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A brief message from SNDG

The American Dental Association, with this office concurring, support dental amalgams as a significant means to restore teeth with dental caries [decay], as has been the case for the past 150 years. If you have concerns about the mercury component of dental amalgams, and/or nursing, following are four research papers addressing this topic. Further information can be obtained by going to: www.ada.org/prof/resources/topics/amalgam.asp.

Beyond this information, go to: www.ada.org
The heading is: Your Oral Health, then A-Z topics, then amalgam. You can download specific research papers by going to the heading: Dental Professional, then A-Z topics, then click on "Amalgam" and surf the different topics. You can read the abstracts of the research papers, and for a fee as a guest, download the entire article.

Author: Dorea JG.

Title: Mercury and lead during breast-feeding. [Review] [240 refs]

Source: British Journal of Nutrition. 92(1):21-40, 2004 Jul.

Local Messages: Holdings in Boston & Medford; check library holdings

Abstract: Hg and Pb are of public health concern due to their toxic effects on vulnerable fetuses, persistence in pregnant and breast-feeding mothers, and widespread occurrence in the environment. To diminish maternal and infant exposure to Hg and Pb, it is necessary to establish guidelines based on an understanding of the environmental occurrence of these metals and the manner in which they reach the developing human organism. In the present review, environmental exposure, acquisition and storage of these metals via maternal-infant interaction are systematically presented. Though Hg and Pb are dispersed throughout the environment, the risk of exposure to infants is primarily influenced by maternal dietary habits, metal speciation and interaction with nutritional status. Hg and Pb possess similar adverse effects on the central nervous system, but they have environmental and metabolic differences that modulate their toxicity and neurobehavioural outcome in infant exposure during fetal development. Hg is mainly found in protein matrices of animal flesh (especially fish and shellfish), whereas Pb is mainly found in osseous structures. The potential of maternal acquisition is higher and lasts longer for Pb than for Hg. Pb stored in bone has a longer half-life than monomethyl-mercury acquired from fish. Both metals appear in breast milk as a fraction of the levels found in maternal blood supplied to the fetus during gestation. Habitual diets consumed by lactating mothers pose no health hazard to breast-fed infants. Instead, cows' milk-based formulas pose a greater risk of infant exposure to neurotoxic substances. [References: 240]

Year of Publication:: 2004

Authors: Gundacker C. Pietschnig B. Wittmann KJ. Lischka A. Salzer H. Hohenauer L. Schuster E.

Title: Lead and mercury in breast milk.

Source: Pediatrics. 110(5):873-8, 2002 Nov.

Local Messages: Current subscription @ Health Sciences Library (Boston), Available electronically; click Full Text, Ovid Full Text, or check library holdings

OBJECTIVE: Heavy metals are potentially toxic substances, especially for the susceptible infant. Exposure to mercury (Hg) and lead (Pb) may result in neurotoxic and nephrotoxic impairment and in anemia. Previous data on breast milk Pb and Hg contents are sparse or missing for the Austrian population. No evaluations of the influence of mothers' lifestyles on Pb and Hg levels in breast milk are available.
METHODS: Five- to 10-mL individual samples of breast milk were provided from healthy mothers in Vienna (urban; n = 59), Linz (industrial; n = 47), and Tulln (rural; n = 59). A questionnaire about area of residence, maternal nutrition, smoking habits, and dental fillings was filled out by the lactating mothers. Milk samples and infant formulas were lyophilized, wet-ashed with nitric acid (65%), and analyzed with atomic absorption spectrophotometry. Spiked skim milk powder was used as reference material. Statistical analysis included the Kruskal-Wallis test and multiple robust regression analysis.
RESULTS: Breast milk showed low Hg and Pb concentrations (Hg: 1.59 +/- 1.21 1g/l, n = 116; Pb: 1.63 +/- 1.66 6g/l, n = 138). Eight percent of the breast milk samples marginally exceeded the screening level of 3.5 micro g/L for Hg. Austrian Pb values declined strongly during the last 20 years. Bivariate comparison revealed that the factors significantly related to metal levels in breast milk were area of residence (Hg, Pb), prematurity (Hg), consumption of fish (Pb) and cereals (Hg), vitamin supplementation (Hg), and smoking (Pb). The Hg and Pb contents of cow milk and infant formulas were far below respective guideline values.
CONCLUSIONS: Neither Hg nor Pb concentrations exceeded critical levels. There are no reports on infants harmed by the intake of milk from unexposed mothers. We conclude that even theoretical risks from current Hg or Pb levels for the breastfed infant of a healthy mother can be ruled out.

