Dental "silver" tooth fillings: a source of mercury exposure revealed by whole-body image scan and tissue analysis

Mercury (Hg) vapor is released from dental "silver" tooth fillings into human mouth air after chewing, but its possible uptake routes and distribution among body tissues are unknown. This investigation demonstrates that when radioactive 203Hg is mixed with dental Hg/silver fillings (amalgam) and placed in teeth of adult sheep, the isotope will appear in various organs and tissues within 29 days. Evidence of Hg uptake, as determined by whole-body scanning and measurement of isotope in specific tissues, revealed three uptake sites: lung, gastrointestinal, and jaw tissue absorption. Once absorbed, high concentrations of dental amalgam Hg rapidly localize in kidneys and liver. Results are discussed in view of potential health consequences from long-term exposure to Hg from this dental material.     

Whole-body imaging of the distribution of mercury released from dental fillings into monkey tissues

The fate of mercury (Hg) released from dental "silver" amalgam tooth fillings into human mouth air is uncertain. A previous report about sheep revealed uptake routes and distribution of amalgam Hg among body tissues. The present investigation demonstrates the bodily distribution of amalgam Hg in a monkey whose dentition, diet, feeding regimen, and chewing pattern closely resemble those of humans. When amalgam fillings, which normally contain 50% Hg, are made with a tracer of radioactive 203Hg and then placed into monkey teeth, the isotope appears in high concentration in various organs and tissues within 4 wk. Whole-body images of the monkey revealed that the highest levels of Hg were located in the kidney, gastrointestinal tract, and jaw. The dental profession's advocacy of silver amalgam as a stable tooth restorative material is not supported by these findings.     

A significant relationship between mercury exposure from dental amalgams and urinary porphyrins: a further assessment of the Casa Pia children’s dental amalgam trial

Previous studies noted specific changes in urinary porphyrin excretion patterns associated with exposure to mercury (Hg) in animals and humans. In our study, urinary porphyrin concentrations were examined in normal children 8–18 years-old from a reanalysis of data provided from a randomized, prospective clinical trial that was designed to evaluate the potential health consequences of prolonged exposure to Hg from dental amalgam fillings (the parent study). Our analysis examined dose-dependent correlations between increasing Hg exposure from dental amalgams and urinary porphyrins utilizing statistical models with adjustments for the baseline level (i.e. study year 1) of the following variables: urinary Hg, each urinary porphyrin measure, gender, race, and the level of lead (Pb) in each subject’s blood. Significant dose-dependent correlations between cumulative exposure to Hg from dental amalgams and urinary porphyrins associated with Hg body-burden (pentacarboxyporphyrin, precoproporphyrin, and coproporphyrin) were observed. Overall, 5–10% increases in Hg-associated porphyrins for subjects receiving an average number of dental amalgam fillings in comparison to subjects receiving only composite fillings were observed over the 8-year course of the study. In contrast, no significant correlations were observed between cumulative exposure to Hg from dental amalgams and urinary porphyrins not associated with Hg body-burden (uroporphyrin, heptacarboxyporphyrin, and hexacarboxyporphyrin). In conclusion, our study, in contrast to the no-effect results published from the parent study, further establishes the sensitivity and specificity of specific urinary porphyrins as a biomarker for low-level Hg body-burden, and also reveals that dental amalgams are a significant chronic contributor to Hg body-burden.     

Increased Zn/Glutathione Levels and Higher Superoxide Dismutase-1 Activity as Biomarkers of Oxidative Stress in Women with Long-Term Dental Amalgam Fillings: Correlation between Mercury/Aluminium Levels (in Hair) and Antioxidant Systems in Plasma

Background

The induction of oxidative stress by Hg can affect antioxidant enzymes. However, epidemiological studies have failed to establish clear association between dental fillings presence and health problems.

Objectives

To determine whether heavy metals (in hair), antioxidant enzymes (SOD-1) and glutathione levels could be affected by the chronic presence of heavy metals in women who had dental amalgam fillings.

