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The Effects of Mercury on Dental Personnel
Why do dentists have such a high suicide rate?
A common refrain from the dental associations is that if mercury from amalgam is so dangerous for the patients, than why aren’t the dentists sick, as they are exposed to levels on a daily basis, far higher than most patients. It’s an interesting proposition, which if it were true would be fair enough to ask.
The results published by the IAOMT show that;
When cutting amalgam with a high speed drill, the levels of mercury vapour 18 inches from the mouth, can exceed 4,000mcg/m3
When the nurse opens a freshly mixed amalgam capsule the level of mercury vapour she (and the rest of the surgery) will be exposed to is 1,000 mcg/m3. This is 200 times above OSHA standards and 50,000 above the ATSDR levels.
These figures are beyond comprehension, especially when our very own dental associations claim that they are safe. A reminder to all dentists and dental associations:
In 1991 (criteria 118) the World Health Organization stated clearly that the No Observable Effects Level (NOEL) for mercury vapour is ZERO.
Are the dental associations really looking after their member's interests by recomending that they expose themselves and their staff to these sorts of levels of mercury vapour?
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From 1975 till 1983 the American Dental Association conducted a survey of the dentists who participated in the Health Assessment Programs they conducted. This study looked at urinary mercury levels of 4,272 Dentists in the USA. They measured straight urine/mercury levels. We could expect that if a DMPS Challenge test had been employed, the figures would be at least five times higher.
These 4,272 dentists had a mean mercury urine level of 14.2mcg/l (micrograms per litre). What was then considered to be the maximum normal level as stated by the American Dental Association was 20mcg/l. The observed ranges of urine mercury levels was 0 to 556 mcg/l.
The study showed that;
- 19.1% are over the maximum normal measurement of 20 ugHg/L
- 10.9% are over the C.D.C. maximum acceptable level of 30 ugHg/L
- 4.9% are over 50 ugHg/L, the level found to cause induced tremors
- 1.3% are over 100 ugHg/L, the level found to cause tremors
This study was used for many years to show how well dentists were! Note that the reference levels used were 20 micrograms of mercury per litre of urine. The new German guidelines for urine mercury levels since 2006 have dropped significantly. The new reference level for urinary mercury is now 0.7 mcg/l. This would suggest that dentists with a level of 20 mcg/l would show significant physical and psychological disturbances.
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A study from 2001 explored the mercury levels in dental students and dental teachers over a one year period. This study is published in the British Dental Journal! (Tezel H Ertas OS Erakin C Kayali A Blood mercury levels of dental students and dentists at a dental school. Br Dent J (2001 Oct 27) 191(8):449-52)
“There were statistically significant increases in plasma mercury concentration between measurements in all groups at the end of the academic year. Red cell mercury levels were also consistently elevated. Although the highest levels of mercury were recorded in persons working with amalgam, increased levels were also found in subjects working in the teaching classrooms but not with amalgam (controls and first year students).”
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“Our results indicate that the urinary mercury levels of the tested dental professionals were significantly higher than those of the control group”
“This study showed that there may be a mercury health hazard in some dental environments.”
“…it is apparent that exposure to mercury during the preparation of silver amalgam definitely presents an additional occupational hazard as an allergen in the dentist.”
“The results showed that mercury levels in the urine and head hair of dental personnel were significantly higher than in the controls
The highest urine mercury level was found in the group of dental assistants.
The amounts of urine mercury from dental assistants, dentists and dental students were 81.0%, 38.2% and 43.5% higher than the threshold limit value respectively.”
“General dentists were found to have more than twice the level of mercury in toenails than non-dental health professionals … and 60 percent higher than dental specialists …”
“Of the 298 dentists evaluated, 28% had greater than 20 micrograms/g of mercury in the head.”
“The urinary concentrations of mercury of the dentists who used amalgam in their work were statistically highly significantly elevated.”
Another study from 1991 concluded; “In the group of dental personnel, the effect of their own amalgam fillings on Hg concentrations....was as important as their occupational exposure to Hg”.
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The publication in 1985, of a huge study of 9,241 people has hardly raised an eyebrow. A study of this size has great statistical significance yet has not made it into the dental association information. This group was comprised of 3,454 male dentists, 1,125 female dentists, 4,662 female dental nurses. It showed that the rate of a particular type of brain cancer called a Glioblastoma was twice as high in this group of dental personnel compared to the rest of the population.
