Hypersensitivity to mercury from dental amalgams

Abstract

A small but vocal group of dentists around the country is claiming that certain people have an extremely low tolerance for mercury and will exhibit signs and symptoms of mercury poisoning at very low body burdens of mercury. These dentists are terming this group of people hypersensitive to mercury and are advocating cutaneous patch testing to detect such hypersensitivity. Because of the different mechanisms involved in mercury poisoning versus bona fide type IV (cell-mediated, delayed) to mercury, as well as the dissimilar clinical manifestations of the two conditions, it is difficult to find any basis for such a diagnostic procedure. At least one mercury patch test kit is currently marketed for use by dentists.* The kit consists of foil packs of 0.02% mercuric chloride, rectangular adhesive bandages, evaluation forms, and instructions. In addition to the usual cutaneous signs evaluated in the interpretation of a conventional patch test, this test kit includes change in systolic Or diastolic blood pressure of -+ 10 mm Hg, change of • 10 beats per minute in pulse rate, body temperature change of --_0.5 ~ F, as well as the development of indigestion, blurred vision, headaches, irritability, fatigue, depression, redness of eyes, and other nonspecific signs and symptoms during the 48-hour test period in assessing hypersensitivity to mercury.] For example, if, dur-