Mercury Exposure in Dentists: Three case reports

Year 2017, Volume 2, Issue 1(4), 58 - 58, 01.11.2017

Meşide Gündüzöz Zehra Nur Töreyin Vugar Ali Türksoy Lütfiye Tutkun Sinan Karacabey Hüseyin İlter

Abstract

OBJECTİVE

Inorganic mercury is widely used in
amalgams. Thus, dentists are chronically exposed to inorganic mercury.Chronic
effects of mercury are mainly on central nervous system. Memory and
concentration deficits, sleep andmood disturbances are commonly notified
symptoms. We are reporting three dentists presenting with neurologicalfindings
of mercury intoxication.

CASE
1

A 42 years-old man has been admitted
to occupational health outpatient clinic with motor retardation and
mooddisturbances. He had been working as a dentist and handling with amalgams
for nineteen years. On neurologicalphysical examination intensional tremor was
detected. Mercury levels in 24-hour urine testing were 44,2 μg/L(normal values
<15 μg/L). Chelation therapy with DMPS was started, thereby declining
Mercury to normal values.Neurological symptoms recovered and he was discharged.

CASE
2

A 43 years-old woman has been
admitted with memory deficit and leg contractions. She had been working as
adentist for eighteen years and using amalgam alloys for filling. MRI scan of
brain revealed atrophic changes andpartially empty sella. Spot urine mercury
level was 10.2 μg/L (normal value <10 μg/L). Substutition withcomposite
fillings instead of amalgam fillings was recommended.

CASE
3

A 42 years-old woman has been
admitted to occupational health outpatient clinic with memory
deficit,distractibility, and extremity tremors. She had been handling with
amalgam alloys for eighteen years as a dentist.Neurological examination
revealed right-sided postural tremor. MRI scan of brain revealed mild atrophic
changes.Spot urine mercury level was 8.3 μg/L (normal value <10 μg/L). After
challenge test with DMPS, spot urinemercury raised to 15 μg/L. Chelation
therapy with DMPS was started. By the end of 6 months, spot urine mercurylevel
declined and neurological findings recovered.

RESULTS

Dentists are exposed to heavy metals
through handling orthodontic materials. Dentists referred with

neuropsychiatric problems should be
evaluated for mercury intoxication and mercury levels should be examined
inbiological specimens. There is no known safe level and no limit to the effect
of the mercury occurrence asunderstood from this case. Use of materials
alternative to amalgam; proper ventilation in workplace; and use ofpersonal
protective equipments may mitigate hazardous effects of toxic materials.

Keywords

Mercury Exposure in Dentists: Three case reports

References

• Meşide Gündüzöz (1), Zehra Nur Töreyin (2), Vugar Ali Türksoy (3), Lütfiye Tutkun (4), Sinan Karacabey (5), Hüseyin İlter (6) (1)Depertmant of Family Medicine, Ankara Occupational Diseases Hospital, Ankara, Turkey (2)Faculty of Medicine,Department of Public Health,EgeUniversity, İzmir, Turkey (3)Faculty of Medicine,Department of Public Health, Bozok University, Yozgat, Turkey (4)Faculty of Medicine, Department of Biochemstry, BozokUniversity, Yozgat, Turkey (5)Faculty of Medicine, Department of Emergency Medicine, Bozok University,Yozgat, Turkey (6)Public Health Institution of Turkey, Head of Environmental Health Department