Clinical study of oral galvanism: no evidence of toxic mercury exposure but anxiety disorder an important background factor.

A total of 142 women and 76 men with self-diagnosed oral galvanism who were referred from dentists and medical doctors for clinical evaluation during the last 2 yr are described from the perspective of general medicine. No case of clinically suspected mercury intoxication was found. Mean concentration of mercury in whole blood (B-Hg) was 17.3 nmol/l, and no value exceeded 50 nmol/l. Amalgam burden and B-Hg were not associated with clinical signs or symptoms except for a significantly lower mean value of B-Hg in patients with psychologic main symptoms than in those without (mean 15.4 vs. 18.1 nmol/l). It was possible to make one or several diagnoses in all 218 cases as reasonable alternatives to the concept of oral galvanism. Mental disorder was the main diagnosis in 93 cases (42.7%), including 41 cases of generalized anxiety disorder and 12 cases of panic disorder. A total of 87 patients (40%) did not work because of medical reasons or unemployment. Amalgam removal was recommended in a total of 65 cases (29%), mainly on psychologic indications, but in 22 cases because of oral conditions. The clinical conditions behind the concept of oral galvanism seem to be explicable in terms of general medicine, and no generalized toxic effect of amalgam fillings need be suspected.