Another study of 298 dentists revealed that 30% of the high mercury group had polyneuropathies. No polyneuropathies were detected in the control group.
The high mercury group had mild visuographic dysfunction; they also had more symptom-distress than did the control group.
These findings suggest that the use of mercury as a restorative material is a health risk for dentists.
A different study of 66 dentists;
“with a sample of 37 (56%), 22 dentists (59.5%, 19 male, 3 female) and 15 dental assistants (40.5%, all female).
Most frequent symptoms referred by dentists were: irritability (54.5%), cephalalgia (45.4%), arthralgias (40.9%), and the ones more referred by assistants were arthralgias (53.3%), irritability (46.7%) and cephalalgia (46.7%).”
Female Dental Personnel
A study published in the Journal of the American Dental Association states that for female dental personnel;
“rates of spontaneous abortion or non-congenital abnormalities in children during this period, were higher in respondents exposed to high levels of mercury in the dental environment than those exposed to low levels.”
In fact the rate of infertility, miscarriage, stillbirths, and congenital deformities is up to twice the rate of the rest of the population. The incidence of menstrual problems increases with length of exposure. ,
The US Environmental Protection Agency have stated that;
“Women chronically exposed to mercury vapour experienced increased frequencies of menstrual disturbances and spontaneous abortions.”
“A high mortality rate was observed among infants born to women who displayed symptoms of mercury poisoning.”
These findings indicate that dental work could be another occupational hazard with respect to reproductive processes.
The probability of falling pregnant at each menstrual cycle for women who prepared 30 or more amalgam fillings per week is only 63% of that for unexposed women.
As long ago as 1981 it was shown that female dentists had a higher rate of spontaneous abortions then a control of female medical personnel or the rest of the population. The Peri-Natal Mortality Rate for the female dentists was significantly higher than for the rest of the population 19.5 / 1000 as compared to 7.5 / 1000 - twice the rate of the controls.
Female dental personnel are perhaps the most sensitive of the dental fraternity exposed to mercury. Many girls start a career in dental nursing in their early teens. They continue often into their 30’s and some longer. This is the prime reproductive age.
Psychological Effects
Psychological studies of dentists show some really scary results. One such by Professor Joel Butler, Professor of Psychology at the University of North Texas, and entitled “Neuropsychological Dysfunctioning Associated with the Dental Office Environment" has the following results.
Fifty-one dentists and dental personnel were studied on standardised tests, which revealed there were a significant number who measured in the abnormal range;
Some motor tremor – 90%
Some psychomotor dysfunction – 41%
Severe psychomotor dysfunction – 16%
Impaired immediate recall – 58%
Impaired auditory memory - 84%
Visual memory reduced – 52%
Vigilance attention concentration and cognitive comprehension – 52%
Work and lives felt to be pointless -36%
Tactile sensory dysfunction/inability to locate finger position – 52%
Logical thinking and story recall impaired – 79%
Spatial and visual memory impaired – 68%
History of unsatisfying interpersonal relationships – 27%
Out of normal range on emotional stability scale – 72%
Suicidal depression / disgust with life / despondency and despair – 27%
Increased state of agitation – 30%
Increased scores on psychopathic scale – 42%
This study concludes that as a group, dentists are, after a number of years, at least one standard deviation below the rest of the population in IQ levels. Considering that a dentist must be at least one standard deviation above the rest of the population to have passed dental school, this represents an enormous and significant drop!
Another study from 1995 stated;
… analysis showed that the coefficient of urinary mercury was statistically and adversely associated with complex attention (switching task), the perceptual motor task (symbol-digit substitution), symptoms and mood.
In the same year other research by Echeverria et al came up with a similar conclusion. “Significant urinary Hg dose-effects were found for poor mental concentration, emotional lability, somatosensory irritation, and mood scores.” There was Evidence of subtle pre-clinical changes in behaviour associated with Hg exposure. Urine mercury Levels Directly related to; Reduced Concentration and Emotional Instability and Fine Motor Function was seriously effected.
