Rethinking the Dental Amalgam Dilemma: An Integrated Toxicological Approach
Department of Biochemistry, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Main Building B210, San Juan 00936, Puerto Rico
Center for Environmental and Toxicological Research, San Juan 00936, Puerto Rico
Department of Chemistry, Rio Piedras Campus, University of Puerto Rico, Av. Dr. José N. Gándara, San Juan 00936, Puerto Rico
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(6), 1036; https://doi.org/10.3390/ijerph16061036
Received: 29 January 2019 / Revised: 21 February 2019 / Accepted: 4 March 2019 / Published: 22 March 2019
(This article belongs to the Special Issue Heavy Metal Pollution and Health Risk Assessment)
Mercury (Hg) has been identified as one of the most toxic nonradioactive materials known to man. Although mercury is a naturally occurring element, anthropogenic mercury is now a major worldwide concern and is an international priority toxic pollutant. It also comprises one of the primary constituents of dental amalgam fillings. Even though dental mercury amalgams have been used for almost two centuries, its safety has never been tested or proven in the United States by any regulatory agency. There has been an ongoing debate regarding the safety of its use since 1845, and many studies conclude that its use exposes patients to troublesome toxicity. In this review, we present in an objective way the danger of dental amalgam to human health based on current knowledge. This dilemma is addressed in terms of an integrated toxicological approach by focusing on four mayor issues to show how these interrelate to create the whole picture: (1) the irrefutable constant release of mercury vapor from dental amalgams which is responsible for individual chronic exposure, (2) the evidence of organic mercury formation from dental amalgam in the oral cavity, (3) the effect of mercury exposure on gene regulation in human cells which supports the intrinsic genetic susceptibility to toxicant and, finally, (4) the availability of recent epidemiological data supporting the link of dental amalgams to diseases such as Alzheimer’s and Parkinson.