Renal Effects of Dental Amalgam in Children

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Renal Effects of Dental Amalgam in Children: The New England Children's Amalgam

Trial Lars Barregard,1 Felicia Trachtenberg,2 and Sonja McKinlay2

1Department of Occupational and Environmental Medicine, Sahlgrenska University

Hospital and Academy, Gothenburg, Sweden; 2New England Research Institutes,

Watertown, Massachusetts, USA

 

Introduction

Participants and Methods

Results

Discussion

 

Abstract

Background: Mercury is nephrotoxic and dental amalgam is a source of mercury

exposure.

Methods: Children 6–10 years of age (n = 534) with two or more posterior teeth

with caries but no prior amalgam restorations, were randomized to one of two

treatments—amalgam or resin composite (white fillings) —used for caries

treatment during 5 years of follow-up. The primary outcome was change in IQ, but

important secondary outcomes were effects on markers of glomerular and tubular

kidney function: urinary excretion of albumin, alpha-1-microglobulin (A1M) ,

-glutamyl transpeptidase (-GT) , and N-acetyl-â-D-glucosaminidase (NAG) . These

markers were measured on several occasions during the trial, together with

urinary mercury and covariates. We evaluated the results using repeated-measures

analyses.

Results: There were no significant differences between treatment groups in

average levels of renal biomarkers, nor significant effects of number of dental

amalgams on these markers. There was, however, a significantly increased

prevalence of microalbuminuria (MA) among children in the amalgam group in years

3–5 (adjusted odds ratio 1.8 ; 95% confidence interval, 1.1–2.9) . Most of these

cases are likely to be temporary MA, but 10 children in the amalgam group had MA

in both years

 

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