An urgent message for the four UK chief dental officers

I have recently reminded readers that The Minamata Convention on Mercury is a global treaty, signed by the UK and over one hundred countries from all over the world in October 2013 with the intention of protecting human health and the environment from the adverse effects of mercury. It contains clauses which limit the use of mercury from all sources, with dentistry being the only area which ‘escaped’ with a ‘phase down’ in mercury use, as opposed to a total ban. The Convention has now been ratified by 55 countries and signed by 128 countries, with the arrangements sealed within the Convention being that the Convention would enter into force on 15th August 2017 in the ratifying countries, that being 90 days after the fiftieth ratification was received. The implication of this being that, from 1st July 2018, amalgam use will be banned in the UK for children under the age of 15 years and for pregnant or nursing women. The need to find an amalgam ‘replacement’ is therefore now extremely urgent but, for the CDOs, this material has to fulfil, not only a list of ideal requirements, but also that any replacement material should not cost more than amalgam to place, given that we are all aware that the NHS in the UK is strapped for cash. Therein lies the problem: it has been known since the early days of composite restorations in posterior teeth that such restorations take longer to place than amalgam.¹ And, given that dentists' time is the most expensive part of any restoration, where is the money going to come from?