Kristoffersen Agnete E, Musial Frauke, Hamre Harald J, Björkman Lars, Stub Trine, Salamonsen Anita, Alræk Terje
The National Research Center in Complementary and Alternative Medicine, (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Institute for Applied Epistemology and Medical Methodology at the University of Witten-Herdecke, Freiburg, Germany.
BMC Complement Altern Med. 2016 Jan 22;16:22. doi: 10.1186/s12906-016-0996-1.
The dental filling material amalgam is generally well tolerated. However, a small proportion of dental patients experience health complaints which they attribute to amalgam. The symptom pattern is often similar to patients with medically unexplained physical symptoms (MUPS) and the health complaints may persist after amalgam removal. Among patients with MUPS, the use of complementary and alternative medicine (CAM) seems to be high. The aim of this survey was to describe the prevalence and range of CAM use among people with health complaints attributed to dental amalgam fillings in which the health problems persist after the removal of all amalgam fillings. Specific attention was paid to (1) self-reported effects of CAM, (2) differences in CAM use dependent on self-reported health, and (3) gender differences in self-reported CAM use.
A survey was distributed to all members of The Norwegian dental patient association (NDPA) (n = 999), the response rate was 36.4%. The anonymous questionnaire asked for socio-demographic data, health complaints related to former amalgam fillings, subjectively perceived health status, symptoms, and experience with therapeutic interventions, mostly from the spectrum of CAM. Only participants who had all their fillings removed, which was the vast majority, were analysed.
A total of 88.9% of included respondents had used at least one CAM modality, with a higher proportion of men (95.7%) compared to women (86.2%, p = 0.015). The most frequently used therapies were dietary supplements, vitamins and minerals recommended by a therapist (used by 66.7%) followed by self-prescribed dietary supplements, vitamins and minerals (59.0%), homeopathy (54.0%), acupuncture (48.8%) and special diets (47.5%). Use of CAM was similar for participants reporting normal to good health compared to participants reporting poor health. For all but two CAM modalities, the self-reported treatment effect was better in the group reporting normal to good health compared to the group reporting poor health.
CAM was widely used by participants in our study, a finding similar to findings from studies of MUPS patients. To date, health problems associated with the use of dental amalgam is not an accepted diagnosis in the healthcare system. Consequently, people suffering from such complaints experience a lack of adequate treatment and support within conventional health care, which might have contributed to the high number of CAM users in this study.
牙科填充材料汞合金通常耐受性良好。然而，一小部分牙科患者会出现他们认为与汞合金有关的健康问题。症状模式通常与患有医学上无法解释的身体症状（MUPS）的患者相似，并且在去除汞合金后健康问题可能仍然存在。在患有MUPS的患者中，补充和替代医学（CAM）的使用似乎很普遍。本次调查的目的是描述在去除所有汞合金填充物后健康问题仍然存在的、认为健康问题与牙科汞合金填充物有关的人群中CAM的使用 prevalence 和范围。特别关注（1）CAM的自我报告效果，（2）根据自我报告的健康状况CAM使用的差异，以及（3）自我报告的CAM使用中的性别差异。
向挪威牙科患者协会（NDPA）的所有成员（n = 999）发放了一份调查问卷，回复率为36.4%。这份匿名问卷询问了社会人口统计学数据、与以前的汞合金填充物相关的健康问题、主观感知的健康状况、症状以及治疗干预的经历，主要来自CAM领域。仅对绝大多数已去除所有填充物的参与者进行了分析。
总共88.9%的纳入受访者至少使用过一种CAM方式，男性（95.7%）的比例高于女性（86.2%，p = 0.015）。最常用的疗法是治疗师推荐的膳食补充剂、维生素和矿物质（66.7%的人使用），其次是自行开具的膳食补充剂、维生素和矿物质（59.0%）、顺势疗法（54.0%）、针灸（48.8%）和特殊饮食（47.5%）。与报告健康状况较差的参与者相比，报告健康状况正常至良好的参与者的CAM使用情况相似。除了两种CAM方式外，报告健康状况正常至良好的组自我报告的治疗效果优于报告健康状况较差的组。
我们研究中的参与者广泛使用CAM，这一发现与对MUPS患者的研究结果相似。迄今为止，与使用牙科汞合金相关的健康问题在医疗保健系统中尚未被认可为一种诊断。因此，患有此类健康问题的人在传统医疗保健中缺乏足够的治疗和支持，这可能导致了本研究中CAM使用者数量众多。
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