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Risks of Dental Amalgam in Children
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To the Editor: The clinical trials by Dr Bellinger and colleagues1 and Dr DeRouen and colleagues2 concluded that there is no evidence of an association between exposure to mercury vapor released from amalgams and human health risks. We disagree. Exposure to mercury vapor is causally linked to oral lichen planus, a chronic inflammatory disease of oral mucosa.3
With regard to potential immunologic impairment in individuals exposed to mercury vapor, Bellinger et al should have included immunologic analyses of their patients. The various forms of mercury (mercury vapor, inorganic mercury ions, and organic mercury) associated with dental amalgams appear to initially affect the immune system and to only subsequently affect the nervous system. Even in the absence of overt renal or neural toxic effects, the immune system may be impaired.4
As described in the methodology article for the Children's Amalgam Trial Study Group,5 immunologic outcomes were measured in a subgroup. They . . . [Full Text of this Article]
Paolo D. Pigatto, MD
paolopigatto@libero.it
Policlinico Foundation IRCCS
Luca Meroni, MD
Institute of Infectious Diseases and Tropical Medicine
University of Milan
Milan, Italy
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