{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:31:58Z","timestamp":1777397518590,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med\ufffdInsights\ufffdArthritis\ufffdMusculoskelet Disord"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>This hypothesis-testing study evaluated the relationship between mercury (Hg)-based dental amalgams and arthritis diagnoses among adults in the United States (US). A total of 86\u2009305\u2009425 weighted-persons with \u2a7e1 dental amalgam filling surface (DAFS) (exposed group) and 32\u2009201\u2009088 weighted-persons with \u2a7e1 other dental filling surface (ODFS) (no DAFS, unexposed group) were examined in the 2015 to 2016 National Health and Nutritional Examination Survey (NHANES). All persons were 20 to 80\u2009years-old with known demographic characteristics and arthritis status. Survey logistic regression and survey frequency modeling in SAS were employed with and without adjustment of covariates. The arthritis rate was significantly increased in the exposed group compared to the unexposed group in the unadjusted (7.68-fold) and adjusted (4.89-fold) models. Arthritis (per 10\u2009000 weighted-person-years) was 6.0-fold significantly increased in the exposed group (6.2) compared to the unexposed group (1.06). A significant bimodal dose-dependent relationship between DAFS and arthritis rate was observed. The arthritis rate increased with increasing DAFS (peak among persons with 4-7 DAFS) and, subsequently, decreased among those with &gt;6 DAFS. A significant decrease in arthritis rate among persons with &gt;13 DAFS as compared to those persons with 4 to 7 DAFS was observed. A significant association between DAFS and arthritis risk and a dose-dependent DAFS associated immune-stimulation\/immune-suppression with arthritis risk were observed. An estimated additional $96\u2009835\u2009814 US dollars (USD) are spent on annual medical costs and $184\u2009797\u2009680 USD are lost in annual wages from reported new onset arthritis attributably associated with DAFS (annual total cost\u2009=\u2009$281\u2009633\u2009494 USD).<\/jats:p>","DOI":"10.1177\/11795441211016261","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T13:16:20Z","timestamp":1621430180000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Dental Amalgams and the Incidence Rate of Arthritis among American Adults"],"prefix":"10.1177","volume":"14","author":[{"given":"David A","family":"Geier","sequence":"first","affiliation":[{"name":"Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA"},{"name":"CoMeD, Inc, Silver Spring, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R","family":"Geier","sequence":"additional","affiliation":[{"name":"Institute of Chronic Illnesses, Inc, Silver Spring, MD, USA"},{"name":"CoMeD, Inc, Silver Spring, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"bibr1-11795441211016261","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6817a2"},{"key":"bibr2-11795441211016261","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-199909000-00012"},{"key":"bibr3-11795441211016261","first-page":"91","volume":"85","author":"Fietta P","year":"2014","journal-title":"Acta Biomed"},{"key":"bibr4-11795441211016261","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000128"},{"key":"bibr5-11795441211016261","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2015.01.001"},{"key":"bibr6-11795441211016261","doi-asserted-by":"publisher","DOI":"10.1007\/s10534-013-9700-9"},{"key":"bibr7-11795441211016261","volume":"3","author":"Rasines Alcaraz MG","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr8-11795441211016261","doi-asserted-by":"publisher","DOI":"10.3390\/molecules26041152"},{"key":"bibr9-11795441211016261","unstructured":"Centers for Disease Control and Prevention. 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