La Trobe University Dental Amalgam Toxicity Research Proposal

This report presents a research proposal investigating the toxicity of dental amalgam fillings, a common dental treatment involving mercury. The study aims to evaluate whether dental amalgam fillings can cause mercury toxicity in the human body. It reviews existing literature on the topic, discussing the potential adverse effects of mercury exposure, including neurodevelopmental disorders, fatigue, and chronic health conditions. The proposal outlines the ethical considerations, study design, and methods, including a quantitative study with experimental and control groups, data collection through diagnostic and cognitive tests, and analysis of mercury levels in blood and urine. The expected outcomes predict higher mercury levels and potential cognitive development delays in the experimental group. The research recommends minimizing the use of dental amalgam and increasing awareness of its health impacts, suggesting future research into alternative, cost-effective dental treatments. The report concludes by providing a detailed reference list of relevant studies.

Running head: DENTAL AMALGAM TOCIXITY
DENTAL AMALGAM TOCIXITY
Name of the university:
Name of the student:
Author note:

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DENTAL AMALGAM TOCIXITY
Overview:
Amalgam is well defined as a metal alloy comprising mercury. Amalgam is mixed in
specific parts with liquid mercury and is used as filling in the dental problems. Amalgams are
used cure medical problems due to its toughness, resistance and ability to seal and along with
that it is also cost-effective hence can be afforded easily. However, dental amalgams might cause
cancer due to the presence of mercury in it. Mercury as previously known is stated to be harmful
to kidney, central nervous system and is associated with other chronic complications also.
Research questions
After conducting a significant amount of research, it is conferred that dental amalgam
toxicity is controversy and hence the research question is formulated to evaluate the toxicity of
dental amalgam
Are dental amalgam fillings can cause mercury toxicity in the human body?
Importance of the research:
Dental amalgam is known to increase toxicity in several cases. Instead of that, it is
practiced by the dentist around the world. Therefore this research is conducted to evaluate the
adverse and toxic effects of amalgam to reduce its practice and its negative impact on human and
to increase awareness among the healthcare staff and patient.
Research aim:
The primary purpose of the research is to appraise the toxic impact of dental amalgam is
the human body.
Literature review:
According to Mitchell et al. (2018), a child who belongs to poor economic status is
observed to have more dental problems. As dental amalgam is cost-effective than any other
treatment, they go for amalgam treatment for their dental issues and hence have to possess extra
toxic burden of mercury into the body. From the findings of the research it is evident that the
neurodevelopmental disorders in such children are found to be high as compared to the other
children. Rendering to the Aaseth, Hilt and Bjørklund (2018), Mercury is proved to be harmful to
humans as it is associated with several chronic health conditions. The symptoms of the illness
related to central nervous system are attributed to the mercury exposure. It can also give rise to

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fatigue, weakness and anorexia in both the health care staff and the patient who are in close
contact with mercury. The dental surgeon or the patient sufferings from any dental illness are
most exposed to mercury and hence possess high risk of getting affected with chronic disease.
Therefore to reduce such adverse effect in human, it is crucial to minimise the use of dental
amalgam. According to a survey conducted by Sahani et al. (2016), it can be said that the
healthcare workers who are involved in the dental amalgam fillings are more exposed to
mercury, which increases their risk of getting affected with illness associated with central
nervous system. Jirau-Colón et al. (2019) state that exposure to mercury for a more extended
period can cause developmental disorder such as Alzheimer’s disorder and Parkinson disease. It
is observed that, increased release of mercury from dental amalgam when in presence of an
electromagnetic field can lead to health illness. The most vulnerable populations of such
exposure are children and pregnant women who often get affected. Therefore, it is crucial to shift
the paradigm to reduce the impact (Mortazavi & Mortazavi, 2015). According to Khwaja, Nawaz
and Ali (2016), Capsulated Mercury, Amalgam Separators and Mechanized Mixings should not
be used in the case of children and pregnant individual as it can violate the safety of the healthy
individual. Guerra et al. (2016) state that, the mercury vapour released from amalgam restoration
is harmful to the health and hence due to this, use of amalgam filling is controversial. Conferring
to the study Carocci et al. (2014), mercury toxicity and neurodegenerative disorder are correlated
with each other, and as the dental amalgam fillings are said to release mercury vapour, there are
chances that it might give rise to neurodegenerative disorder. In a trial conducted by Homme et
al. (2014), it is observed that several individuals who had been previously treated dental
amalgam receive hazardous exposure of mercury. The release of mercury from the dental
amalgam is increased when in presence of High-field MRI which is proved to be responsible for
the brain concern (Mortazavi et al., 2014).
Ethical consideration:
Ethical consideration in any research is significant as it aids the researcher to avoid any
further legal or moral issue. It supports the researcher and the other participants involved in the
study to differentiate between acceptable and non-acceptable behaviour. Ethical consideration in
the research aids to prevent the falsifying of the data and provides the appropriate and accurate
result without violating the moral perspective of any participant. The ethical considerations
which are evaluated in the research proposal and plan include, informed consent, do no harm,
confidentiality, anonymity and voluntary participation.
As the research is conducted in the healthcare setting; hence, it is essential to take
informed consent from all the higher healthcare authorities to avoid any legal consequences in
future. Along with that, informed consent from the entire patient who has participated in the
research is also taken. No one from the participant is forced to involve in the study and the
confidentiality and anonymity of all the respondents have been maintained throughout the whole

