgam restorations constitute a health hazard? Sci Total Environ. 1990; 99(1-2):1-22.
  133. Eggleston DW. Effect of dental amalgam and nickel alloys on T-lymphocytes: preliminary report. J Prosthet Dent. 1984; 51(5):617-23.
  134. Prochazkova J, Sterzl I, Kucerkova H, Bartova J, Stejskal VDM. The beneficial effect of amalgam replacement on health in patients with autoimmunity. Neuroendocrinology Letters. 2004; 25(3): 211-218.
  135. Cooper GS, Parks CG, Treadwell EL, St Clair EW, Gilkeson GS, Dooley MA. Occupational risk factors for the development of systemic lupus erythematosus. J Rheumatol. 2004; 31(10): 1928-1933.
  136. Barregard L, Fabricius-Lagging E, Lundh T, Molne J, Wallin M, Olausson M, Modigh C, Sallsten G. Cadmium, mercury, and lead in kidney cortex of living kidney donors: impact of different exposure sources. Environ, Res. Sweden, 2009; 110: 47-54.
  137. Nylander M., Friberg L, Lind B. Mercury concentrations in the human brain and kidneys in relation to exposure from dental amalgam fillings. Swed Dent J. 1987; 11(5): 179-187.
  138. Mortada WL, Sobh MA, El-Defrawi, MM, Farahat SE. Mercury in dental restoration: is there a risk of nephrotoxity? J Nephrol. 2002; 15(2): 171-176.
  139. Fredin B. The distribution of mercury in various tissues of guinea-pigs after application of dental amalgam fillings (a pilot study). Sci Total Environ. 1987; 66: 263-268.
  140. Boyd ND, Benediktsson H, Vimy MJ, Hooper DE, Lorscheider FL.  Mercury from dental “silver” tooth fillings impairs sheep kidney function. Am J Physiol. October 1991;261(4 Pt 2):R1010-4.
  141. Mutter J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. Journal of Occupational Medicine and Toxicology. 2011; 6:2.
  142. Siblerud RL. A comparison of mental health of multiple sclerosis patients with silver/mercury dental fillings and those with fillings removed. Psychol Rep. 1992; 70(3c):1139-51.
  143. Huggins HA, Levy TE. Cerebrospinal fluid protein changes in multiple sclerosis after dental amalgam removal. Altern Med Rev. 1998; 3(4): 295-300.
  144. Siblerud RL, Kienholz E. Evidence that mercury from silver dental fillings may be an etiological factor in multiple sclerosis. The Science of the Total Environment. 1994; 142(3): 191-205.
  145. Laine J, Kalimo K, Forssell H, Happonen R. Resolution of Oral Lichenoid Lesions After Replacement ofAmalgam Restorations in Patients Allergic to Mercury Compounds. JAMA. 1992; 267(21):2880.
  146. Lind PO, Hurlen B, Lyberg T, Aas E. Amalgam-related oral lichenoid reaction. Scand J Dent Res. 1986 Oct;94(5):448-51.
  147. Henriksson E, Mattsson U, Håkansson J. Healing of lichenoid reactions following removal of amalgam. A clinical follow-up. J Clin Periodontol. 1995; 22(4):287-94.
  148. Ibbotson SH, Speight EL, Macleod RI, Smart ER, Lawrence CM. The relevance and effect of amalgam replacement in subjects with oral lichenoid reactions. British Journal of Dermatology. 1996; 134(3):420-423.
  149. Camisa C, Taylor JS, Bernat JR, Helm TN. Contact hypersensitivity to mercury in amalgam restorations may mimic oral lichen planus. Cutis. 1999; 63(3):189-92.
  150. Dunsche A, Kastel I, Terheyden H, Springer ING, Christopher E, Brasch J. Oral lichenoid reactions associated with amalgam: improvement after amalgam removal. British Journal of Dermatology. 2003; 148(1):70-76.
  151. Wong L, Freeman S. Oral lichenoid lesions (OLL) and mercury in amalgam fillings. Contact Dermatitis. 2003; 48(2): 74-79.
  152. Finne K, Goransson K, Winckler L. Oral Lichen Planus and Contact Allergy to Mercury. Int J Oral Surg. 1982; 11(4):236-9.
