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To the Editor: In his Editorial, Dr Needleman¹ presents opinions that are not well supported by peer-reviewed scientific research, and he invokes medical literature without critically appraising the internal or external validity of the studies.

He states that "a number of investigations suggest that" mercury released from amalgam "has toxic consequences." However, studies, including the 2 JAMA trials on which he is commenting, suggest that the low levels of mercury released from amalgam fillings have no toxic consequences. Brownawell et al² reported that their recent review "uncovered no convincing evidence pointing to any adverse health effects that are attributable to dental amalgam restorations besides hypersensitivity in some individuals."

Needleman also states that dental professionals have deficits in motor function and cognitive scores in relation to their number of amalgam fillings and their urinary mercury excretion and cites a 24-year-old study.³ That study examined occupational exposure in dental professionals who . . . [Full Text of this Article]

Amid I. Ismail, BDS, MPH, MBA, DrPH
ismailai@umich.edu
University of Michigan School of Dentistry
Ann Arbor