The contribution of dental amalgam to mercury in blood

Abstract

We determined the exposure to mercury from dental amalgam by comparison of blood levels of mercury before and after removal of all amalgams from ten subjects. Baseline concentrations of mercury in whole blood were measured weekly for four to 18 weeks (median = 6.6 weeks) prior to removal. All amalgams were removed in a single appointment. The subjects had an average of 14 surfaces of amalgam, seven of which were occlusal surfaces. Weekly blood sampling was continued for five to 18 weeks (median = 7.6 weeks) after the amalgams were removed. The mean baseline concentration of total mercury in whole blood of the ten subjects was 2.18 (SD = 0.90) ng Hg/mL before the amalgams were removed. The baseline mercury levels were related to the number of amalgam surfaces. The linear correlation coefficient was 0.724 with number of occlusal surfaces, and 0.433 with total number of surfaces. After removal of the amalgams, nine of the ten subjects exhibited a statistically significant decrease in blood mercury at the 95% level of confidence. The mean decrease in mercury was 1.13 (SD = 0.60) ng Hg/mL. The half-time for elimination of mercury from blood after amalgam removal was 30.2 (SD = 5.8) days. Removal of the amalgams provided an additional exposure of 1.46 (SD = 1.17) ng Hg/mL that was rapidly cleared from the blood with a half-time of 2.9 days. The daily intake of mercury from amalgam in the subjects was estimated to be at least 1.3 micrograms.