  153. Lundstrom, IM. Allergy and Corrosion of Dental Materials in Patients With Oral Lichen Planus. Int J Oral Surg. 1984; 13(1):16.
  154. Athavale PN, Shum KW, Yeoman CM, Gawkrodger DJ. Oral lichenoid lesions and contact allergy to dental mercury and gold. Contact Dermatitis. 2003; 49(5): 264-265.
  155. Ministry of the Environment, Norway. Minister of the Environment and International Development Erik Solheim: Bans mercury in products [Press release]. 2007 December 21. Available from Government of Norway Web site: https://www.regjeringen.no/en/aktuelt/Bans-mercury-in-products/id495138/. Accessed December 15, 2015.
  156. Swedish Chemicals Agency. The Swedish Chemicals Agency’s chemical products and biotechnical organisms regulations. (KIFS 2008: 2 in English, consolidated up to KIFS 2012: 3). 2008: 29-30. Available from http://www3.kemi.se/Documents/Forfattningar/Docs_eng/K08_2_en.pdf. Accessed December 22, 2015.
  157. BIO Intelligence Service. Study on the potential for reducing mercury pollution from dental amalgam and batteries. Final Report prepared for the European Commission- DG ENV. 2012. Page 188. Available from the European Commission Web site: http://ec.europa.eu/environment/chemicals/mercury/pdf/final_report_110712.pdf. Accessed December 15, 2015.
  158. BIO Intelligence Service. Study on the potential for reducing mercury pollution from dental amalgam and batteries. Final Report prepared for the European Commission- DG ENV. 2012. Page 40. Available from the European Commission Web site: http://ec.europa.eu/environment/chemicals/mercury/pdf/final_report_110712.pdf. Accessed December 15, 2015.
  159. Health and Environment Alliance and Health Care without Harm. Mercury and dental amalgams [fact sheet]. 2007. Page 3. Available from Health and Environment Alliance Web site: http://www.env-health.org/IMG/pdf/HEA_009-07.pdf. Accessed December 15, 2015.
  160. Dental Tribune International. EU endorses amalgam ban in children and pregnant or breastfeeding women. December 13, 2016. Available from: https://eu.dental-tribune.com/news/eu-endorses-amalgam-ban-in-children-and-pregnant-or-breastfeeding-women/. Accessed February 27, 2018.
  161. European Commission. European Commission – Fact Sheet. Questions and answers: EU mercury policy and the ratification of the Minamata Convention. May 18, 2017. Available from: http://europa.eu/rapid/press-release_MEMO-17-1344_en.htm. Accessed February 27, 2018.
  162. United Nations Environment Programme. Minamata Convention on Mercury: Text and Annexes. 2013: 48. Available from UNEP’s Minamata Convention on Mercury Web site: http://www.mercuryconvention.org/Portals/11/documents/Booklets/Minamata%20Convention%20on%20Mercury_booklet_English.pdf. Accessed December 15, 2015.
  163. United Nations Environment Programme. Minamata Convention on Mercury: Text and Annexes. 2013: 48. Available from UNEP’s Minamata Convention on Mercury Web site: http://www.mercuryconvention.org/Portals/11/documents/Booklets/Minamata%20Convention%20on%20Mercury_booklet_English.pdf. Accessed December 15, 2015.
  164. United States Food and Drug Administration. About dental fillings: potential risks. Last updated 2 February 2015. Available from FDA Web site: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/ucm171094.htm. Accessed December 15, 2015.
  165. International Academy of Oral Medicine and Toxicology. Lawsuit filed today against FDA for failing to address risks of mercury in dental fillings [press release]. ChampionsGate, FL: International Academy of Oral Medicine and Toxicology. March 5, 2014. Available from IAOMT Web site: https://iaomt.org/lawsuit-filed-today-fda-failing-address-risks-mercury-dental-fillings/. Accessed January 25, 2016.
  166. FDA Safety Communication: Reducing Exposure to Mercury Vapor Released from Dental Amalgam (“Silver Fillings”). January XX, 2012. Available from IAOMT Web site: https://iaomt.org/text-of-fdas-actual-2012-amalgam-safety-proposal/. Accessed January 25, 2016.
  167. United States Environmental Protection Agency. Effluent Limitation Guidelines and Standards for the Dental Category Mercury in Dental Amalgam. EPA – 821-F-14-002. September 2014.
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