Materials and Methods

55 hair samples (42 females with amalgam fillings and 13 female control subjects) were obtained. All subjects (mean age 44 years) who had dental amalgam filling for more than 10 years (average 15 years). Certain metals were quantified by ICP-MS (Mass Spectrophotometry) in hair (μg/g: Al, Hg, Ba, Ag, Sb, As, Be, Bi, Cd, Pb, Pt, Tl, Th, U, Ni, Sn, Ti) and SOD-1 and Glutathione (reduced form) levels in plasma. Data were compared with controls without amalgams, and analyzed to identify any significant relation between metals and the total number of amalgam fillings, comparing those with four or less (n = 27) with those with more than four (n = 15). As no significant differences were detected, the two groups were pooled (Amlgam; n = 42).

Findings

Hg, Ag, Al and Ba were higher in the amalgam group but without significant differences for most of the heavy metals analyzed. Increased SOD-1 activity and glutathione levels (reduced form) were observed in the amalgam group. Aluminum (Al) correlated with glutathione levels while Hg levels correlated with SOD-1. The observed Al/glutathione and Hg/SOD-1 correlation could be adaptive responses against the chronic presence of mercury.

Conclusions

Hg, Ag, Al and Ba levels increased in women who had dental amalgam fillings for long periods. Al correlated with glutathione, and Hg with SOD-1. SOD-1 may be a possible biomarker for assessing chronic Hg toxicity.     

Mercury from maternal “silver” tooth fillings in sheep and human breast milk

Neonatal uptake of mercury (Hg) from milk was examined in a pregnant sheep model, where radioactive mercury (Hg²⁰³)/silver tooth fillings (amalgam), were newly placed. A crossover experimental design was used in which lactating ewes nursed foster lambs. In a parallel study, the relationship between dental history and, breast milk concentration of Hg was also examined in 33 lactating women. Results from the animal studies showed that, during pregnancy, a primary fetal site of amalgam Hg concentration is the liver, and, after delivery, the neonatal lamb kidney receives additional amalgam Hg from mother's milk. In lactating women with aged, amalgam fillings, increased Hg excretion in breast milk and urine correlated with the number of fillings or Hg vapor concentration levels in mouth air. It was concluded that Hg originating from maternal amalgam tooth fillings transfers across the placenta to the fetus, across the mammary gland into milk ingested by the newborn, and ultimately into neonatal body tissues. Comparisons are made to the U.S. minimal risk level recently established for adult Hg exposure. These findings suggest, that placement and removal of “silver” tooth fillings in pregnant and lactating humans will subject the fetus and neonate to unnecessary risk of Hg exposure.     

Breast-milk mercury concentrations and amalgam surface in mothers from Brasília, Brazil

Human milk is the best source of nourishment for the newborn because of its incomparable balanced nutrition and psychological benefits to the infant's development. Dental fillings containing metallic Hg are the primary source of inorganic Hg contamination of humans. We studied Hg concentrations in the breast milk of mothers during the first month (7-30 d) postnatal in relation to the number of amalgam surfaces. The concentration of total Hg was determined in 23 samples of human milk collected from lactating mothers with a varied number of amalgam dental restorations. The average number of amalgam surfaces was 6.87 (5.81, SD) with a range of 0 to 20. The mean concentration of total Hg in breast milk was 5.73 ng/g (range: 0-23.07). The Pearson correlation coefficient was significant (r = 0.6087, p = 0.0057) between breast-milk Hg and number of amalgam surfaces. In 56.5% of low-fish-eating mothers, the amount of Hg likely to be ingested by breast-fed infants is above the World Health Organization reference.     

