Journal of Clinical Toxicology
Open Access

Mercury in BMS, OLP and trigeminal neuralgia

15^th Euro Global Summit on Toxicology and Applied Pharmacology

July 02-04, 2018 | Berlin, Germany

Gianpaolo Guzzi, Anna Ronchi, Claudio Guastella, Lucia Brambilla, Silvia Ferrucci, Marco Scarpelli and Paolo D Pigatto

Italian Association for Metals and Biocompatibility Research ��? A.I.R.M.E.B., Milan, Italy.
Pavia Poison Control Center and National Toxicology Information Centre, Toxicology Unit, IRCCS Maugeri Found. and University of Pavia, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy
Private Practice, Forensic Odontologist, Milan, Italy.
IRCCS Galeazzi Hospital, University of Milan, Milan, Italy.

Posters & Accepted Abstracts: J Clinic Toxicol

Abstract :

Oral neuropathy and oral precancerous lesions may be caused by exposure to mercury. We evaluated a cohort of 227 patients with burning mouth syndrome (BMS) associated with adverse reactions to dental metals. Mean (�?±SD) age was 57.1�?±12, 199 were female (87.7%). In 57 patients, mean (�?±SD) concentrations of mercury in whole-blood was 7.9�?±8.4 micrograms Hg per liter, toxic limit: 2 micrograms Hg per liter. In 88 patients, mean (�?±SD) concentrations in salivary mercury was 24�?±45.7 micrograms Hg per liter, toxic limit: 2.7 micrograms Hg per liter. Patch testing was performed in 167 patients, 33.5% had nickel allergy; 11.4% had cobalt allergy; 9.6% had chromium allergy; 14.4% had allergy to gold; 14.4% had palladium allergy; 10.8% had mercurials allergy (in aggregate). As oral pathology, the most common adverse events associated to dental metals were: sialadenitis (3 patients, 1.3%); metallic taste/dysgeusia (3 patients, 1.3%); leukokeratosis (9 patients, 4%); oral lichen planus (OLP) (8 patients, 3.5%); oral allergic syndrome (37 patients, 16,3%). As systemic disease: fibromyalgia (15 patients, 6.6%); hypothyroidism (11 patients, 4.8%) headache (22 patients, 9.7%); urticaria (20 patients, 8.8%); dizziness (20 patients, 8.8%); multiple chemical sensitivity â�?�? MCS (29 patients, 12.8%); atypical facial pain (18 patients, 7.9%); trigeminal neuralgia (7 patients, 3.1%) can develop years before and/or years after diagnosis of BMS/OLP. Acute and/or chronic exposure to mercurycontaining dental amalgam may inevitably trigger a small fiber neuropathy of the oral cavity. Burning mouth syndrome (BMS) may be also associated with concurrent diseases, such as oral lichen planus and/or trigeminal neuralgia.
Recent Publications:
1. Costa A, V Branca, P D Pigatto and G Guzzi (2007) BMD, fMRI study and brain hypoactivity. Pain. 128:290-291.
2. Guzzi G (2006) Case 21-2006: a man with left-sided facial pain. N. Engl. J. Med. 355:2375-2376.
3. Pigatto P D, G Guzzi, P Persichini and S Barbadillo (2004) Recovery from mercury-induced burning mouth syndrome due to mercury allergy. Dermatitis. 15(2):75-77.
4. Pigatto P D et al. (2014) Trace elements in saliva and burning mouth syndrome. Contact Dermatitis 70:110.
5. Lamey P J et al. (1994) Type 3 burning mouth syndrome: psychological and allergic aspects. J. Oral. Pathol. Med. 23(5):216-219.

Biography :

Gianpaolo Guzzi is the President - Founder and Clinical Research Coordinator of the Italian Association for Metals and Biocompatibility Research – A.I.R.M.E.B., a Milan-based not-for-profit organization. His field of expertise is toxicology of mercury.

E-mail: gianpaolo_guzzi@fastwebnet.it