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Adverse health effects related to mercury exposure from dental amalgam fillings: toxicological or psychological causes?

Published online by Cambridge University Press:  09 April 2001

J. BAILER ,
F. RIST ,
A. RUDOLF ,
H. J. STAEHLE ,
P. EICKHOLZ ,
G. TRIEBIG ,
M. BADER  and
U. PFEIFER
J. BAILER
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
F. RIST
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
A. RUDOLF
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
H. J. STAEHLE
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
P. EICKHOLZ
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
G. TRIEBIG
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
M. BADER
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
U. PFEIFER
Affiliation:
Department of Clinical Psychology, Central Institute of Mental Health, Mannheim; Psychological Institute I, University of Münster; Department of Operative Dentistry and Periodontology, University of Heidelberg; and Institute and Policlinic of Occupational and Social Medicine, University Hospital of Heidelberg, Germany
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Abstract

Background. Possible adverse health effects due to mercury released by amalgam fillings have been discussed in several studies of patients who attribute various symptoms to the effects of amalgam fillings. No systematic relation of specific symptoms to increased mercury levels could be established in any of these studies. Thus, a psychosomatic aetiology of the complaints should be considered and psychological factors contributing to their aetiology should be identified.

Methods. A screening questionnaire was used to identify subjects who were convinced that their health had already been affected seriously by their amalgam fillings (N = 40). These amalgam sensitive subjects were compared to amalgam non-sensitive subjects (N = 43). All participants were subjected to dental, general health, toxicological and psychological examinations.

Results. The two groups did not differ with respect to the number of amalgam fillings, amalgam surfaces or mercury levels assessed in blood, urine or saliva. However, amalgam sensitive subjects had significantly higher symptom scores both in a screening instrument for medically unexplained somatic symptoms (SOMS) and in the SCL-90-R Somatization scale. Additionally, more subjects from this group (50% versus 4·7%) had severe somatization syndromes. With respect to psychological risk factors, amalgam sensitive subjects had a self-concept of being weak and unable to tolerate stress, more cognitions of environmental threat, and increased habitual anxiety. These psychological factors were significantly correlated with the number and intensity of the reported somatic symptoms.

Conclusions. While our results do not support an organic explanation of the reported symptoms, they are well in accord with the notion of a psychological aetiology of the reported symptoms and complaints. The findings suggest that self-diagnosed ‘amalgam illness’ is a label for a general tendency toward somatization.

Type
Research Article
Information
Psychological Medicine , Volume 31 , Issue 2 , February 2001 , pp. 255 - 263
Copyright
© 2001 Cambridge University Press

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