New distinctions between subtle preclinical effects on symptoms, mood, motor function, and cognition were found associated with Hg body burden as compared with those associated with recent exposure. … presents convincing new evidence of adverse behavioral effects associated with low Hg(o) exposures within the range of that received by the general population.
In neurobehavioural tests measuring motor speed (finger tapping), visual scanning (trail making), visuomotor coordination and concentration (digit symbol), verbal memory (digit span, logical memory delayed recall), visual memory (visual reproduction, immediate and delayed recall), and visuomotor coordination speed (bender-gestalt time), the performance of the dentists was significantly worse than that of the controls.
In trail making, digit span, logical memory delayed recall, visual reproduction delayed recall, and bender-gestalt time test scores were more than 10% poorer. … the performance decreased as the exposed dose increased. These results raise the question as to whether the current threshold limit value of 0.050 mg/m3 (TWA) provides adequate protection against adverse effects of mercury.
Another study was performed “to find out if the first "professional" contact of dental students with amalgam resulted in an increased mercury excretion.”
The study was conclusive. The longer the students were exposed to mercury in the clinic, the greater was their body burden of mercury.
The levels of Hg in the urine samples of the dentists was about three times higher than the control subjects. …
30% of the 23 high mercury dentists had polyneuropathies. No polyneuropathies were detected in the control group. The high mercury group had mild visuographic dysfunction; they also had more symptom- distress than did the control group. These findings suggest that the use of mercury as a restorative material is a health risk for dentists.
Dentists were significantly more likely than control subjects to have had disorders of the kidney and memory disturbance.
The older dentists showed significantly better performance on the simple reaction time test and significantly poorer performance in the immediate word recall and delayed word recall tests.
In light of new research, which shows that over time there is a reduction in kidney filtration and a reduction in urine mercury levels due to the inability to excrete, these statements become even more terrifying.
Studies demonstrating increased mercury levels and serious health effects in Dentists.
Just to give you an idea that there is more than one interesting study out there demonstrating serious health effects on dentists and dental personnel, I offer the following:
- Molin M Marklund SL Bergman B Nilsson B Mercury, selenium, and glutathione peroxidase in dental personnel. Acta Odontol Scand (1989 Dec) 47(6):383-90
- Morton J Mason HJ Ritchie KA White M Comparison of hair, nails and urine for biological monitoring of low level inorganic mercury exposure in dental workers. Biomarkers (2004 Jan-Feb) 9(1):47-55
- Ritchie KA Burke FJ Gilmour WH Macdonald EB Dale IM Hamilton RM McGowan DA Binnie V Collington D Hammersley R Mercury vapour levels in dental practices and body mercury levels of dentists and controls. Br Dent J (2004 Nov 27) 197(10):625-32;
- Brown D A study of the mercury levels in Scottish dentists. Br Dent J (2004 Nov 27) 197(10):621
- Tezel H Ertas OS Erakin C Kayali A Blood mercury levels of dental students and dentists at a dental school. Br Dent J (2001 Oct 27) 191(8):449-52
- Ngim CH Foo SC Boey KW Jeyaratnam J Chronic neurobehavioural effects of elemental mercury in dentists. Br J Ind Med (1992 Nov) 49(11):782-90
- Verschoor MA Herber RF Zielhuis RL Urinary mercury levels and early changes in kidney function in dentists and dental assistants.
