Facebook PixelCould non-allergic chronic rhinosinusitis be cured by replacing the amalgam dental fillings?
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Could non-allergic chronic rhinosinusitis be cured by replacing the amalgam dental fillings?

Image credit: Photos taken from https://www.dental-tribune.com/news/bda-northern-ireland-labels-dental-amalgam-phase-out-unworkable/ and https://www.clinicbarcelona.org/en/assistance/diseases/rhinosinusitis/definition and edited.

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Juranium Oct 15, 2021
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Necessity

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From time to time, I feel that my nose is really dry and soon after that, I can't feel any smell. Few hours or sometimes even days later, I feel the smell again. I went to see the otorhinolaryngologist and dermatologist multiple times, did tons of tests and checks, to get a lot of unlinked results. The last result of the allergy test showed different allergies than the previous one. Something is weird, but according to them, I have chronic rhinosinusitis.
The new idea I got is inspired by the paper on how severe dermatitis might be caused by a cross‐reaction between nickel and palladium from dental amalgam and was resolved following removal of dental restorations. If the hypersensitivity of the immune system can be caused by metals (as discussed in this contribution), could the high metal concentrations from dental implants account for local chronic inflammation of the upper respiratory tract?

The experiment idea: Linking the non-allergic chronic rhinitis/sinusitis with the hyperreactive immune system due to locally high concentration of metals present in dental fillings
I would first check the prevalence of dental implants in patients with non-allergic chronic rhynitis. Patients would be split in groups according to the number and type of dental implants. Patients without dental implants would be used as a negative control.
The next step would be to measure the concentrations of implant-related (mercury, silver, tin, and copper) and other metals (aluminium, nickel) in the surrounding tissues (upper respiratory tract, neck limph nodes, mouth mucosa, etc).
Finally, the approximately half of the patients would have the dental implants replaced by non-metal ones and subsequently monitored for changes in occurrenceof symptoms of chronic rhynitis.
If the correlation would exist, deeper analysis of immune system activation would be performed.

What do you think about this general design of the experiment?
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Creative contributions

A similar theory about the negative effects of root canal treatment

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Povilas S
Povilas S Oct 15, 2021
There is a similar theory of how the fillings used in root canal treatment may cause/influence many chronic diseases. This theory is generally regarded as pseudoscientific by mainstream dentists while often supported by those practicing so-called holistic dentistry. The theory originated from an ~100-year-old medical theory called "focal infection theory". Even though the theory is conspiracy-like, there is some scientific evidence that supports it. There is a quite recent documentary on the matter, which was removed from Netflix likely due to opposition from dental specialists.
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Juranium2 months ago
Thank you Povilas S! I am not so informed about the procedure and the materials used for root canal treatment, but I will check the links you provided. Maybe there is a good takeaway message that can help to elucidate the key factors or experiments to prove my theory.
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Povilas S
Povilas S2 months ago
Juran You are welcome, just take the information supporting the theory with a grain of gutta-percha ;)
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Test patient-specific immune reaction to dental implants in vitro

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Michaela D
Michaela D Oct 15, 2021
I find the idea of a correlation between chronic inflammation and implants very intriguing!It would be a bit drastic to replace people’s implants without further evidence.Therefore, I would add one step to your experimental design:
*Isolate patients and control immune cells
*Test the reaction of immune cells to different metals, implant-related as well as other metals as a control in vitro. It would be especially interesting to see if the patient’s immune cells show greater reactivity to the specific metal that has been implanted in the patient.
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Juranium2 months ago
I completely agree with you, Michaela D! It should be done prior to the in vivo experiments and could help to direct the experiment and saving time. Also, based on the papers I read recently, there is a good test called MELISA, which tests the reactivity of the lymphocytes to certain metals. The procedure is described in this paper if you are interested and have thoughts on this.
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Positive examples and possible use of lymphocyte reactivity test as a predictive biomarker

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Juranium Oct 17, 2021
A study from 2004 showed that 25 (71%) out of 35 patients with autoimmune diseases, which had their dental amalgam replaced, showed a significant decrease in inorganic mercury, silver, organic mercury, and lead levels. The best results were seen in patients with multiple sclerosis. The initial mercury-specific lymphocyte reactivity measured by MELISA® was significantly higher in the responder group than in the non-responders, whose health was not improved by amalgam removal. This could mean that lymphocyte reactivity could be the predictive biomarker of dental amalgam removal in patients with some autoimmune diseases.
A similar effect of amalgam removal was seen in patients with orofacial granulomatosis, who have shown to be allergic to certain metals and positive at the lymphocyte transformation test (the same one used above). After the amalgam removal, 100% of patients showed recovery of the disease symptoms almost within one month.

[1]https://pubmed.ncbi.nlm.nih.gov/15349088/

[2]https://pubmed.ncbi.nlm.nih.gov/21684771/

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Michaela D
Michaela D2 months ago
Very interesting paper. I never thought that people with autoimmune diseases could be susceptible to reactions to different types of material, such as metal. But it makes complete sense, as both are signs of an overreacting immune system.
This can have a bigger impact, beyond dental implants. It could be related to a hypersensitivity reaction to orthopedic implants, as well. An important aspect to stress is that the reaction may not always be obvious, like in the case of allergy to the material. Milder, chronic reaction is harder to identify. So, as you said, Juran. lymphocyte reactivity could be tested to all people with autoimmune diseases before insertion of any type of implants that could trigger the immune system.
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General comments

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Shubhankar Kulkarni
Shubhankar Kulkarni2 months ago
Just a side-thought to probably take into account going ahead. All dental procedures (surgical ones) are followed by high doses of antibiotics. These antibiotics eliminate the existing microbiota. Replenishing it takes time and the new biota may not resemble the original composition. Lack of any pathogens in the mouth (or in the body) may lead to an altered immune response. The alteration in the immune response could be in the form of a decreased immune response, where there is decreased mucus secretion, leading to dryness in the nose and throat. The other form of alteration could be an excess response against molecules that, otherwise, would not lead to such a heightened immune response, for example, metals. Have any of the studies cited above been performed in patients who did not take any antibiotics? Such studies might be rare since most procedures involve an antibiotic regime.
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Juranium2 months ago
Shubhankar Kulkarni I am not sure about the standards in the other countries, but the procedure of implanting amalgam dental fillings in my country does not require antibiotics. Also, amalgam fillings do not require maintenance, so again, no antibiotics are used. The replacement of them is done in the same way. In that manner, I am not sure what did you mean.
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Shubhankar Kulkarni
Shubhankar Kulkarni2 months ago
Juran I didn't know the procedure of amalgam dental fillings. Good to know! Maybe what you say is correct. My previous comment was a hunch, theory at best. If even the procedures that do not require antibiotics end up with rhinosinusitis, then we may need to look into that.
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Juranium2 months ago
Shubhankar Kulkarni I will also check it once again, but I myself have some dental amalgam in my mouth. That's why I know. But I like the link with microbiota you highlighted. I'll definitely check it.
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