Changes in health complaints after removal of amalgam fillings

Abstract

SUMMARY The aim of the present study was to investigate whether removal of all amalgam fillings was associated with long-term changes in health complaints in a group of patients who attributed subjective health complaints to amalgam fillings. Patients previously examined at the Norwegian Dental Biomaterials Adverse Reaction Unit were included in the study and assigned to a treatment group (n = 20) and a reference group (n = 20). Participants in the treatment group had all amalgam fillings replaced with other restorative materials. Follow-ups took place 3 months, 1 and 3 years after removal of all amalgam fillings. There was no intervention in the reference group. Subjective health complaints were measured by numeric rating scales in both groups. Analysis of covariance was used to compare changes in health complaints over time in the two groups. In the treatment group, there were significant reductions in intra-oral and general health complaints from inclusion into study to the 3-year follow-up. In the reference group, changes in the same period were not significant. Comparisons between the groups showed that reductions in intra-oral and general health complaints in the treatment group were significantly different from the changes in the reference group. The mechanisms behind this remain to be identified. Reduced exposure to dental amalgam, patientcentred treatment and follow-ups, and elimination of worry are factors that may have influenced the results.

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

“…Several studies have reported that patients experience improved health after amalgam removal (Lygre et al, 2005;Melchart et al, 2008;Nerdrum et al, 2004;Sjursen et al, 2011). This has also been described in the qualitative studies performed within this field (Jones, 2004;Stahlnacke & Soderfeldt, 2013).…”

“…Studies investigating changes in general health complaints after removal of amalgam fillings have found reductions in health complaints (Lygre et al, 2005;Melchart et al, 2008;Nerdrum et al, 2004;Sjursen et al, 2011), but not to the levels found in the general population (Lygre et al, 2005;Nerdrum et al, 2004). The observed reductions in health complaints might be interpreted as effects of patients being seen and heard, improved dental conditions, the natural variation in the course of the complaints, reduced exposure to mercury, as well as placebo effect and discontinued nocebo effect (Melchart et al, 2008;Nerdrum et al, 2004;Sjursen et al, 2011).…”

“…The observed reductions in health complaints might be interpreted as effects of patients being seen and heard, improved dental conditions, the natural variation in the course of the complaints, reduced exposure to mercury, as well as placebo effect and discontinued nocebo effect (Melchart et al, 2008;Nerdrum et al, 2004;Sjursen et al, 2011). Because of difficulties in masking whether patients have their amalgam fillings removed or not, randomized clinical trials of the effects of amalgam removal are likely to be influenced by participants' expectations.…”

Use of complementary and alternative medicine in patients with health complaints attributed to former dental amalgam fillings

“…CAM is also frequently used by patients with health complaints related to amalgam [9,[13][14][15][16]. In recent studies, the most commonly reported CAM modalities for this patient group were dietary supplements/vitamins (58-92 %) [9,14,15,17], homeopathy (17-26 %) [9,13,14], acupuncture (13-28 %) [2,9,14,16] and chiropractic (18-21 %) [14,16]. In Norway the most commonly reported CAM modalities used for amalgam-related health complaints are dietary supplements, acupuncture and homeopathy (65 %, 28 % and 26 % respectively) [9,17].…”

“…In recent studies, the most commonly reported CAM modalities for this patient group were dietary supplements/vitamins (58-92 %) [9,14,15,17], homeopathy (17-26 %) [9,13,14], acupuncture (13-28 %) [2,9,14,16] and chiropractic (18-21 %) [14,16]. In Norway the most commonly reported CAM modalities used for amalgam-related health complaints are dietary supplements, acupuncture and homeopathy (65 %, 28 % and 26 % respectively) [9,17]. The literature has revealed that the prevalence and associations for use of CAM differs between men and women with regard to several socio demographic variables [18][19][20][21][22][23] and underline the importance of gender-specific analyses [24].…”