The dental amalgam issue. A review.

Using an interdisciplinary approach, the current position in the dental amalgam controversy and the potential impact of amalgam mercury on human health are reviewed. Aspects of materials science, corrosion, mercury exposure, toxicology, neurology and immunology are included. New data on mercury exposure from corroded amalgam fillings in vivo are presented. The exposure can reach levels considerably over known threshold limit values. Also, measurements of mercury absorption from intraoral air are presented. The vital importance of avoiding a galvanic amalgam-gold coupling is emphasized. The symptomatology of a disabled patient, who recovered after amalgam removal, has been included. It is concluded that discussion of the dental amalgam issue has suffered from the lack of an interdisciplinary approach. It would be wise to learn from the lesson of acrodynia, and consider amalgam mercury among other possible factors in neurological and immunological diseases of unclear etiology.