- Community Dent Oral Epidemiol (1988 Jun)
- Moszczynski P Moszczynski P [Health damage due to exposure to mercury vapour (Hg)] Szkody zdrowotne wywolane narazeniem na pary rteci (Hg). Czas Stomatol (1989 Apr) 42(4):233-8
- Visser H Pieper K Isemann M Stalder K [A prospective study on the incidence of mercury levels in dental students. 2. Correlation analysis] Eine prospektive Untersuchung uber die Quecksilberbelastung von Zahnmedizinstudenten. 2. Korrelationsanalysen. Dtsch Zahnarztl Z (1991 Aug) 46(8):555-7
- Ott KH Grimmeisen J Alt F Messerschmidt J Tolg G [Mercury in the hair of dentists and dental personnel]Quecksilber im Haar von zahnarztlichem Personal. Dtsch Zahnarztl Z (1991 Feb) 46(2):154-8
- Pieper K Visser H Isemann M Stalder K [Prospective study on the mercury uptake of dental students. Part 1: Increase in mercury excretion during simulated training] Eine prospektive Untersuchungen uber die
- Quecksilberbelastung von Zahnmedizinstudenten. Teil 1: Anstieg der Hg-Ausscheidung im Verlauf des Phantomkurses. Dtsch Zahnarztl Z (1989 Sep) 44(9):714-6
- Kroncke A Ott K Petschelt A Schaller KH Szecsi M Valentin H [Mercury concentrations in blood and urine in persons with and without amalgam fillings] Uber die Quecksilberkonzentrationen in Blut und Urin von Personen mit und ohne Amalgamfullungen. Dtsch Zahnarztl Z (1980 Aug) 35(8):803-8
- Kessel R Bencze K Hamm M Sonnabend E [Mercury concentrations in the air, in the blood and urine of dentists in dental clinics and free practice] Untersuchungen uber die Quecksilber-Konzentrationen in der Raumluft, im Blut und im Urin bei zahnarztlicher Tatigkeit in Klinik und freier Praxis. Dtsch Zahnarztl Z (1980 Apr) 35(4):457-61
- Mayer R [Work-hygienic studies connected with the manipulation of silver-tin- mercury alloys at the dentists working place] Arbeitshygienische Untersuchungen bei der Verarbeitung von Silber- Zinn-Quecksilberlegierungen am zahnarztlichen Arbeitsplatz Dtsch Zahnarztl Z (1975 Mar) 30(3):181-8
- Urban P Lukas E Nerudova J Cabelkova Z Cikrt M Neurological and electrophysiological examinations on three groups of workers with different levels of exposure to mercury vapors. Eur J Neurol (1999 Sep) 6(5):571-7
- Arenholt-Bindslev D Environmental aspects of dental filling materials. Eur J Oral Sci (1998 Apr) 106(2 Pt 2):713-20
- Echeverria D Aposhian HV Woods JS Heyer NJ Aposhian MM Bittner AC Mahurin RK Cianciola M Bittner AC Jr Neurobehavioral effects from exposure to dental amalgam Hg(o): new distinctions between recent exposure and Hg body burden. FASEB J (1998 Aug) 12(11):971-80
- Nadorfy-Lopez E Torres SH Finol H Mendez M Bello B Skeletal muscle abnormalities associated with occupational exposure to mercury vapours. Histol Histopathol (2000 Jul) 15(3):673-82
- Karahalil B Rahravi H Ertas N Examination of urinary mercury levels in dentists in Turkey. Hum Exp Toxicol (2005 Aug) 24(8):383-8
- Sikorski R Juszkiewicz T Paszkowski T Szprengier-Juszkiewicz T Women in dental surgeries: reproductive hazards in occupational exposure to metallic mercury. Int Arch Occup Environ Health (1987)
- Fan PL Arenholt-Bindslev D Schmalz G Halbach S Berendsen H Environmental issues in dentistry--mercury. FDI Commission. Int Dent J (1997 Apr) 47(2):105-9
- Newman SM The relationship of metals to the general health of the patient, the dentist and office staff. Int Dent J (1986 Mar) 36(1):35-40
- Steinberg D Grauer F Niv Y Perlyte M Kopolovic K Mercury levels among dental personnel in Israel: a preliminary study. Isr J Med Sci (1995 Jul) 31(7):428-32
- Vandenberge J Moodie AS Keller RE Keller RE Jr Blood serum mercury test report. J Am Dent Assoc (1977 Jun) 94(6):1155-7
