Managing the phase-down of amalgam: part I. Educational and training issues

Phase-Down of Amalgam Use in Dentistry: A Perspective For its Effective Control and Management

“…Ten per cent (10%) of the total world consumption is by the dental profession in the form of amalgam fillings [11][12][13][14][15].…”

“…It is cheap, easy to manipulate, long clinical life span, less prone to secondary caries and less sensitive to technique during placement. However, it does not bond to tooth substance, it cannot be used in anterior region of the dental arch because of its unpleasant color, it discolors the tooth substance and its cavity preparation is more destructive of sound tooth tissue as compared with tooth colored materials such as composite resins and glass ionomer cements [12,13].…”

“…These are tooth-colored materials with less destruction of sound tooth tissue during cavity preparation [12,13]. GIC and Compomers bond chemically and micro-mechanically to tooth tissue while composite resins can bond to tooth tissue by means of micro-mechanical interlocking mechanism using acid etch technique.…”

“…Restorations of composite resins have been found to leach various substances and ions, but the amounts released do not reach levels associated with adverse health outcomes. However, it must be noted that no material is completely innocuous; and all materials exhibit varying degrees of sideeffects on humans based on the degree of toxicity and individuals idiosyncrasy [12,13].…”

“…However, with the signing of Minamata Treaty and ratification of the Treaty by concerned nations of the world, it is imperative for the concerned nations to put in place strategic plans to phase-down amalgam use over a given period of time in compliance with one of the major provisions of the Minamata Treaty [6][7][8][9]11]. The Scandinavian countries had already banned the use of amalgam as a restorative material in dentistry [12,13]. Nonetheless, the treaty provides for a phase-down approach on the use of amalgam as opposed to outright ban so that countries can put up strategic plans to reduce and control amalgam use and its eventual elimination as a restorative material in dentistry.…”