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Article: Volume 43 Number 1 Page 8 - January/February 2016

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  Dent Update 2016; 43: 8-18

Restorative dentistry:  British Society of Prosthodontics Debate on the Implications of the Minamata Convention on Mercury to Dental Amalgam − Should our Patients be Worried?

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Abstract: 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.

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.

Author notes: Rupert Austin (RA), BDS(Hons), MClinDent, PhD, MPros RCS(Ed), MJD FRCS(Eng), FAcadM(Ed), FHEA, Clinical Lecturer and Specialist in Prosthodontics, King’s College London Dental Institute, Shiyana Eliyas, BDS, MFDS RCS(Eng), MRD RCS(Eng), FDS(RestDent) RCS(Eng), PGCertHE, Consultant in Restorative Dentistry, St George’s Hospital NHS Foundation Trust, FJ Trevor Burke (TB), DDS, MSc, MDS, FDS MGDS RCS(Edin) FDS RCS, FADM, Professor of Primary Dental Care, Birmingham School of Dentistry, Phil Taylor (PT), BDS(Ncle), MGDS RCS(Eng), MSc(Lond), MRD RCS(Eng), FDS RCS(Edin), Senior Lecturer and Consultant in Restorative Dentistry, Barts and the London School of Medicine and Dentistry, James Toner (JT), BA(Hons), FHEA, Senior Learning Technologist, King’s Learning Institute and Centre for Technology Enhanced Learning, King’s College London and Peter Briggs (PB), BDS(Hons), MSc, MRD RCS(Eng), FDS RCS(Eng), Consultant in Restorative Dentistry, Barts and the London School of Medicine and Dentistry, London, UK.

Objective: To determine the views of a 'convenience' sample of dentists on the future of dental amalgam and its alternatives.