Mercury leaching from dental amalgam fillings and its association with urinary zinc
Zanager, Afaf Mohamed
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Mercury (Hg) is an example of a toxic metal that is not essential for nutrition. It exists in organic and inorganic forms in seafood and vapour from dental amalgam fillings respectively. Elemental mercury (Hg0) from dental amalgam was the focus of this study. Dental amalgam is one of the most commonly used dental filling materials and has been used for over 150 years. It is composed of Hg0 (approximately 50%) combined with other metals such as copper and zinc (Zn). These fillings give off Hg0 vapour throughout their existence, and is further enhanced by activities such as chewing, grinding of teeth and drinking hot liquids. Mercury consumption can lead to Zn loss or deficiency, and is reported to displace Zn and copper. Several European nations have outlawed the use of amalgam as a restorative material due to controversies regarding its safety in children, women of childbearing age and individuals with renal disease. Moreover, various studies have reported correlations between the number of amalgam fillings and Hg concentration in blood plasma, urine, faeces, saliva and different organs. Blood, urine, and hair mercury levels are used to predict possible health effects that may be caused by the different forms of Hg. Urine Hg is used to test exposure to metallic Hg0 vapour and inorganic Hg forms. This study aimed to evaluate the effects of Hg0 from dental amalgam restorations on the status of Zn in the urine. This was done by determining the concentrations of Hg0 in urine, buccal cells and the oral cavity, and its relationship with urinary Zn concentrations in the same individuals. Samples of urine, buccal tissues, chewing gum and completed questionnaires were collected from the participants (women and men) at the dental clinics in Tygerberg Hospital (TBH), Cape Town. Samples were analyzed using inductively coupled plasma mass spectrometer (ICP-MS). Findings from this study show that there was a correlation between levels of urinary Hg0 and urinary Zn (p=0.02). However, urinary Hg0 did not predict the amount of urinary Zn. Also, no relationship was found between levels of Hg0 in buccal swab or the chew test samples and urinary Zn level. There was a significant difference between females and males in the level of urinary Zn, men had higher levels of Zn excreted in the urine than females (p=0.05). However, there was no significant difference in the level of urinary Hg0 between males and females. The number of fillings (4-7) and age of fillings were significantly associated with urinary Hg0 level (p˂0.05), while smoking ˃15 cigarettes/day increased the level of Hg0 in buccal swab samples (p=0.002). We were not able to demonstrate a causal effect of Hg0 leaching on urinary zinc levels.