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Care of patients who are worried about mercury poisoning from dental fillings
Journal article   Open access

Care of patients who are worried about mercury poisoning from dental fillings

David Vearrier and Michael I Greenberg
Journal of the American Board of Family Medicine, v 23(6), pp 797-798
01 Nov 2010
PMID: 21057078
url
https://doi.org/10.3122/jabfm.2010.06.100038View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

INTRODUCTIONPublic concern about adverse health effects from mercury exposure from dental amalgams remains a high-profile issue. Patients with nonspecific neuropsychiatric symptoms may incorrectly attribute their complaints to mercury poisoning, and some alternative medical providers diagnose mercury toxicity using nonvalidated tests or without testing at all.CASE REPORTWe report the case of a 37-year-old female who was referred to our outpatient medical toxicology clinic by her family medicine physician after a wellness doctor involved in her care ordered a dimercaptopropanesulfonic acid (DMPS) challenge urine study that revealed an "elevated" mercury level.DISCUSSIONThe use of postchelator challenge urine testing to diagnose mercury poisoning has not been validated. Use of such tests may cause falsely elevated urine mercury levels resulting in misdiagnosis of mercury poisoning and unncessary, expensive, and potentially dangerous chelation therapy.CONCLUSIONFamily medicine physicians may encounter patients who are concerned about mercury poisoning after undergoing postchelator challenge urine testing. In patients with a low suspicion for mercury toxicity, reassurance is adequate. In patients with moderate to high suspicion for mercury toxicity, a validated test for mercury, such as a 24-hour urine mercury level, or referral to a medical toxicologist is the most appropriate approach.

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Collaboration types
Domestic collaboration
Web of Science research areas
Primary Health Care
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