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International Journal of Toxicology
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Articles

Legislation and Informed Consent Brochures for Dental Patients Receiving Amalgam Restorations

Richard F. Edlich

Legacy Emanuel Verified Level I Shock Trauma Center for Children and Adults, Portland, Oregon, USA

Amy A. Cochran

Clark College, Vancouver, Washington, USA

Catherine L. Cross
Courtney A. Wack

Legacy Emanuel Hospital, Portland, Oregon, USA

William B. Long, III

Trauma Specialists, LLP, Legacy Emanuel Verified Level I Shock Trauma Center for Children and Adults, Portland, Oregon, USA

Anthony T. Newkirk

Synergy Dental, Portland, Oregon, USA

Correspondence: Address correspondence to Richard F. Edlich, MD, PhD, 22500 NE 128th Circle, Brush Prairie, WA 98606, USA. E-mail:richard-edlichmd{at}gmail.com

In 2008, Norway banned the use of mercury for amalgam restorations. Four states in the United States have developed Informed Consent Brochures for amalgam restorations that must be given to their dental patients. The authors describe a patient who had a large cavity in his left lower molar tooth no. 18 that had to be removed by an oral surgeon. When the patient went to the oral surgeon, the surgeon told the patient that he would replace the carious tooth with a gold implant. He was not given an Informed Consent Brochure regarding dental restorative materials. The oral surgeon extracted the carious tooth, replacing the tooth with a supposed gold crown implant. On his yearly dental examination, his dentist took an x-ray of his dental implant and explained that the x-ray could not distinguish whether the implant contained either gold or mercury. Consequently, the dentist referred him to a dental clinic in which the dental implant could be removed without mercury contamination of the patient’s neurologic system during the extraction of the implant from the root canal. During the removal of the dental restoration, the dentist found build up expanding into the root canal that had a black color. The crown and underlying tooth were sent to ALT BioScience for analysis. Elemental analysis of the crown and underlying tooth confirmed the presence of mercury in the restoration. The patient should have been given an Informed Consent Brochure by the dentist that described the dental restoration that was used in the dental implant.

Key Words: Amalgam Restorative Material • Central Nervous System • Kidney • Mercury Vapor

International Journal of Toxicology, Vol. 27, No. 4, 313-316 (2008)
DOI: 10.1080/10915810802366851
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