Year of Publication: 2002

Authors: Drexler H. Schaller KH.

Title: The mercury concentration in breast milk resulting from amalgam fillings and dietary habits.

Source: Environmental Research. 77(2):124-9, 1998 May.

Local Messages: Current subscription @ Health Sciences Library (Boston), Available electronically; click Full Text, Ovid Full Text, or check library holdings

Abstract: : Health risks from amalgam fillings are a subject of controversy. In Germany it is not advised to use amalgam fillings during breast feeding. Objectives of this study were to examine the concentration of mercury in human breast milk and the confounders which may modify the mercury levels. Women who gave birth between August 1995 and May 1996 in a district hospital were asked to participate in the study. The examination included a standardized anamnesis and an inspection of the teeth by an dentist. Blood and urine samples of 147 women and breast milk samples of 118 women were collected in the first week after birth. After 2 months of breast feeding a second breast milk sample was collected from 85 of women. Mercury was measured by cold-vapor atomic absorption spectrometry. The concentration of mercury in the breast milk collected immediately after birth showed a significant association with the number of amalgam fillings as well as with the frequency of meals. Urine mercury concentrations correlated with the number of amalgam fillings and amalgam surfaces. In the breast milk after 2 months of lactation, the concentrations were lower (mean: <0.25 microg/L; range <0.25-11.7 microg/L) compared with the first sample (mean: 0.90 microg/L; range <0.25-20. 3 microg/L) and were positively associated with the fish consumption but no longer with the number of the amalgam fillings. Accordingly, the additional exposure to mercury of breast-fed babies from maternal amalgam fillings is of minor importance compared to maternal fish consumption. Copyright 1998 Academic Press.

Year of Publication: 1998

Authors: Klemann D. Weinhold J. Strubelt O. Pentz R. Jungblut JR. Klink F.

Title: [Effects of amalgam fillings on the mercury concentrations in amniotic fluid and breast milk]. [German]

Source: Deutsche Zahnarztliche Zeitschrift. 45(3):142-5, 1990 Mar.

Local Messages: Inactive print title @ Health Sciences Library (Boston); check library holdings

Abstract: : Human amniotic fluid was gained from 95 pregnant women by amniocentesis (group 1) and from 20 women during delivery (group 2). The concentrations of inorganic mercury in amniotic fluid as assessed directly by cold-vapor atomic absorption spectrophotometry (CV-AAS) averaged 0.29 +/- 0.1 microgram/l in group 1 and 0.86 +/- 0.25 microgram/l in group 2. Surface areas of dental amalgam fillings were also estimated in these women and ranged between 0 and 930 mm2. There was no correlation between the surface area of maternal amalgam fillings and the concentrations of inorganic mercury in amniotic fluid (r = -0.122 and -0.069, respectively). Furthermore, no positive correlation existed between amalgam fillings and the concentration of total mercury in maternal blood (4.48 +/- 2.33 micrograms/l) and in neonatal blood (3.28 +/- 1.57 micrograms/l) as measured by CV-AAS in group 2 (r = -0.4 and -0.12, respectively). Concentrations of total mercury were also measured by CV-AAS in the breast milk of 86 women, five to ten days after delivery. These concentrations averaged 1.9 +/- 1.6 micrograms/l and were also not significantly correlated to the maternal amalgam surface areas (r = 0.188). In conclusion, maternal amalgam fillings are of no importance for the mercury load of the fetus and the neonate.

Year of Publication: 1990