Patients' experiences of changes in health complaints before, during, and after removal of dental amalgam.

In this article, we explore how patients with health complaints attributed to dental amalgam experienced and gave meaning to changes in health complaints before, during, and after removal of all amalgam fillings. We conducted semistructured qualitative interviews with 12 participants from the treatment group in a Norwegian amalgam removal trial. Interviews took place within a couple months of the final follow-up 5 years after amalgam removal. Using the NVivo9 software, we conducted an explorative and reflective thematic analysis and identified the following themes: Something is not working: betrayed by the body, You are out there on your own, Not being sure of the importance of amalgam removal, The relief experienced after amalgam removal, and To accept, to give up, or to continue the search. We discuss the findings in the context of patients' assigning meaning to illness experiences.

Characterization of health complaints before and after removal of amalgam fillings--3-year follow-up.

OBJECTIVE: Some patients attribute health complaints to amalgam fillings and report improvement of health after replacement of amalgam fillings. The aim of the present study was to characterize the changes of different health complaints after replacement of amalgam fillings and compare with an external reference group from the general population. MATERIALS AND METHODS: The study group included 20 patients with health complaints attributed to amalgam fillings who were participants in the treatment group of a clinical trial at the Norwegian Dental Biomaterials Adverse Reaction Unit. The patients were asked to indicate the intensity of local and general health complaints on numeric rating scales (0-10) before removal of amalgam fillings and at follow-up 3 years after removal. Data from the patient group were compared with data from an external reference group (n = 441). RESULTS: Before treatment the mean intensity of complaints were on a higher level in the treatment group compared to the reference group. The most frequently reported complaints in the treatment group were gastrointestinal symptoms, fatigue, pain from muscles and joints, symptoms from ear/nose/throat and difficulty concentrating. From pre-treatment examination to the 3-year follow-up 20 of 23 health complaints decreased, being statistically significant for taste disturbances, pain from muscles and joints, gastrointestinal complaints, complaints from ear/nose/throat and fatigue. CONCLUSIONS: The inter-individual variation of intensities of health complaints was considerable and the reduction of health complaints varied for the different complaints. Several factors may be of importance for the observed reduction of complaint intensity.

Exposure to dental amalgam restorations in pregnant women.

OBJECTIVES: The Norwegian Mother and Child Cohort Study (MoBa) started in 1999 to identify environmental factors that could be involved in mechanisms leading to disease. Questions have been raised about potential risks to the fetus from prenatal exposure to mercury from amalgam fillings in pregnant women. The aim of the present study was to identify factors potentially associated with amalgam fillings in pregnant women participating in the Norwegian Mother and Child Cohort Study (MoBa). An additional aim was to obtain information about dental treatment in the cohort. METHODS: Total of 67,355 pregnancies from the MoBa study were included in the present study. Information regarding age, education, smoking habits, alcohol consumption, weight, and height for the women was obtained from a questionnaire that was filled in at the 17th week of pregnancy. In another questionnaire, which was sent to all participants in the 30th week of pregnancy, the women reported types of dental treatment during pregnancy, total number of teeth, and number of teeth with amalgam fillings. The self-assessed number of teeth and number of teeth with amalgam fillings were validated in an external sample of 97 women of childbearing age. RESULTS: Odds ratio for having more than 12 teeth with amalgam fillings increased considerably with age. Other significant risk factors for having high exposure to amalgam were low education, high body mass index (BMI), and smoking during pregnancy. Women with the lowest levels of education had a twofold increased odds ratio of having more than 12 teeth filled with amalgam compared with women who had more than 4 years of university studies. According to the results from the validation of self-assessed number of teeth with amalgam fillings, the information obtained was reliable. CONCLUSION: Age, education, smoking habits, and BMI were associated with amalgam exposure.

[Health complaints related to dental filling materials]. / Pasienter med helseplager relatert til tannfyllinger.

BACKGROUND: A wide range of materials is used in dental treatment. To what extent these materials lead to adverse reactions is under dispute. The aim of this study was to investigate whether patients with suspected adverse reactions to dental materials experienced an improvement in health after these materials were replaced. MATERIAL AND METHODS: Information on health complaints related to dental materials was obtained from the Dental Biomaterials Adverse Reaction Unit in Bergen, Norway for 142 patients. A follow-up questionnaire regarding subjective health was sent to these patients 1(1/2) to 2(1/2) years later. A similar questionnaire was sent to a reference group of 800 persons drawn from the general population. RESULTS: The patient group had more health complaints than the reference group (p < 0.001) at baseline. Of the 84 patients who completed the questionnaire (59%) 35 had changed dental materials. Amalgam fillings had been replaced in most of these patients. 23 patients (66%) reported improved health after replacement. Intraoral complaints decreased significantly (p = 0.022), and were most pronounced in patients with lesions in contact with dental materials. The intensity of various health complaints decreased slightly in most patients with replaced dental materials, but the patient group still had significantly higher health complaint indices than the reference group. INTERPRETATION: The intensity of subjective health complaints was reduced after replacement of dental materials, but it was still higher than for a comparable group in the general population. The results indicate that there may be a specific health effect of replacing dental materials, but normal symptom fluctuations over time and placebo effects such as positive effects from expectations and general care from the health personnel may have had an influence.