Care of patients who are worried about mercury poisoning from dental fillings.

INTRODUCTION: Public concern about adverse health effects from mercury exposure from dental amalgams remains a high-profile issue. Patients with nonspecific neuropsychiatric symptoms may incorrectly attribute their complaints to mercury poisoning, and some alternative medical providers diagnose mercury toxicity using nonvalidated tests or without testing at all. CASE REPORT: We report the case of a 37-year-old female who was referred to our outpatient medical toxicology clinic by her family medicine physician after a wellness doctor involved in her care ordered a dimercaptopropanesulfonic acid (DMPS) challenge urine study that revealed an "elevated" mercury level. DISCUSSION: The use of postchelator challenge urine testing to diagnose mercury poisoning has not been validated. Use of such tests may cause falsely elevated urine mercury levels resulting in misdiagnosis of mercury poisoning and unncessary, expensive, and potentially dangerous chelation therapy. CONCLUSION: Family medicine physicians may encounter patients who are concerned about mercury poisoning after undergoing postchelator challenge urine testing. In patients with a low suspicion for mercury toxicity, reassurance is adequate. In patients with moderate to high suspicion for mercury toxicity, a validated test for mercury, such as a 24-hour urine mercury level, or referral to a medical toxicologist is the most appropriate approach.

Copper release from dental prosthetic crowns, dental materials, and human teeth into acetic acid.

This article examines the dilution of the ion of copper from human teeth and dental prosthetic crowns in 4% CH(3)COOH during a period of 24 hr at room temperature. The content of the diluted copper in an acetate extract, as well as the overall content of this metal in the samples, was determined by means of a potentiometric stripping analysis. The comparative measurements were carried out using the furnace atomic absorption spectrophotometry technique, which is recommended by the International Standards (ISO 6872:2008; ISO 24234:2004) as a method for quality control of dental-prosthetic material (dental ceramic, metal restorative materials, dental amalgams) in the process of checking for heavy metals. During a 24-hr period in 4% CH(3)COOH at a temperature of 25 degrees C, approximately 72% of the overall copper was released from the tooth. The percentage of the released copper from baby teeth is higher, ranging from 88 to 92%, which is probably a consequence of the bone tissue being in development, its infirmity, and inadequate stability. On these conditions, approximately 72% of the overall copper was released from the dental-ceramic prosthetic crowns.