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Overview
A recent article by Reuters Health1 identified dentistry as an occupation that may be associated with potential risk for neurodegenerative diseases (NDD). This article presented the findings of a case-control study,2 which
assessed over 2.6 million death certificates from 22 states
(for the years 1992–1998) to identify occupations at risk for
NDD, including Alzheimer’s disease, Parkinson’s disease, presenile dementia and motor neuron disease.
Specifically, the study indicated that dentists could be at increased risk for developing presenile dementia (PSD), which occurs in people under 65 years of age. Exposure to mercury and other synthetic substances was suggested as a possible cause of the increased risk. However, the researchers acknowledged several limitations to their study, including basing findings solely on death certificate data, the variable reliability of reporting, the roles of genetic or environmental factors and other chronic conditions, and the lack of definitive criteria for PSD diagnosis. According to the authors, “professionals may have lower risks for competing causes of death (such as heart disease) due to favorable factors (e.g., less smoking, better health care) not adequately controlled [in the study].” In other words, since positive lifestyle habits prevent death earlier in life from other diseases, more professionals may develop NDD-related conditions later in life, making it appear that they are at risk. Also, the data indicate that the NDD risk for dentists is comparable to that for physicians, judges and lawyers, which supports another point from the study’s lead author: “At best, such research can tease out general patterns that can then be studied further.”1
In comparison, several studies have concluded that dentists are not at increased risk of Alzheimer’s disease or other neurodegenerative illnesses.3-5 In addition, the ADA Foundation’s Health Screening Program has documented a significant decrease in dentists’ mean urinary mercury levels over the past 20 years, which is likely attributable to the use of precapsulated amalgam and a greater awareness of mercury hygiene.6-7
Dentists are strongly encouraged to follow the Mercury Hygiene Recommendations  of the ADA Council on Scientific Affairs, including the use of precapsulated amalgam alloy, and the ADA Best Management Practices (BMPs) for Amalgam Waste. Dentists are also encouraged to handle all synthetic substances according manufacturer’s instructions. Finally, for over 40 years, the ADA Foundation’s Health Screening Program has monitored the general health status of the dental profession and examined potential occupational risks. This ongoing program will continue to compile long-term data to assist the ADA in evaluating the profession’s overall health and developing appropriate recommendations.
Footnote
1 Norton A. Range of jobs tied to degenerative brain disease. Reuters Health. August 18, 2005.
2 Park RM, Schulte PA, Bowman JD, Walker JT, Bondy SC, Yost MG, Touchstone JA, Dosemeci M. Potential occupational risks for neurodegenerative diseases. Am J Ind Med. 2005 Jul;48(1):63-77.
3 Saxe SR, Wekstein MW, et al. Alzheimer's disease, dental amalgam and mercury . J Am Dent Assoc. 1999 Feb;130(2):191-9.
4 Fung YK, Meade AG, Rack EP, Blotcky AJ. Brain mercury in neurodegenerative disorders. J Toxicol Clin Toxicol. 1997;35(1):49-54.
5 Life Sciences Research Office. Review and analysis of the literature on the potential health effects of dental amalgams (executive summary).
6 Chou HN, Korach EM, Gruninger SE, Siew C. Urinary mercury levels in dentists, 1984-2001 (abstract 1457).
7 ADA Council on Scientific Affairs. Dental Amalgam: Update of Safety Concerns JADA 1998; 129(4):494-503.
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Additional Resources
Science in the News is a service by the American Dental Association (ADA) to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.
Document Posted September 2005
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