Abstract

The aim of the present study was to investigate whether removal of all amalgam fillings was associated with long-term changes in health complaints in a group of patients who attributed subjective health complaints to amalgam fillings. Patients previously examined at the Norwegian Dental Biomaterials Adverse Reaction Unit were included in the study and assigned to a treatment group (n = 20) and a reference group (n = 20). Participants in the treatment group had all amalgam fillings replaced with other restorative materials. Follow-ups took place 3 months, 1 and 3 years after removal of all amalgam fillings. There was no intervention in the reference group. Subjective health complaints were measured by numeric rating scales in both groups. Analysis of covariance was used to compare changes in health complaints over time in the two groups. In the treatment group, there were significant reductions in intra-oral and general health complaints from inclusion into study to the 3-year follow-up. In the reference group, changes in the same period were not significant. Comparisons between the groups showed that reductions in intra-oral and general health complaints in the treatment group were significantly different from the changes in the reference group. The mechanisms behind this remain to be identified. Reduced exposure to dental amalgam, patient-centred treatment and follow-ups, and elimination of worry are factors that may have influenced the results.

Highlights

  • Dental amalgam has been extensively used in the treatment of caries lesions

  • It has been established that dental amalgam fillings may lead to local adverse reactions, including oral lichenoid reactions [21], and removal of amalgam fillings in contact with the lesions is generally recommended

  • The study was designed as a before-and-after study with a comparison group comparing changes in health complaints in a treatment group, which had all amalgam fillings replaced with other restorative materials, with changes in health complaints in a comparable reference group, which did not receive any intervention

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Summary

Introduction

Dental amalgam has been extensively used in the treatment of caries lesions. The safety of dental amalgam has been questioned, and it has been discussed to what extent mercury released from amalgam fillings may lead to adverse health effects [2,3,4,5,6,7,8]. It has been established that dental amalgam fillings may lead to local adverse reactions, including oral lichenoid reactions [21], and removal of amalgam fillings in contact with the lesions is generally recommended. For a number of patients, no objective signs of adverse reactions to amalgam fillings, or other diseases explaining their complaints, can be observed [22]. There is a lack of treatment options for patients without objective signs of adverse reactions to amalgam fillings, and removal of sound amalgam fillings is generally not recommended. Some patients decide to remove all amalgam fillings at their own initiative [23], and studies have reported significant improvements in subjective health complaints after the removal of amalgam fillings [24, 25]

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