Assessment of exposures and potential risks to the US adult population from the leaching of elements from gold and ceramic dental restorations

Using data from the 2001 to 2004 US National Health and Nutrition Examination Survey (NHANES) on the number and placement of tooth restorations in adults, we quantified daily doses due to leaching of elements from gold (Au) alloy and ceramic restorative materials. The elements with the greatest leaching rates from these materials are often the elements of lowest proportional composition. As a result, exposure due to wear will predominate for those elements of relatively high proportional composition, while exposure due leaching may predominate for elements of relatively low proportional composition. The exposure due to leaching of silver (Ag) and palladium (Pd) from Au alloys exceeded published reference exposure levels (RELs) for these elements when multiple full surface crowns were present. Six or more molar crowns would result in exceeding the REL for Ag, whereas three or more crowns would be necessary to exceed the REL for Pd. For platinum (Pt), the majority of tooth surfaces, beyond just molar crowns, would be necessary to exceed the REL for Pd. Exposures due to leaching of elements from ceramic dental materials were less than published RELs for all components examined here, including having all restorations composed of ceramic.