Minamata: two years on

Not many clinicians in the UK will have missed the publicity surrounding the Minamata Agreement, which was signed by the UK and over one hundred countries from all over the world in October 2013. This was a far reaching agreement to limit the use of mercury from all sources, including LED light bulbs, fluorescent tubes, fertilisers, thermometers and, of course, dental amalgam. The agreement intimated that the mercury limitation would commence within four years, and Annex A Part II dealt specifically with dentistry. Of course, an obvious way to cut down the use of dental amalgam would be to reduce the number of new cavities, but this is a laudable aim which the dental profession, worldwide, has been wrestling with, ever since GV Black, in the late 1800s, suggested that we should ‘soon be practising preventive rather than reparative dentistry’. A clause in the annex to the agreement mentioned the phasing down of mercury-containing restoratives. Two years on, it is timely to reflect how close we are to achieving this, given that two years is half of the suggested four! We have also agreed to ‘Promote the development of cost-effective and clinically effective mercury-free alternatives’, so how far down that road are we?