- White RR Brandt RL Development of mercury hypersensitivity among dental students. J Am Dent Assoc (1976 Jun) 92(6):1204-7
- Chang SB Siew C Gruninger SE Examination of blood levels of mercurials in practicing dentists using cold-vapor atomic absorption spectrometry. J Anal Toxicol (1987 Jul-Aug) 11(4):149-53
- Saengsirinavin C Pringsulaka P [Mercury levels in urine and head hair of dental personnel] J Dent Assoc Thai (1988 Jul-Aug) 38(4):170-9
- Langworth S Sallsten G Barregard L Cynkier I Lind ML Soderman E Exposure to mercury vapor and impact on health in the dental profession in Sweden. J Dent Res (1997 Jul) 76(7):1397-404
- Chang SB Siew C Gruninger SE Factors affecting blood mercury concentrations in practicing dentists. J Dent Res (1992 Jan) 71(1):66-74
- Sutow EJ Hall GC MacLean CA Effectiveness of wet and dry mercury vapour suppressant systems in a faculty of dentistry clinic. J Oral Rehabil (2004 Aug) 31(8):822-6
- Gonzalez-Ramirez D Maiorino RM Zuniga-Charles M Xu Z Hurlbut KM Junco-Munoz P Aposhian MM Dart RC Diaz Gama JH Echeverria D et al Sodium 2,3-dimercaptopropane-1-sulfonate challenge test for mercury in humans: II. Urinary mercury, porphyrins and neurobehavioral changes of dental workers in Monterrey, Mexico. J Pharmacol Exp Ther (1995 Jan) 272(1):264-74
- Eedy DJ Burrows D Clifford T Fay A Elevated T cell subpopulations in dental students. J Prosthet Dent (1990 May) 63(5):593-6
- Nimmo A Werley MS Martin JS Tansy MF Particulate inhalation during the removal of amalgam restorations. J Prosthet Dent (1990 Feb) 63(2):228-33
- Sinclair PM Turner PR Johns RB Mercury levels in dental students and faculty measured by neutron activation analysis. J Prosthet Dent (1980 May) 43(5):581-5
- Joshi A Douglass CW Kim HD Joshipura KJ Park MC Rimm EB Carino MJ Garcia RI Morris JS Willett WC The relationship between amalgam restorations and mercury levels in male dentists and nondental health professionals. J Public Health Dent (2003 Winter) 63(1):
- Naleway C Chou HN Muller T Dabney J Roxe D Siddiqui F On-site screening for urinary Hg concentrations and correlation with glomerular and renal tubular function. J Public Health Dent (1991 Winter) 51(1):12-7
- Cianciola ME Echeverria D Martin MD Aposian HV Woods JS Epidemiologic assessment of measures used to indicate low-level exposure to mercury vapor (Hg). J Toxicol Environ Health (1997 Sep) 52(1):19-33
- Woods JS Martin MD Naleway CA Echeverria D Urinary porphyrin profiles as a biomarker of mercury exposure: studies on dentists with occupational exposure to mercury vapor. J Toxicol Environ Health (1993 Oct-Nov) 40(2-3):235-46
- Scarlett JM Gutenmann WH Lisk DJ A study of mercury in the hair of dentists and dental-related professionals in 1985 and subcohort comparison of 1972 and 1985 mercury hair levels. J Toxicol Environ Health (1988) 25(3):373-81
- Francis PC Birge WJ Roberts BL Black JA Mercury content of human hair: a survey of dental personnel. J Toxicol Environ Health (1982 Oct-Nov) 10(4-5):667-72
- Nylander M Mercury in pituitary glands of dentists. Lancet (1986 Feb 22) 1(8478):442
- Shapiro IM Cornblath DR Sumner AJ Uzzell B Spitz LK Ship II Bloch P Neurophysiological and neuropsychological function in mercury-exposed dentists. Lancet (1982 May 22) 1(8282):1147-50
- Bloch P Shapiro IM An x-ray fluorescence technique to measure the mercury burden of dentists in vivo. Med Phys (1981 May-Jun) 8(3):308-11
- Echeverria D Heyer NJ Martin MD Naleway CA Woods JS Bittner AC Bittner AC Jr Behavioral effects of low-level exposure to elemental Hg among dentists. Neurotoxicol Teratol (1995 Mar-Apr)
- Finkelstein Y Vardi J Kesten MM Hod I The enigma of parkinsonism in chronic borderline mercury intoxication, resolved by challenge with penicillamine. Neurotoxicology (1996 Spring) 17(1):291-5
