Final Exam: Amalgams Safety

Question 1

There are a number of anti-amalgamists out there. Dentists specialize in treating purported mercury toxicity has become what?

Answer 1

– Becomes a marketing tool

Question 2

Who is Hal Huggins?

• • What has he created?
• • What has he implemented –> Removal of amalgam purportedly cures what??

Answer 2

Doctor whom has created publications, videotapes and seminars.

• • removal of amalgam purportedly cures
    - - Leukemia
    - - Hodgkin’s disease
    - - Multiple Sclerosis

Question 3

Evidence-Based Care

Nearly 50% believe that there is a correlation between health problems and dental amalgams, what two ways are allowing people to believe in these purportedly information?

Answer 3

– lay population unfamiliar with
peer-reviewed dental literature
– rely on media stories and internet

Question 4

Amalgam Restorations:

How many amalgam restorations are done each year?
– How many mercury is used?

Answer 4

• • Half-billion restorations per year

- - 75 tons of mercury

Question 5

How is mercury vapor released (from the teeth)?

Answer 5

– Chewing and brushing (Berglund J Dent Res 1990)

Question 6

What is the vest way to remove amalgam?

By how much % through this process?

Answer 6

– Reduced 90% with high-volume evacuation (aka, dental suction) (Pohl Acta Odontol Scand 1995)

Question 7

Is it easy to determine the vapor levels accurately in amalgam restorations?

Answer 7

– difficult to determine vapor levels accurately (Olsson J Dent Res 1992)

Question 8

Mercury Dose from Amalgam

• • What’s the average daily dose of vapor levels from 8-10 amalgam surfaces
• • Is this dose value above or below threshold levels
• • 1 % of dose is obtained from a TLV exposure of _______ µg Hg/m3 (fill in the blank with a value)?

Answer 8

• • 1-2 µg per day
• • well below threshold levels
• • 1% of dose obtained from a TLV exposure of 50 µg Hg/m3

Question 9

What are the three forms of mercury?

Answer 9

• • Element
• • Inorganic
• • Organic

Question 10

With elemental mercury, mercury absorption occurs readily from which part of the body?

• • Poorly from which part of the body?
    
    • -What percent is absorbed from GI and skin?
    • • Is elemental mercury toxic when swallowed?

Answer 10

Absorption:

- - readily from lungs
- - poorly from GI and skin
         - -

Question 11

The exposure of mercury vapor is accounted mostly from where?

Answer 11

• • Accounts for most occupational and home exposures

- – Mercury spills: thermometers and fluorescent light bulbs

Question 12

Organic Mercury

• • What is the most toxic form of organic mercury and is responsible for several mass poisonings
    
    • – What % is absorbed in gut?

Answer 12

• • (Alkyl) methyl - most toxic form
    - - 95% absorbed in gut
    - - responsible for several mass
    poisonings: Minamata Bay, Japan

Question 13

Mercury Monitoring

URINE is the best method to monitor mercury during what degree of mercury exposure ( slight, mild or chronic)
– Give symptoms and normal values for mercury detection in urine.

Answer 13

– best method for chronic
exposure
– symptoms – 300 µg/L
– normal

Question 14

Mercury Monitoring

Measuring mercury in blood is reflected upon what?
– What is the half-life of mercury present in blood

Answer 14

• • Reflects recent exposure

- - 3-day half-life

Question 15

Mercury Monitoring

What is not a reliable method for mercury monitoring?

Answer 15

– Hair

Question 16

Has there been any studies that have found a relationship btwn amalgam restorations and multiple sclerosis?

Answer 16

– NO! Studies found no relationship btwn amalgam restorations and MS.

Question 17

(T/F) Controlled human studies fail to find link between amalgam or mercury levels and Alzheimer’s.

Answer 17

TRUE

Question 18

(T/F) Studies showing no renal dysfunction due to amalgam restorations

Answer 18

True

Question 19

(T/F) Studies have shown mild damage to immune system from amalgam restorations.
( Reduced immunocompetence)

Answer 19

FALSE: Studyies show NO damage to immune system from amalgam restorations.

Question 20

(T/F) There have been no evidence linking amalgam and:

   1) multiple sclerosis
   2) Alzheimer's disease
   3) Renal toxicity
   4) Reduced Immunocompetence

Answer 20

TRUE. Make sure you know these four specifically. o Multiple Sclerosis
o Alzheimer’s Disease
o Renal toxicity
o Reduced Immunocompetence