Mercury and selenium in whole blood and serum in relation to fish consumption and amalgam fillings in adolescents

Mercury and selenium in whole blood and serum of 245 17-year old Swedish adolescents were analysed. The relationships between these elements' concentrations and the consumption of fish as well as the number of dental amalgam fillings were studied. The geometric means (GM) of the mercury concentrations were 1.1 microg/L in blood and 0.43 microg/L in serum. The mean selenium concentration in blood was 110 microg/L and the GM of the serum selenium concentration 110 microg/L. Fish species with dietary restrictions due to elevated mercury Levels (i.e. pike, perch, pikeperch, burbot, eel and halibut) were consumed on average 0.7 times/month and fish species without such restrictions 4.1 times/month. Despite this comparatively low fish consumption, the adolescents' blood mercury concentrations were positively correlated with fish consumption. Of the adolescents, 39% had amalgam fillings (mean 2 +/- 1.5). Serum mercury was influenced by the number of amalgam fillings, by fish consumption, blood and serum levels of selenium and the residential area. Blood and serum selenium concentrations were not influenced by fish consumption, but were positively associated with the serum mercury concentration.     

Major element chemistry,weathering and element yields for the Caura River drainage,Venezuela

The Caura River, a major tributary of the Orinoco River, was sampled at bi-weekly intervals for two years. Because the watershed is covered with undisturbed forest overlying a Precambrian shield, the water of the Caura River has low conductivity (mean, 15 uS/cm), contains small amounts of particulate material (mean, 11 mg/1), and is slightly acidic (median pH, 6.8). Concentrations of total dissolved solids vary less than two-fold in response to the seasonal ten-fold variation in discharge; concentrations of particulate material vary more (ten-fold) and are lowest at the time of peak discharge. Seasonal changes in concentrations of Si, major metal cations, and hydrogen ion are complementary to each other and indicate regular seasonal changes in weathering rates. Measurements of bulk atmospheric deposition and the observed runoff yield of Cl and S were used in estimating the basin-wide atmospheric deposition of major elements, which were as follows (kg/ha/yr): Ca, 1.3; Mg, 0.29; Na, 8.2; K, 1.0; Cl, 12; S, 2.8; P, 0.14. Element ratios show that terrestrial sources contribute strongly to the atmospheric deposition of Ca, K, S, and P. From the atmospheric contributions and runoff yields, watershed retention was computed for major elements with reference to Si. The watershed accumulates Al, Fe, and P, whereas losses of Ca, Mg, Na, K, and S originating from non-atmospheric sources exceed the relative loss rates of Si. The rock weathering rate based on Si is 1.8 cm/ 1,000 years. Although significant amounts of Ca, Mg, Na, and K are found in atmospheric deposition, the dominant influence on the mass balances of these elements is weathering rather than deposition. Weathering has a trivial influence on the cycles of Cl and S. Both atmospheric deposition and weathering are important in the mass balance of P. The ecosystem does not effectively conserve most biologically active elements (Ca, Mg, Na, K). The ecosystem conserves significant amounts of phosphorus (31% of total input), but probably by abiotic mechanisms.     

Magnesium secretion by the distal segment of the Malpighian tubules of the black field cricket Teleogryllus oceanicus

The short distal segment of unstimulated Teleogryllus Malpighian tubules secreted hyperosmotic fluid containing primarily Mg (125mmoll(-1)), Cl (242mmoll(-1)) and Na (43mmoll(-1)). Remarkably, the volume secreted by the distal segment in unit time was independent of segment length, i.e. the volume was constant regardless of the length of the segment. Magnesium was secreted at a rate of 75.5pmolmin(-1)mm(-1); the highest rate recorded for any epithelium. Low concentrations of K (20mmoll(-1)) were present but almost no P or S. Ca (2.5mmoll(-1)) concentration was higher than in the main segment. The short distal segment secreted 100% of the Mg, 54% of the Cl and 23% of the Na secreted by the whole tubule. The main segment secreted fluid containing primarily K (199mmoll(-1)), Cl (149mmoll(-1)), Na (104mmoll(-1)) and P (48mmoll(-1)) with very low concentrations of Ca (1mmoll(-1)) and S. The main segment appeared to reabsorb a small fraction of the Mg secreted by the distal segment. The fluid secreted by the whole tubule was isosmotic and alkaline, approximately pH8.     

