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DHAKA, Bangladesh: Representatives of dental and civil society organisations in Asia recently signed a declaration that calls for a phase-out of dental fillings containing mercury throughout the region. The agreement also aims for the cease of trade in amalgam and to educate dental professionals about mercury-free alternatives, such as Atraumatic Restorative Treatment.
Use of amalgam in the treatment of children and pregnant women is to be prohibited already this year, the paper states. It also calls for developing measures to raise public awareness about the environmental hazards of amalgam and to help hospitals and dental institutions continent wide to provide mercury-free dental health care services.
An overall phase-out of amalgam in dentistry in Asia is targeted for 2020.
Signed by dental representatives from India, Nepal, Bangladesh, Thailand, Pakistan and Sri Lanka, the declaration is considered a practical step towards implementing the Minamata Convention on Mercury, an international agreement signed by 87 countries two years ago in Japan, that has banned the use of the substance in industrial products like batteries and fluorescents lamps, on the continent. Although amalgam is generally exempt from the ban, the convention recommended phasing down its use in dentistry worldwide.
If implemented effectively, the new declaration, formulated in Dakha, Bangladesh, last November, would make Asia the largest and most densely populated continent to phase out the controversial material, said Dillip Pattanaik, Executive Director of the Orissa State Volunteers and Social Workers Association, a local non-profit organisation, and one of the initiators of the initiative.
“Amalgam is a primitive, polluting product whose high metal content leads to cracked teeth. It is so old that it pre-dates the birth of Mahatma Gandhi. It has no role in 21st century dentistry and it is generally rejected among younger and more modern dentists,” he commented.
While mercury-free dentistry is growing even in rural parts of India, Pattanaik said, more than 70 per cent of dentists in the country are still using it as their primary filling material. The widespread use results in 65 tons of amalgam waste per year, which, despite new initiatives to educate dentists about the benefits of amalgam separators, is released into the environment. It is then transformed into methylmercury, a highly toxic form of the metal that poses health risks to wildlife and human beings.
“The large number of dental practitioners and dental professionals both in the private and government sectors are unaware of these things and required to be sensitised to avoid amalgam disposal through the normal sewer system,” Prof. Mahesh Verma, Indian Dental Association President and Director and Principal of the Maulana Azad Institute of Dental Sciences in New Delhi, told Dental Tribune Asia Pacific.
Religious practices like Hindu cremations further add to the environmental problem, as they release mercury from dental fillings into the air.
While the environmental effects of amalgam waste in Asia remain largely unknown, it is believed that the continent contributes significantly to the overall global burden. According to a 2013 report released by the United Nations Environment Programme, amalgam waste entering the solid waste stream amounts to 340 tons worldwide.
Total emissions of mercury resulting from cremation of human remains were estimated at 3.6 tons.
