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British society of prosthodontics debate on the implications of the minamata convention on mercury to dental amalgam – should our patients be worried? Rupert Austin Shiyana Eliyas FJ Trevor Burke Phil Taylor James Toner Peter Briggs Dental Update 2024 43:1, 707-709.
In 2013, the Minamata Convention on Mercury called for a global phase-down of amalgam use, with a view to reduce environmental mercury pollution. This will significantly impact UK dentistry, given the still extensive use of amalgam in UK general dental practice. However, until now there has been little national discussion or debate. In Spring 2015, The British Society of Prosthodontics dedicated a significant part of its Annual Conference to debating the implications of this issue. Clinical case examples were discussed with audience interaction and voting facilitated using innovative Audience Response System Technology. A remarkable range of concerns and opinions were given. The debate elicited specific concerns amongst clinicians regarding the suitability of mercury-free alternatives to amalgam; particularly where cavities are large and extend beneath the gingival anatomy. There are also anecdotal reports of Dental Foundation (DF) dentists not being adequately taught the use of dental amalgam in undergraduate dental schools.
CPD/Clinical Relevance: Many clinicians, especially those treating patients for whom moisture control is challenging, feel that amalgam should remain available for clinicians to choose in certain clinical circumstances for the restoration of posterior teeth, even in the event of a complete phase-down.
Article
The Minamata Convention on Mercury, a United Nations treaty signed on the 10 October 2013 by 128 signatory nations, including the UK, was designed to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compound.1 Minamata Bay in Japan was heavily polluted from the 1930s by wastewater, mixed with mercury, dumped into Hyakken Harbour from the Chisso Corporation's factory in Minamata, particularly by methylmercury. The highly toxic compound bio-accumulated in fish and shellfish in the bay which, when eaten by the people living around the bay, gave rise to Minamata disease (mercury intoxication) affecting more than 10,000 people.2 Article 4 on the Convention addresses the question of mercury-added products and includes specific requirements for signatory nations regarding the use of dental amalgam. The requirements are shown in Figure 1.
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