- Martin MD Naleway C The inhibition of mercury absorption by dietary ethanol in humans: cross-sectional and case-control studies. Occup Environ Med (2004 Feb) 61(2):e8
- Ritchie KA Gilmour WH Macdonald EB Burke FJ McGowan DA Dale IM Hammersley R Hamilton RM Binnie V Collington D Health and neuropsychological functioning of dentists exposed to mercury. Occup Environ Med (2002 May) 59(5):287-93
- Echeverria D Mercury and dentists. Occup Environ Med (2002 May) 59(5):285-6
- Atesagaoglu A Omurlu H Ozcagli E Sardas S Ertas N Mercury exposure in dental practice. Oper Dent (2006 Nov-Dec) 31(6):666-9
- Lehto T Alanen P Ronnemaa T Helenius H Kallio V Urinary mercury concentrations in Finnish dentists. Proc Finn Dent Soc (1989) 85(3):177-85
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- Brune D Hensten-Pettersen A Beltesbrekke H Exposure to mercury and silver during removal of amalgam restorations. Scand J Dent Res (1980 Oct) 88(5):460-3
- Skare I Bergstrom T Engqvist A Weiner JA Mercury exposure of different origins among dentists and dental nurses. Scand J Work Environ Health (1990 Oct)
- Nilsson B Gerhardsson L Nordberg GF Urine mercury levels and associated symptoms in dental personnel. Sci Total Environ (1990 May 15) 94(3):179-85
- Skare I Engqvist A Urinary mercury clearance of dental personnel after a longterm intermission in occupational exposure. Swed Dent J (1990) 14(6):255-9
- 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):235-43
- Nilsson B Nilsson B Mercury in dental practice. II. Urinary mercury excretion in dental personnel. Swed Dent J (1986) 10(6):221-32
- Kim DE Song KB Kim YJ [Mercury contents in hair of dental personnel and evaluation of various agents suppressing mercury vaporization] Taehan Chikkwa Uisa Hyophoe Chi (1989 Jul)
- Heyer NJ Echeverria D Bittner AC Farin FM Garabedian CC Woods JS Chronic low-level mercury exposure, BDNF polymorphism, and associations with self-reported symptoms and mood. Toxicol Sci (2004 Oct) 81(2):354-63
- Zander D Ewers U Freier I Brockhaus A [Mercury exposure of the population. IV. Mercury exposure of male dentists, female dentists and dental aides] Untersuchungen zur Quecksilberbelastung der Bevolkerung. IV. Quecksilberbelastung von Zahnarzten, Zahnarztinnen und Zahnarzthelferinnen. Zentralbl Hyg Umweltmed (1992 Dec) 193(4):318-28
- Vimy MJ Takahashi Y Lorscheider FL Am J Physiol (1990 Apr) 258(4 Pt 2):R939-45
- Hahn LJ Kloiber R Leininger RW Vimy MJ Lorscheider FL. FASEB J (1990 Nov) 4(14):3256-60
- Koos, Longo . Am J Obstet Gynecol., 1976: 126; 390-409
- Koos, B.J. and Longo, L.D.: Mercury Toxicity in the Pregnant Woman, Fetus and Newborn Infant. Am. J. Obstet. Gynecol. 12d, 390, 1970.
- Warfvinge, K; Hua, J; Logdberg, B. Mercury distribution in Cortical Areas and Fiber Systems of the Neonatal and Maternal Adult Cerebrum After Exposure of Pregnant Squirrel Monkeys to Mercury Vapour. EnvironRes. 67(2):196-208,Nov 1994.
- Takahashi, Y; Tsuruta, S; Hasegawa, J; Kameyama, Y.: Number of Amalgam Fillings in Pregnant Rats and Mercury Concentration in Their Fetuses. J Dent Res. 71(SI):571. A-445. 1992.
- Khera et al., Teratogenic and genetic effects of mercury toxicity. The biochemistry of Mercury in the environment. Nriagu, J.O.Ed Amsterdam Elsevier, 503-18,1979
- Babich et al ., The mediation of mutagenicity and clastogenicity of heavy metals by physio chemical factors. Environ Res., 1985:37;253-286
- Hansen K et al A survey of metal induced mutagenicity in vitro and in vivo J Amer Coll Toxicol ., 1984:3;381-430
- Verchaeve L et al., Comparative in vitro cytogenetic studies in mercury exposed human lymphocytes Mutation Res., 1985:157;221-226.
