Association between blood lead and mercury levels and periodontitis in the Korean general population: analysis of the 2008–2009 Korean National Health and Nutrition Examination Survey data

  • Yangho Kim
  • Byung-Kook LeeEmail author
Original Article



We present data from the Korean National Health and Nutrition Examination Survey 2008–2009 regarding the association between blood lead and mercury levels and periodontitis in a representative sample of the adult South Korean population.


The analysis was restricted to participants ≥20 years of age who completed the health examination survey, including blood lead, cadmium, and mercury measurements (n = 3,966). Odds ratios (ORs) for periodontitis were calculated for log-transformed blood metal levels and quartiles thereof after covariate adjustment.


In a logistic regression analysis using log-transformed blood lead and mercury levels as independent variables after covariate adjustment, including blood lead, mercury, and cadmium, the ORs and 95 % CI values in men for having periodontitis with doubling of blood lead and mercury were 1.699 (1.154–2.503) and 1.394 (1.057–1.838), respectively. Furthermore, in a logistic regression analysis using tertiles of blood lead and mercury as independent variables after covariate adjustment, the ORs and 95 % CIs of men for having periodontitis in the highest tertile were 1.756 (1.184–2.604) and 1.575 (1.507–2.347), respectively. ORs in the logistic regression analysis for men using log-transformed blood cadmium or the tertile of blood cadmium as independent variables after covariate adjustments were not statistically significant in either model. Unlike men, ORs in the logistic regression analyses for women using the same independent variables after covariate adjustment were not statistically significant in any blood metal analysis.


The association between blood lead and mercury levels and periodontitis was significant regardless of the type of variable (continuous or categorical) in the Korean male population.


Lead Mercury Cadmium Periodontitis Gingiva 


Conflicts of interest

The authors declare they have no conflicts of interest.


  1. Albandar JM, Brunelle JA, Kingman A (1999) Destructive periodontal disease in adults 30 years of age and older in the United States, 1988–1994. J Periodontol 70:13–29CrossRefGoogle Scholar
  2. Bolewska J, Holmstrup P, Moller-Madsen B, Kenrad B, Danscher G (1990) Amalgam associated mercury accumulations in normal oral mucosa, oral mucosal lesions of lichen planus and contact lesions associated with amalgam. J Oral Pathol Med 19:39–42CrossRefGoogle Scholar
  3. Centers for Disease Control and Prevention (CDC) Fourth national report on human exposure to environmental chemicals. CDC, 2009 Available at: Accessed May 24 2012
  4. Dye BA, Hirsch R, Brody DJ (2002) The relationship between blood lead levels and periodontal bone loss in the United States. Environ Health Perspect 110:997–1002CrossRefGoogle Scholar
  5. El-Said KF, El-Ghamry AM, Mahdy NH, El-Bestawy NA (2008) Chronic occupational exposure to lead and its impact on oral health. J Egypt Public Health Assoc 83:451–466Google Scholar
  6. Freden H, Hellden L, Milleding P (1974) Mercury content in gingival tissues adjacent to amalgam fillings. Odontol Revy 25:207–210Google Scholar
  7. Genco RJ (1996) Current view of risk factors for periodontal diseases. J Periodontol 67:1041–1049Google Scholar
  8. Han DH, Lim SY, Sun BC, Janket SJ, Kim JB, Paik DI, Paek D, Kim HD (2009) Mercury exposure and periodontitis among a Korean population: the Shiwha-Banwol environmental health study. J Periodontol 80:1928–1936CrossRefGoogle Scholar
  9. Jarup L (2003) Hazards of heavy metal contamination. Br Med Bull 68:167–182CrossRefGoogle Scholar
  10. Korean Center of Disease Center, Ministry of Health and Welfare (2009) Korean national health and examination surveys: the 4th surveys, 2007. Available at: Accessed December 9 2009
  11. Landrigan PJ (1982) Occupational and community exposures to toxic metals: lead, cadmium, mercury and arsenic. West J Med 137:531–539Google Scholar
  12. Lee BK, Kim Y (2012) Iron deficiency is associated with increased levels of blood cadmium in the Korean general population: analysis of the 2008–2009 Korean National Health and Nutrition Examination Survey data. Environ Res 112:155–163CrossRefGoogle Scholar
  13. Li P, He L, Sha YQ, Luan QX (2009) Relationship of metabolic syndrome to chronic periodontitis. J Periodontol 80:541–549CrossRefGoogle Scholar
  14. Liu Y, Cotgreave I, Atzori L, Grafstrom RC (1992) The mechanism of Hg2+ toxicity in cultured human oral fibroblasts: the involvement of cellular thiols. Chem Biol Interact 85:69–78CrossRefGoogle Scholar
  15. Lockitch G (1993) Perspectives on lead toxicity. Clin Biochem 26:371–381CrossRefGoogle Scholar
  16. Mozaffarian D, Rimm EB (2006) Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 296:1885–1899CrossRefGoogle Scholar
  17. Offenbacher S (1996) Periodontal diseases: pathogenesis. Ann Periodontol 1:821–878CrossRefGoogle Scholar
  18. Pineda-Zavaleta AP, Garcia-Vargas G, Borja-Aburto VH et al (2004) Nitric oxide and superoxide anion production in monocytes from children exposed to arsenic and lead in region Lagunera, Mexico. Toxicol Appl Pharmacol 198:283–290CrossRefGoogle Scholar
  19. Pinkerton LE, Biagini RE, Ward EM et al (1998) Immunologic findings among lead exposed workers. Am J Ind Med 33:400–408CrossRefGoogle Scholar
  20. Pounds JG, Long GJ, Rosen JF (1991) Cellular and molecular toxicity of lead in bone. Environ Health Perspect 91:17–32CrossRefGoogle Scholar
  21. Reichl FX, Esters M, Simon S et al (2006) Cell death effects of resin-based dental material compounds and mercurials in human gingival fibroblasts. Arch Toxicol 80:370–377CrossRefGoogle Scholar
  22. Saito T, Shimazaki Y, Koga T, Tsuzuki M, Ohshima A (2001) Relationship between upper body obesity and periodontitis. J Dent Res 80:1631–1636CrossRefGoogle Scholar
  23. Saraiva MC, Taichman RS, Braun T, Nriagu J, Eklund SA, Burt BA (2007) Lead exposure and periodontitis in US adults. Periodontal Res 42:45–52CrossRefGoogle Scholar
  24. Shenker BJ, Pankoski L, Zekavat A, Shapiro IM (2002) Mercury-induced apoptosis in human lymphocytes: caspase activation is linked to redox status. Antioxid Redox Signal 4:379–389CrossRefGoogle Scholar
  25. Silbergeld EK, Sauk J, Sommerman M et al (1993) Lead in bone: storage site, exposure source, target organ. Neurotoxicology 14:225–236Google Scholar
  26. Williams RC (1990) Periodontal disease. N Engl J Med 322:373–382CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Occupational and Environmental MedicineUlsan University Hospital, University of Ulsan College of MedicineUlsanSouth Korea
  2. 2.Institute of Environmental and Occupational MedicineSoonchunhyang UniversityShinchang-myun, Asan-si, ChoongnamSouth Korea

Personalised recommendations