Dental amalgam Print
Friday, 30 July 2010 17:02

Dental amalgam contains approximately 50% elemental mercury, 30% silver and 20% other metals such as copper, tin and zinc.

In 2005 approximately 240-300 tonnes of mercury were used as an ingredient in dental amalgam by dentists worldwide.

Some countries are taking a precautionary approach to protect the environment from the harmful effects of mercury and taking measures to reduce the use of mercury in dentistry.

 

Alternatives to mercury dental amalgam exist, such as composites (most common), glass ionomers and copolymers (modified composites). These are all effective alternatives that are generally considered more attractive than traditional amalgam.

 

Most dental practitioners continue to charge less for mercury amalgams than for the alternatives. The speed with which dental amalgams are being replaced varies widely, and mercury use is still significant in most countries.

 

Relevant legislation and advisories and NGO policy work

In the EU

Mercury in dental amalgam was relevant to two actions included in the 2005 EU Mercury Strategy. NGOs followed all relevant developments from 2005 - 2008. 

In 2011 the EU launched a study to carry out a full life-cycle assessment of the mercury us in dentistry- mainly looking at the environmental effects caused. The study is expected to be completed by spring 2012.

Relevant work and follow up by the NGOs can be found here.

The European Parliament resolution on the European Environment & Health Action Plan 2004-2010 - Article 6, declared that, consistent with the “opinion of the relevant Scientific Committee, urgent consideration should be given to restricting the marketing and/or the use of mercury used in dental amalgams

Further to above, a number of countries have put in place measures to reduce or even phase out the use of mercury in the dental sector. In addition to the use of amalgam separators to substantially reduce the amount of mercury discharges through wastewater from dental clinics (combined with appropriate service to maintain the effectiveness of these systems), some countries are also promoting the substitution of mercury-containing amalgam fillings, especially among sensitive populations including pregnant women, children and those with impaired kidney functions.

Denmark and Sweden maybe the only countries that have gone farthest in eliminating the use of mercury-containing amalgam. The Swedish Government’s overall goal to phase out mercury also includes dental amalgam. In Sweden, where dental amalgam has been subject primarily to voluntary phasing out measures, the consumption of mercury for dental use has decreased significantly after a policy decision by the Parliament in 1994 to phase out the use of dental amalgam.

In Denmark, dental amalgam is allowed only in molar teeth where the filling is subject to wear, but the Government is ready to ban the remaining use of dental amalgam as soon as the Danish National Board of Health is satisfied that the non-mercury alternatives are adequate for all requirements.

Norway has also developed a directive (from 1 January 2003) on the use of dental filling materials, which encourages dentists to reduce the use of amalgam as much as possible.

 

Globally

Work is currently being undertaken under the UNEP Mercury partnership area on Mercury in Products.

In the US

In 2006, EPA was developing a dental office amalgam recycling program called its “gray bag” program. This program would assist dentists in properly collecting and managing dental amalgam wastes generated in their offices to minimize mercury releases to air, land, and water. This program also will ensure that dental amalgam is sent to responsible recyclers who would ensure that it does not end up in wastewater streams as well as in municipal and medical waste incinerators.

In the US see also relevant laws and regulations at http://www.epa.gov/hg/regs.htm and at http://www.newmoa.org/prevention/mercury/modelleg.cfm

In New Zealand, a “Practice guideline - controlling dental amalgam waste and wastewater discharges” has been adopted. It recommended that amalgam waste should be collected, stored and sent for recycling, or for disposal at an approved landfill when collection for recycling is not available. Also, amalgam scrap and contaminated particulate amalgam waste should not be disposed of in any medical waste to be incinerated. Dental surgeries should use systems to reduce amalgam discharge to wastewater, including amalgam separators where local authorities require. It has issued precautionary advice for dentists and pregnant women. It recommended that amalgam should be used with informed consent of patients (UNEP, 2002).