- PelletierL et al., In - vivo self reactivity of mononuclear cells to T cells and macrophages exposed to HgCl2 Eur. J Immune., 1985: 460-465
- Veron et al Amalgam Dentaires et allergies J Biol Buccale., 1986 : 14; 83-100
- NouyeM., Murao K., Kajiwara Y., Behavorial and neuropathological effects of prenatal methyl mercury exposure in mice. Neurobeahv.Toxicol Teratol. ,1985:7;227-232
[Gonzalez-Ramirez, D. Et al. Urinary mercury, porphyrins and neurobehavioral changes in dental workers in Monterrey, Mexico. J Pharmacol Exp Therap. 272:264-274,1995]
[Echeverria D. et al. Behavorial Effects of Low-Level Exposure to Hg0 Among Dentists. Neurotoxicology and Teratology 17(2):161-168, 1995]
Echeverria D Aposhian HV Woods JS Heyer NJ Aposhian MM Bittner AC Mahurin RK Cianciola M Bittner AC Jr Neurobehavioral effects from exposure to dental amalgam Hg(o): new distinctions between recent exposure and Hg body burden. FASEB J (1998 Aug) 12(11):971-80
Ngim CH Foo SC Boey KW Jeyaratnam J Chronic neurobehavioural effects of elemental mercury in dentists. Br J Ind Med (1992 Nov) 49(11):782-90
Pieper K Visser H Isemann M Stalder K Prospective study on the mercury uptake of dental students. Part 1: Increase in mercury excretion during simulated training Dtsch Zahnarztl Z (1989 Sep) 44(9):714-6
Karahalil B Rahravi H Ertas N Examination of urinary mercury levels in dentists in Turkey. Hum Exp Toxicol (2005 Aug) 24(8):383-8
Shapiro IM Cornblath DR Sumner AJ Uzzell B Spitz LK Ship II Bloch P Neurophysiological and neuropsychological function in mercury-exposed dentists. Lancet (1982 May 22) 1(8282):1147-50
Ritchie KA Gilmour WH Macdonald EB Burke FJ McGowan DA Dale IM Hammersley R Hamilton RM Binnie V Collington D Health and neuropsychological functioning of dentists exposed to mercury. Occup Environ Med (2002 May) 59(5):287-93
[JADA Vol. 122 August 1991 By Irwin Mandel DDS Assoc. Dean for Research School of Dental and Oral Surgery Colombia University New York]
[Sikorski R et al .Women in dental surgeries: reproductive hazards in occupational exposure to metallic mercury. Int Arch Occup Environ Health (1987) 59(6):551-7]
Sikorski R Juszkiewicz T Paszkowski T Szprengier-Juszkiewicz T Women in dental surgeries: reproductive hazards in occupational exposure to metallic mercury. Int Arch Occup Environ Health (1987) 59(6):551-7
[Nylander et al.Fourth international symposium Epidemiology in Occupational Health.,Como Italy Sept 1985]
Steinberg D Grauer F Niv Y Perlyte M Kopolovic K Mercury levels among dental personnel in Israel: a preliminary study. Isr J Med Sci (1995 Jul) 31(7):428-32
Vandenberge J Moodie AS Keller RE Keller RE Jr Blood serum mercury test report. J Am Dent Assoc (1977 Jun) 94(6):1155-7
White RR Brandt RL Development of mercury hypersensitivity among dental students. J Am Dent Assoc (1976 Jun) 92(6):1204-7
Saengsirinavin C Pringsulaka P [Mercury levels in urine and head hair of dental personnel] J Dent Assoc Thai (1988 Jul-Aug) 38(4):170-9
Joshi A Douglass CW Kim HD Joshipura KJ Park MC Rimm EB Carino MJ Garcia RI Morris JS Willett WC The relationship between amalgam restorations and mercury levels in male dentists and nondental health professionals. J Public Health Dent (2003 Winter) 63(1):52-60
Bloch P Shapiro IM An x-ray fluorescence technique to measure the mercury burden of dentists in vivo. Med Phys (1981 May-Jun) 8(3):308-11
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- Never enter a dental surgery where amalgam is used. Mercury levels may be high
- Never allow root therapy on your teeth.
- Never allow fluoride to be placed in your body.






