Abstract
Multiple sclerosis (MS) is an inflammatory neurological disease characterized by autoimmune-mediated demyelination of the central nervous system. Genetic and environmental factors may contribute to the development of MS. This has not been confirmed yet. Dental amalgam has long been controversial in MS due to its mercury content but the toxicological implications of mercury-containing amalgam fillings (AMF) for MS remain to be elucidated. We conducted a case–control study to investigate the association between AMF and the risk of MS from the Taiwanese National Health Insurance Research Database (NHIRD). Case (n = 612) and control (n = 612) groups were matched by sex, age, urbanization level, monthly income, and Charlson comorbidity index by propensity score matched with a 1:1 ratio from 2000 to 2013. Differences between cases and controls was not statistically significant (OR: 0.82, 95% CI = 0.65–1.05). In subjects stratified by gender, MS was also not associated with AMF for women (OR: 0.743, 95% CI = 0.552–1.000) and men (OR: 1.006, 95% CI = 0.670–1.509), respectively. In summary, this Taiwanese nationwide population-based case–control study did not find an association between MS and AMF.
Highlights
Multiple sclerosis (MS) is an immune disorder of the central nervous system
Mercury vapor from dental amalgam preparation and restoration could underlie the relation with MS
With the nationwide population derived from the National Health Insurance Research Database (NHIRD), this longitudinal sampling dataset from 2000 to 2013 made the study more representative than most, with this case–control study having more strength than previous cross-sectional designs
Summary
The abnormal inflammation of the brain and spinal cord causes damage to axonal myelin sheath, which leads to multiple neurological abnormalities [1]. The exact symptoms vary depending on the actual location of the patient’s lesion [2]. Several environmental exposures such as Epstein–Barr virus, low levels of Vitamin D, and smoking has been associated with an increased risk of developing MS [3]. Mercury vapor from dental amalgam preparation and restoration could underlie the relation with MS. Dental amalgam is constituted of approximately 50% mercury and copper, tin, silver, and zinc to form solid amalgams, and has been used continuously in dentistry
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