Nutrient cycling in an excessively rainfed subtropical grassland at Cherrapunji

Cycling of six mineral elements (N, P, K, Na, Ca and Mg) was studied in a humid subtropical grassland at Cherrapunji, north-eastern India during 1988-1989. Elemental concentrations in the shoot of four dominant grass species,viz., Arundinella khaseana, Chrysopogon gryllus, Eragrostiella leioptera andEulalia trispicata were very low, and none of the species appears suitable for fodder use. Among different vegetation compartments, live root was the largest reservoir of all the nutrients (except Ca) followed by live shoot, dead shoot, litter and dead root. For Ca, live shoot was the major storage compartment. The total annual uptake (kg ha^-1) was 137.3, 10.4, 51.1, 5.5, 8.7 and 18.2 for N, P, K, Na, Ca and Mg, respectively. In an annual cycle 98% N, 77% P, 49% K, 109% Na, 87% Ca and 65% Mg returned to the soil through litter and belowground detritus. A major portion of N, P and Na was recycled through the belowground system, whereas nearly half of K, Ca and Mg was recycled through the shoot system. Precipitation acts as the source of N and P input, but at the same time causes loss of cations.     

鼎湖山主要森林类型土壤交换性阳离子含量及其季节动态特征

研究鼎湖山自然保护区马尾松林、马尾松荷木混交林和季风常绿阔叶林三种代表性森林类型表层土壤(0~20cm)交换性阳离子含量及其季节动态。结果表明:土壤交换性阳离子含量因元素种类、森林类型和季节不同而异。三种森林土壤交换性阳离子含量都表现为:Al3+>H+>K+>Ca2+、Mg2+、Na+。几乎所有调查的阳离子含量在阔叶林显著高于马尾松林和混交林,但后两者之间大多数阳离子含量差异不显著。鼎湖山森林土壤可交换性阳离子含量虽然较高,但盐基饱和度却很低。马尾松林、混交林和阔叶林土壤可交换性阳离子含量在1997年6月份分别为:58.3、84.5和118.7mmolc/kg,盐基饱和度分别为:5.5%、3.2%和4.5%。三种森林土壤交换性Ca2+、Mg2+、K+和H+含量季节差异极显著(P<0.001),但交换性Al3+含量只在马尾松林土壤存在极显著的季节性差异(P<0.001)。同一元素季节变化大小程度趋向马尾松林>混交林>阔叶林。森林土壤交换性Ca2+、Na+和H+含量与土壤pH值相关关系不明显,但交换性Mg2+、K+和Al3+与土壤pH值间呈极显著负相关。     

ELEMENTAL COMPOSITION,CORRELATIONS, AND RATIOS WITHIN A POPULATION OF STAURASTRUM PLANCTONICUM (ZYGNEMATALES): AN X-RAY MICROANALYTICAL STUDY1

Individual cells of Staurastrum planctonicum (Teil.) within a mixed freshwater phytoplankton sample were analyzed by scanning electron microscope X-ray microanalysis to determine their elemental composition. X-ray emission spectra routinely showed clear peaks of P, S, and Cl, plus monovalent (Na, K, and divalent (Mg, Ca) cations. Si and Cu were also present in lower quantities. Concentrations of individual elements (expressed as mmol.kg⁻¹ dry weight) varied widely among cells, with values over the sample population approximating to a normal distribution. Although intracellular anion and cation levels varied considerably, significant correlations occurred between concentrations of monovalent and divalent cations (mean ratio 1.4), major diffusible anions and cations (mean ratio 1,2), and total levels of electropositive and electronegative elements (mean ratio 1.2). The monovalent cations of K and Na occurred at a mean ratio of 1.2 and were not significantly correlated. Concentrations of individual elements (except Si) showed clear positive correlations within the analyses, with 12 highly significant (99% probability) correlations out of 36 possible combinations. Principal factor analysis showed that elemental correlations were determined by two major factors, with two resulting groups of elements—(Na, S, Cl, Ca, Cu) and (Mg, P, K). Statistical relationships between elements followed a clear correlation pattern, which retained its characteristics even when elemental concentrations were expressed per unit P rather than per unit dry weight. Elemental concentrations were closely similar in matching, but not nonmatching, smicells. The statistical pattern of elemental associations noted in Staurastrum parallels that seen in X-ray micro-analytical studies of other algae but differs in detail. This pattern of statistical associations has biological implications in terms of cell compartmentation, characterization of different cell types, and cell interactions with their environment.     

