Mercury exposure, neopterin profile, and tryptophan degradation in dental technicians

Abstract Amalgam has been widely used as a restorative dental material for over 150 years. Most standard dental amalgam formulations contain approximately 50% elemental mercury in a mixture of copper, tin, silver, and zinc. Mercury is a highly volatile metal, which can easily vaporize to a colorless and odorless gas. It has been demonstrated that mercury is released from dental amalgam, which is increased by chewing, eating, brushing, and drinking hot liquids. Besides this, amalgam is the main occupational exposure source of mercury for dental workers. It is known that mercury exposure causes immune modulation in humans. In this study, it was aimed to evaluate the changes in neopterin levels and tryptophan (Trp) degradation in dental technicians. It was observed that low levels of occupational mercury exposure resulted in decreased neopterin, kynurenine (Kyn), and Kyn/Trp levels. Moreover, mercury and neopterin levels had a significant positive correlation in workers. The lower neopterin levels and Kyn/Trp in dental technicians compared to an unexposed group indicates a possible immune suppression with low level of occupational mercury exposure during amalgam preparation. The relationship between urinary mercury levels as an indicator of occupational mercury exposure and neopterin reminded an effect on T-cell-mediated immune response.