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process. No one is harmed during the research, and the right of the entire patient and the
healthcare staff who are selected as respondents is maintained.
Study design and method:
Appropriate study design and practice is vital for the successful implementation of the
research plan. The study design and method is used to describe the type of research. The study
design used in the research proposal is the quantitative study. The quantitative research helps in
collecting the primary data directly from the respondents. The research method used in the
project is observational, as the patient who is selected as respondents are observed for a specific
period.
Participant and sample size:
To conduct active research, it is crucial to select the participant who can provide the
required information for the research. Children’s who have been treated with amalgam
previously are selected as the experimental group, and the other group of children are taken as
control group. The dental nurses are also selected for the proper assessment of the patient who
has been nominated for the proposal. The total number of participant chosen for the proposal is
50 (25 experimental groups and 25 for the control group). The participants are observed for the
period of 4 months.
Data collection:
Data collection is one of the most vital steps of the research proposal, and a small error in
the data collection can lead to failure in the expected results of the proposal. The data is collected
by conducting a diagnostic test that is used to assess the neurodegenerative disorder, as mercury
toxicity is said to cause neurodegenerative disease. After the completion of the cognitive
research test is also performed for all the patient to compare the cognitive development between
the experiment and control group and also to evaluate the signs of neurodegenerative disorder.
Apart from that blood test and urine test of all the respondents are collected at regular interval
throughout the whole process to assess the amount of mercury in the children who have been
treated with amalgam.
Data analysis:
After collecting the required data from the patient, the data are analyzed effectively. The data
collected from the diagnostic test of the neurodegenerative disorder is analysed to evaluate if the
patient has any signs of the disease. The mercury level in the urine and blood of the patient (both

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control and experimental) is assessed. The mercury level in the urine and blood of the control
and experimental group is compared. If the mercury level in the respondents is found to be
higher than ten mcg/L, it can be stated that it is due to the amalgam filling.
Expected outcomes:
As the research is conducted to evaluate the toxicity level in the body due to dental
amalgam filling, the expected outcome of the research is the increased level of mercury in the
experimental group. After analysing the data, it is expected that the level of mercury in the urine
and blood of the experimental group is more as compared to that of the control group. Along
with that, symptoms of delayed cognitive development are also expected to be found in the
experimental group.
Recommendation:
After considering the adverse impact of the dental amalgam filling, it is recommended
that the use of amalgam for the dental should be minimized. In addition to that, awareness
regarding the negative impact of amalgam in human health among the patient as well as the
healthcare staff should be created.
Future research:
Dental amalgam is commonly used due to its cost-effectiveness as the other methods are
expensive and are not possible for everyone to afford that. Hence, in the future research should
be conducted to evaluate different methods which can be used for the treatment of dental
complication at low cost.

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Reference:
Aaseth, J., Hilt, B., & Bjørklund, G. (2018). Mercury exposure and health impacts in dental
personnel. Environmental research, 164, 65-69.
Carocci, A., Rovito, N., Sinicropi, M. S., & Genchi, G. (2014). Mercury toxicity and
neurodegenerative effects. In Reviews of environmental contamination and toxicology
(pp. 1-18). Springer, Cham.
Guerra, M., Ferreira, C., Carvalho, M. L., Santos, J. P., & Pessanha, S. (2016). Distribution of
toxic elements in teeth treated with amalgam using μ-energy dispersive X-ray
fluorescence. Spectrochimica Acta Part B: Atomic Spectroscopy, 122, 114-117.
Homme, K. G., Kern, J. K., Haley, B. E., Geier, D. A., King, P. G., Sykes, L. K., & Geier, M. R.
(2014). New science challenges old notion that mercury dental amalgam is safe.
Biometals, 27(1), 19-24.
Jirau-Colón, H., González-Parrilla, L., Martinez-Jiménez, J., Adam, W., & Jiménez-Velez, B.
(2019). Rethinking the Dental Amalgam Dilemma: An Integrated Toxicological
Approach. International journal of environmental research and public health, 16(6),
1036.
Khwaja, M. A., Nawaz, S., & Ali, S. W. (2016). Mercury exposure in the work place and human
health: dental amalgam use in dentistry at dental teaching institutions and private dental
clinics in selected cities of Pakistan. Reviews on environmental health, 31(1), 21-27.
Mitchell, M., Warren, R., Bellinger, D., & Browne, D. (2018). Is Dental Amalgam Toxic to
Children of Color?. Journal of the National Medical Association, 110(4), 414.
Mortazavi, G., & Mortazavi, S. M. J. (2015). Increased mercury release from dental amalgam
restorations after exposure to electromagnetic fields as a potential hazard for
hypersensitive people and pregnant women. Reviews on environmental health, 30(4),
287-292.
Mortazavi, S. M. J., Neghab, M., Anoosheh, S. M. H., Bahaeddini, N., Mortazavi, G., Neghab,
P., & Rajaeifard, A. (2014). High-field MRI and mercury release from dental amalgam
fillings. Int J Occup Environ Med (The IJOEM), 5(2 April), 316-101.
Sahani, M., Sulaiman, N. S., Tan, B. S., Yahya, N. A., Anual, Z. F., Mahiyuddin, W. W., ... &
Muttalib, K. A. (2016). Mercury in dental amalgam: Are our health care workers at risk?.
Journal of the Air & Waste Management Association, 66(11), 1077-1083.