‘Phase down’ dental amalgam, says WHO

A World Health Organization (WHO) report suggests there should be a phasing down rather than a phasing out of amalgam.

The report, Future Use of Materials for Dental Restorations, reflects a November 2009 meeting at WHO’s Geneva headquarters which considered environmental and health factors arising from the use of different filling materials.

It says that it may be prudent to consider a phasing down, rather than a phasing out, of the use of dental amalgam and calls for a multi-pronged strategy with short-, medium- and long-term elements.

It also contends that the quality of alternatives to amalgam must be further improved for use in public dental care, arguing that a progressive move away from amalgam would be dependent on that quality improvement being achieved.

Stuart Johnston, chair of the BDA’s representative body and a member of the FDI World Dental Federation Dental Amalgam Task Team, said: ‘This is a thorough report that provides a balanced view of the use of different filling materials in dentistry and will make a useful contribution to the ongoing debate in this area.

‘Dentists find amalgam to be a stable material for fillings, with good handling properties. Expert toxicologists and medics have reported no evidence that it causes harm to patients. The alternative materials that are available are not so well proven and have their own disadvantages.

‘The environmental risks around amalgam use are taken extremely seriously and modern disposal processes are very sophisticated in preventing mercury emissions. In the long term, of course, the aim should be that preventive care advances sufficiently so that the need for fillings is diminished.

‘In the meantime, it is important that the potential problems with, and likely impact of, any change in policy are fully considered by the experts and competent authorities who make decisions about the use of dental amalgam and other fillings materials.’

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