Urinary mercury levels in females: Influence of skin-lightening creams and dental amalgam fillings

The influence of application of skin-lightening creams and dental amalgam fillings on the urinary mercury (Hg) level was evaluated in 225 females (ages 17 to 58 years) living in Riyadh, capital of Saudi Arabia. The arithmetic mean of the urinary Hg level was 6.96 ± 20.43 g l, in the range 0 to 204.8 g l. The mean urinary Hg level adjusted by creatinine (Cr) was 11.22 ± 37.23 g g Cr, in the range 0 to 459.37 g g. No significant difference in urinary Hg was noted between the females regarding the use of skin-lightening creams. On the other hand, results showed that urinary Hg concentration was influenced by the use and number of dental amalgam fillings. No women were identified with symptoms or signs that could be attributed to Hg intoxication. Urine analyses for creatinine, urea, uric acid, phosphorus, magnesium, glucose and calcium showed significant correlation with urinary Hg. This suggests that chronic exposure to Hg may be associated with a deterioration of renal function.     

Na+/K(+)-ATPase: modes of inhibition by Mg2+.

Adding 15 mM free Mg2+ decreased Vmax of the Na+/K(+)-ATPase reaction. Mg2+ also decreased the K0.5 for K+ activation, as a mixed inhibitor, but the increased inhibition at higher K+ concentrations diminished as the Na+ concentration was raised. Inhibition was greater with Rb+ but less with Li+ when these cations substituted for K+ at pH 7.5, while at pH 8.5 inhibition was generally less and essentially the same with all three cations: implying an association between inhibition and ion occlusion. On the other hand, Mg2+ increased the K0.5 for Na(+)-activation of the Na+/K(+)-ATPase and Na(+)-ATPase reactions, as a mixed inhibitor. Changing incubation pH or temperature, or adding dimethylsulfoxide affected inhibition by Mg2+ and K0.5 for Na+ diversely. Presteady-state kinetic studies on enzyme phosphorylation, however, showed competition between Mg2+ and Na+. In the K(+)-phosphatase reaction catalyzed by this enzyme Mg2+ was a (near) competitor toward K+. Adding Na+ with K+ inhibited phosphatase activity, but under these conditions 15 mM Mg2+ stimulated rather than inhibited; still higher Mg2+ concentrations then inhibited with K+ plus Na+. Similar stimulation and inhibition occurred when Mn2+ was substituted for Mg2+, although the concentrations required were an order of magnitude less. In all these experiments no ionic substitutions were made to maintain ionic strength, since alternative cations, such as choline, produced various specific effects themselves. Kinetic analyses, in terms of product inhibition by Mg2+, require Mg2+ release at multiple steps. The data are accommodated by a scheme for the Na+/K(+)-ATPase with three alternative points for release: before MgATP binding, before K+ release and before Na+ binding. The latter alternatives necessitate two Mg2+ ions bound simultaneously to the enzyme, presumably to divalent cation-sites associated with the phosphate and the nucleotide domains of the active site.     

