Amalgam use and waste management by Pakistani dentists: an environmental perspective

Mumtaz, Rohail; Khan, Abbas; Noor, Nurliyana Athirah Mohd; Humayun, Sadaf

doi:10.26719/2010.16.3.334

Cited by 13 publications

(13 citation statements)

References 2 publications

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“…About 56% of the study samples disagreed that amalgam should be phased out and replaced with non-mercury fillings, 92% perceived amalgam a health risk, whereas 46% considered it an environmental hazard (13). However, in a study that monitored mercury air pollution at dental sites, very high indoor mercury contamination levels have been found at some dental sites.…”

Section: Introductionmentioning

confidence: 95%

Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites

Khwaja

Abbasi

2014

Reviews on Environmental Health

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Section: Introductionmentioning

confidence: 95%

Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites

Khwaja

Abbasi

2014

Reviews on Environmental Health

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“…The dental amalgam waste in Pakistan and India is disposed of into wastewater streams diluted or undiluted [ 14 – 17 ]. According to Mumtaz et al [ 18 ], about 92% of dentists in Pakistan used amalgam but also perceived it as a health risk. However, 56% of the subjects disagreed that amalgam should be replaced with nonmercury fillings.…”

Section: Introductionmentioning

confidence: 99%

Use of Mercury in Dental Silver Amalgam: An Occupational and Environmental Assessment

Jamil

Baqar

Ilyas

et al. 2016

BioMed Research International

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The objective of this study was to assess the occupational exposure to mercury in dentistry and associated environmental emission in wastewater of Lahore, Pakistan. A total of ninety-eight blood samples were collected comprising 37 dentists, 31 dental assistants, and 30 controls. Results demonstrate that the dentistry personnel contained significantly higher mean concentration of mercury in their blood samples (dentists: 29.835 µg/L and dental assistants: 22.798 µg/L) compared to that of the controls (3.2769 µg/L). The mean concentration of mercury was found maximum in the blood samples of older age group (62.8 µg/L) in dentists and (44.3 µg/L) in dental assistants. The comparison of mercury concentration among dentists, dental assistants, and controls (pairing based on their ages) revealed that the concentration increased with the age and experience among the dentists and dental assistants. Moreover, the mercury concentration in all the studied dental wastewater samples, collected from twenty-two dental clinics, was found to be exceeding the recommended discharge limit of 0.01 mg/L. Therefore, we recommend that immediate steps must be taken to ensure appropriate preventive measures to avoid mercury vapors in order to prevent potential health hazards to dentistry personnel. Strong regulatory and administrative measures are needed to deal with mercury pollution on emergency basis.

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“…Publicly funded restoration provision predominates in the United Kingdom, with amalgam the most commonly used posterior material. This limits the generalizability of the findings, although it could be comparable to other, primarily developing, countries where amalgam use is still high (Mumtaz et al 2010;World Health Organization 2011). Data pertaining to private dentists could potentially be generalized to other countries where this is the main mode of health care provision and amalgam use is still permitted.…”

Section: Discussionmentioning

confidence: 84%

Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives

Bailey

Vernazza

Stone

et al. 2020

JDR Clinical & Translational Research

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Introduction: Amalgam use has recently been phased down, and the potential for a phase-out is being investigated. Objectives: The study aimed to identify knowledge of the phase-down and opinions of a potential phase-out of amalgam by UK primary care clinicians and assess their confidence in using different materials in different situations. Methods: An anonymized, prepiloted cross-sectional e-survey was used to assess primary care clinicians’ knowledge and opinions of the amalgam phase-down and potential phase-out and their confidence in using amalgam and the alternatives in different situations. In total, 11,902 invitations were distributed through British dentist and therapist associations. Prior hypotheses were tested alongside descriptive statistics. Results: Response rate was 13% ( n = 1,513). Knowledge of the amalgam phase-down was low, with just 3% clinicians correctly identifying all patient groups in whom amalgam use should be avoided in the United Kingdom. Postgraduate education on posterior composite placement was high (88%), but a large majority had personal and patient-centered concerns over the suitability of the alternatives and lacked confidence when placing composite in comparison to amalgam in difficult situations ( P < 0.0001). Logistic regressions revealed that the best predictors of high confidence in placing mesio-occluso-distal composites and composites in difficult situations were being a private general dentist or being primarily a composite user. Conclusion: Primary care clinicians have major personal and patient-centered concerns regarding the amalgam phase-down (of which they have limited knowledge) and potential phase-out. Many lack confidence in using the alternative, composite, to restore posterior teeth in difficult situations, whereas confidence in using amalgam in similar situations is high. Effective education of clinicians and understanding patients’ needs, alongside policy changes, are required to enable a successful amalgam phase-down and potential phase-out. Knowledge Transfer Statement: This study shows that UK primary care clinicians are worried about the phase-down of amalgam for themselves and their patients. Many lack confidence in the alternative, composite, when used in difficult situations, which is in stark contrast to amalgam. Knowledge of the phase-down is limited. There is a need for more effective education of clinicians, an understanding of patients’ values, and policy changes to ensure the success of the phase-down and potential phase-out of amalgam.

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Amalgam use and waste management by Pakistani dentists: an environmental perspective

Cited by 13 publications

References 2 publications

Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites

Mercury poisoning dentistry: high-level indoor air mercury contamination at selected dental sites

Use of Mercury in Dental Silver Amalgam: An Occupational and Environmental Assessment

Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives

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