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Amalgam

Irish Dental Association: Statement on Dental Amalgam (Dental Restorative Material)

A Statement on Dental Amalgam in response to the Minamata Convention on Mercury (2013):

The Irish Dental Association (IDA), the country’s principal representative organisation for dentists, calls on the Irish Government to ratify the Minamata Convention on Mercury, which it signed in October 2013. The IDU acknowledges the Government’s intent to be bound to the principles of the Convention as a signatory but that signature is subject to ratification to endorse the purpose and objectives of the convention as legal, domestic policy and to be bound by international legal obligations as required by the Articles and Annexes of the Convention.

The IDA acknowledges that mercury and its organic compounds are a significant environmental and health threat.

Dental amalgam has a long history of safe use which has withstood repeated scrutiny by the dental and scientific community. Dental amalgam is a mixture of metals (alloy) of which one is metal mercury. Dental amalgam does not contain organic mercury.

The IDA supports the continued use of amalgam when clinically indicated.  Dental amalgam is a predictable and effective restorative material. It still has a very important role in the restoration of teeth injured by dental caries due to its reliability and durability. This is acknowledged by a 2009 WHO expert consultation Future Use of Materials for Dental Restorations, World Health Organisation, 2009.

In light of the current scientific and clinical evidence supporting the use of dental amalgam as a safe and reliable filling material, existing dental amalgam fillings should only be replaced following a thorough clinical assessment of the need to do so and an understanding of what is in the patient’s best interest.

The IDA, in common with the World Dental Federation (FDI) and the Council of European Dentists (CED), supports the phasing-down of dental amalgam as outlined in the Minamata Convention but the IDA calls on the Government and the dental community to:

  • Champion disease prevention and health promotion, thereby reducing the need for dental restorations;
  • Encourage dental education in the best, evidence-based management of dental caries and restoration of teeth once damaged by dental caries;
  • Ensure that third party schemes permit clinical autonomy in the choice of dental restorative materials by means of contractual and financial structure, allowing dentists to continue to act in the best interests of their patients;
  • Support on-going research into restorative dental materials in the search for cost-effective, durable and safe alternatives to dental amalgam;
  • Acknowledge the need for on-going research on the health and environmental impact of alternative dental restorative materials;
  • Insist on the full declaration of the chemical composition of alternative dental restorative materials by manufacturers;
  • Advocate best management practice in the use and disposal of dental amalgam, especially the use of well-maintained and serviced amalgam separators, of ISO standards, and safe clinical waste disposal;
  • Ensure compliance with waste management regulations, ensuring that the disposal of waste is carried out by licenced carriers with ensuing protection of the environment and human health.

The IDA seeks the support of the dental community including the dental trade to eliminate the use of elemental mercury by the profession in Ireland and to ensure the use of pre-encapsulated amalgam only forthwith. A ban on the provision of elemental mercury, for use with dental amalgam alloys, will enhance the safety of the dental team and suppliers.