Dental amalgam mercury exposure in rats

The aim of this study was to measure the distribution of mercury, in tissues of rats exposed to amalgam over a two months period. Possible interaction of mercury with copper and zinc in organs was also evaluated. Rats were either exposed to mercury from 4 dental amalgams, or fed the diet containing powdered amalgam during two months. Mercury was measured in the kidney, liver and brain, copper in kidney and brain and zinc in kidney. The results showed significantly higher concentrations of mercury in the kidneys and the brains of rats in both exposed groups compared to control. Even after two months of exposure to mercury brain mercury concentration in rats with amalgam fillings was 8 times higher than in the control and 2 times higher than in rats exposed to amalgam supplemented diet. The highest mercury concentration in the latter group was found in the kidneys and it was 5 times higher than in the control group. We found no significant differences between mercury levels in exposed and control rat's liver. Exposure to mercury from dental amalgams did not alter the concentrations of copper and zinc in the tissues. Histopathological analyses of rats tissues did not show any pathological changes. These results support previously proposed nose-brain transport of mercury released from dental amalgam fillings.     

Elimination of mercury from amalgam in rats.

The aim of this study was to measure the urinary mercury excretion in rats exposed to amalgam over a two months period. Animals were either exposed to mercury from 4 dental amalgams or fed the diet containing powdered amalgams. The results showed significantly higher mercury amount in urine of both exposed groups than in control. Even two months after the amalgam had been placed in rats teeth, the amount of mercury in the urine remained 4-5 times higher than in control, and 4 times higher than in rats exposed to diet containing powdered amalgam. The elevated urinary Hg amount was accompanied by an increased level of total protein in urine. In the same exposure period the excretion of total protein in urine of rats with amalgam fillings was 2 times higher than in control and 1.5 times higher than in rats exposed to amalgam through diet. Concentrations of mercury in the sera of all groups were below the detection limit of the method. The results show that amount of mercury and protein in the urine of rats were related to the mercury release from dental malgam.     

Epithelial lining fluid solute concentrations in chronic obstructive lung disease patients and normal subjects.

The exhaled breath condensate (EBC) method represents a new, noninvasive way to detect inflammatory and metabolic markers in the fluid that covers the airways [epithelial lining fluid (ELF)]. However, respiratory droplets represent only a very small and variable fraction of the EBC, most (approximately 99.99%) of which is water vapor. Our objective was to show that ELF concentrations could be calculated from EBC values by using any of three dilutional indicators (urea, total cations, and conductivity) in nine normal and nine chronic obstructive lung disease (COPD) subjects. EBC concentrations of Na(+), K(+), Ca(2+), Mg(2+), total cations, urea, and conductivity varied over a 10-fold range among individuals, but concentrations of these constituents (except Ca(2+)) remained well correlated (r(2) = 0.44-0.83, P < 0.001). Dilution (D) of respiratory droplets in water vapor was calculated by dividing plasma concentrations of the dilutional indicators by EBC concentrations. Estimates of D were not significantly different among these indicators, and urea D averaged 10,800 +/- 2,100 (SE) in normal and 12,600 +/- 3,300 in COPD subjects. Although calculated Na(+) concentrations in the ELF were less than one-half those in plasma, and concentrations of K(+), Ca(2+), and Mg(2+) exceeded those in plasma, total cation concentrations in ELF were not significantly different from those in plasma, indicating that ELF is isotonic in both normal and COPD subjects. EBC amylase concentrations (measured with an ultrasensitive procedure) indicated that saliva represented <10% of the respiratory (ELF) droplets in all but three samples. Dilutional and salivary markers are essential for interpretation of EBC studies.     

Circadian changes in salivary constituents and conductivity in women and men.

