Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2004 Jun;61(6):535–540. doi: 10.1136/oem.2003.009555

Evaluation of the mercury exposure of dental amalgam patients by the Mercury Triple Test

G Hansen 1, R Victor 1, E Engeldinger 1, C Schweitzer 1
PMCID: PMC1763642  PMID: 15150394

Abstract

Aims: To establish and analyse reference data for the mercury burden of patients with and without amalgam fillings.

Methods: Atomic absorption spectroscopy was used to quantify Hg concentrations in the scalp hair and urine (before and after application of dimercaptopropane sulphonate), and Hg release from dental amalgams (using a newly developed, amalgam specific chew test), in 2223 subjects.

Results: 50th centiles were 1.3 µg Hg/g creatinine in basal urine, 32 µg Hg/g creatinine after DMPS application, 454 ng Hg/g in hair, and 27 µg Hg per g of chewing gum, which corresponds to about 1 µg Hg released per minute of chewing. Total Hg intake (from ambient air, drinking water, food, and amalgams) of most patients is well below the provisioned tolerable weekly intake (PTWI) defined by the WHO, unless extremely Hg rich food is consumed on a regular basis. However, for patients exceeding the 75thcentile in chew tests, total Hg intake exceeds the PTWI by about 50%, even at the low limit of intake from food. In the absence of occupational exposure, significant Hg release from dental amalgams is a necessary but insufficient condition to obtain a high long term body burden. After removal of dental amalgams, chew tests no longer exhibit oral Hg exposure, while basal urine Hg content and DMPS induced excretion display a exponential decrease (half life about 2 months in both cases).

Conclusions: A standardised procedure for evaluation of the magnitude and origin of the Hg burden of individuals has been developed, which, by comparison with the database presented here for the first time, can serve as a diagnostic tool.

Full Text

The Full Text of this article is available as a PDF (329.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Begerow J., Zander D., Freier I., Dunemann L. Long-term mercury excretion in urine after removal of amalgam fillings. Int Arch Occup Environ Health. 1994;66(3):209–212. doi: 10.1007/BF00380782. [DOI] [PubMed] [Google Scholar]
  2. Bernard S., Enayati A., Redwood L., Roger H., Binstock T. Autism: a novel form of mercury poisoning. Med Hypotheses. 2001 Apr;56(4):462–471. doi: 10.1054/mehy.2000.1281. [DOI] [PubMed] [Google Scholar]
  3. Goldberg D. M., Clarke A. D. Measurement of mercury in human urine. J Clin Pathol. 1970 Mar;23(2):178–184. doi: 10.1136/jcp.23.2.178. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Leong C. C., Syed N. I., Lorscheider F. L. Retrograde degeneration of neurite membrane structural integrity of nerve growth cones following in vitro exposure to mercury. Neuroreport. 2001 Mar 26;12(4):733–737. doi: 10.1097/00001756-200103260-00024. [DOI] [PubMed] [Google Scholar]
  5. Lorscheider F. L., Vimy M. J., Summers A. O. Mercury exposure from "silver" tooth fillings: emerging evidence questions a traditional dental paradigm. FASEB J. 1995 Apr;9(7):504–508. [PubMed] [Google Scholar]
  6. Maugh T. H., 2nd Hair: a diagnostic tool to complement blood serum and urine. Science. 1978 Dec 22;202(4374):1271–1273. doi: 10.1126/science.725602. [DOI] [PubMed] [Google Scholar]
  7. Molin M., Bergman B., Marklund S. L., Schütz A., Skerfving S. Mercury, selenium, and glutathione peroxidase before and after amalgam removal in man. Acta Odontol Scand. 1990 Jun;48(3):189–202. doi: 10.3109/00016359009005875. [DOI] [PubMed] [Google Scholar]
  8. Sandborgh-Englund G., Elinder C. G., Langworth S., Schütz A., Ekstrand J. Mercury in biological fluids after amalgam removal. J Dent Res. 1998 Apr;77(4):615–624. doi: 10.1177/00220345980770041501. [DOI] [PubMed] [Google Scholar]
  9. Snapp K. R., Boyer D. B., Peterson L. C., Svare C. W. The contribution of dental amalgam to mercury in blood. J Dent Res. 1989 May;68(5):780–785. doi: 10.1177/00220345890680050501. [DOI] [PubMed] [Google Scholar]
  10. Wawschinek O. Zur toxikologischen Analyse des Quecksilbers im biologischen Material. Extraktionsphotometrische Dithizonmethode. Arch Toxikol. 1972;29(2):107–115. [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES