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  Dental Workers May Risk Exposure to Beryllium
April 13, 2001 — The health hazards posed by exposure to the metal beryllium were once mainly associated with workers in the nuclear, electronics, and aircraft industries. However, the element may also pose risks to dental technicians who handle dental crowns and bridges composed of beryllium—nickel alloys.

Dental laboratory technicians must often grind, finish, and machine beryllium—containing metals, producing small beryllium dust particles that can lodge in the lungs. We now know that workplace exposure to beryllium can lead to chronic beryllium disease, a painful scarring of the lung tissue. Considered carcinogenic, beryllium may also cause lung cancer, skin rashes, and other ailments.

Although the potential problems of beryllium exposure in the dental industry were known for many years, it was not until 1993 that a case of chronic beryllium disease in a dental laboratory technician was documented in a scientific journal (Kotloff, R.M., P.S. Richman et al., (1993) Am Rev Respir Dis 147(1) 205—7).The researchers suspected that the technician had chronic beryllium disease based on clinical, radiographic and histological studies. They confirmed the diagnosis by using a beryllium lymphocyte proliferation test, known as BeLPT. Recently, a medical researcher spoke out about another case of chronic beryllium disease in a dental laboratory technician (Dr. Lee Newman, Head, Division of Environmental and Occupational Health Sciences, National Jewish Medical and Research Center, letter dated January 30, 2001). The technician had sandblasted metal alloys containing beryllium; cut the metal pieces with a high—speed lathe; and removed the bubbles with a handheld electric grinder and burr. She performed this work repeatedly over a period of eight years while wearing only a paper dust mask.

Use of metal alloys at dental laboratories

In a survey of 51 dental laboratories in the Cleveland, Ohio area, 11 laboratories indicated that they used beryllium alloys, 27 said that they did not, and 13 refused to respond (Ohio Citizen Action Survey, February 21, 2001). An informal study by the same group showed that many dental suppliers did not provide the laboratories with adequate information about beryllium health hazards in their Material Safety Data Sheets, forms required by the Occupational Safety and Health Administration or OSHA (Ohio Citizen Action, letter dated February 21, 2001).

This study, although limited in scope, illustrates the need for better monitoring of the dental industry. Because of the serious health problems associated with beryllium, it is important that dental laboratory workers be correctly informed about the hazards of beryllium dust and fumes. Safety precautions such as the use of respirators and advanced ventilation systems are necessary not only in large manufacturing companies, but also in the dental laboratory.

What are the risks for patients?

The story of beryllium and the dental industry would not be complete without looking at how beryllium—containing alloys may affect dental patients. A preliminary study describes two patients who developed gingivitis (gum disease) adjacent to a beryllium—containing alloy in dental prostheses (Kuang, B. and P. A. Rubenstein (1993); Contact Dermatitis 28(3): 157—62; revised in Contact Dermatitis 29(4):222). Patch testing showed positive reactions to beryllium sulfate, a component of the alloy. In another study, some patients exhibited allergic reactions to nickel, beryllium, copper and other metals in dental prostheses (Vilaplana, J., C. Romaguera, et al. (1994); Contact Dermatitis 30(2):80—4).

More work needs to be done to determine if beryllium—containing alloys are problematic to dental patients. We know very little about how or if these alloys may affect patients over long periods of time. Meanwhile, wisdom dictates that dentists consider using dental crowns and bridges that do not contain beryllium.
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