Circadian rhythms in salivary [glucose], [Na+], [K+] and conductivity were measured in 2 age groups of men (men A, 20-45 years and men B, 46-60 years) and 8 different states of fertility in women (normally menstruating, taking oral contraceptives, pregnant, lactational amenorrhea, lactational amenorrhea and taking oral contraceptives, lactating and menstruating, menopausal, and post-menopausal). Unstimulated whole saliva (2-3 ml) was collected every 3 h over a 48 h span. Analysis of Spearman Rank Correlations indicated significant circadian rhythms (significant positive coefficients) for all groups of [Na+] (mean = 0.577 +/- 0.040) and conductivity (mean = 0.410 +/- 0.050). There was no evidence of differences in prominence of rhythm across groups for [Na+] and conductivity. [K+] showed less evidence of rhythms and much greater variability between groups (mean correlation coefficient = 0.198 +/- 0.055). Rhythms in [glucose] (mean correlation coefficient = 0.409 +/- 0.051) were evident in all groups except men B (0.016), menopausal women (0.151) and post-menopausal women (0.310). Model analysis of the data showed no discernible rhythmic trend with age for either conductivity, [Na+] or [K+], where any differences were explainable by the group characteristics. The rhythm in [glucose] showed a significant weakening with age over all groups (F-ratio = 7.46**), and was different between men A and men B (F-ratio = 6.95**). It was concluded that circadian rhythms were present in whole unstimulated saliva for conductivity and [Na+] and that these rhythms were independent of reproductive state, whereas circadian rhythms in [K+] were dependent on reproductive state. Circadian rhythms for [glucose] were dependent on age. The loss of a rhythm in [glucose] with age indicates that glucose, Na+ and K+ are not linked in their entry into saliva. The influence of entry and reabsorption on the final concentrations of glucose, Na+ and K+ in saliva is discussed.     

Copper,zinc, and selenium in human blood and urine after injection of sodium 2,3-dimercaptopropane-1-sulfonate: a study on subjects with dental amalgam

This study investigated the effects of a single dose of intravenously administered sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) on the essential elements copper, zinc, and selenium in human blood and urine. The possible role of dental amalgam was also addressed. Eighty individuals, divided in four groups according to the presence or absence of dental amalgam fillings and symptoms self-related to such fillings, were given DMPS (2 mg/kg body wt) and 500 mL Ringer’s acetate intravenously. Urine and blood were collected prior to the injection, and thereafter at intervals over a 24-h period. Cu, Zn, and Se concentrations were determined by atomic absorption spectrometry methods. A statistically significant increase in the concentrations of Cu and Zn in urine was observed 30 and 120 min after the DMPS injection compared to the preinjection concentrations. The concentrations of Se were not affected. The cumulated excretion over 24 h after DMPS injection constitutes only from 0.1% to 0.7% of the body content of these elements. There was no effect of different amalgam statuses on Cu and Zn excretion. We found a temporary decrease (4–7%) in the concentrations of Cu, Zn, and Se in blood 15 and 30 min after DMPS, but this seems to be the result of dilution factors. Administration of a single dose of DMPS does not affect the body stores of the essential elements Cu, Zn, and Se.     

Dental amalgam affects urinary selenium excretion

Selenium may have a protective effect against mercury toxicity. The aim of the present study was to investigate if selenium excretion in urine was affected in persons with dental amalgam fillings. The reason for this study is that dental amalgam is the most important source of inorganic mercury exposure in the general population, although the potential toxic effects of this exposure remain a subject for debate. The chelating agent 2,3 dimercaptopropane-1-sulfonate (DMPS) was injected intravenously (2 mg/kg) to provoke metal excretion. Urine samples were subsequently collected at intervals over a 24-h period. Selenium concentration was determined by hydride-generation atomic absorption spectrometry. The study was comprised of 20 persons who claimed symptoms from dental amalgam and 21 healthy persons with amalgam fillings. There were two control groups without amalgam. One control group had amalgam replaced because of concern about illness resulting from mercury release (n=20), whereas the other control group never had amalgam (n=19). Individuals with amalgam excreted less selenium (36.4 μg, median value) over 24 hours than those without amalgam (47.5 μg) (p=0.016). There was no difference in selenium excretion between groups with (42.4 μg) and without (39.4 μg) amalgam-related symptoms (p=0.15). The findings indicate that individuals exposed to low levels of elemental mercury from dental amalgam excrete less selenium to urine than unexposed individuals.