APPG for dentistry debates phase down of dental amalgam

14 February 2012

The UK could cope with a phase down of the use of dental amalgam in the longer term, but not in the immediate future, a meeting of the All-Party Parliamentary Group (APPG) for Dentistry has been told.

The meeting of Parliamentarians and senior stakeholders from the dental industry, which was held against a backdrop of ongoing United Nations Environment Programme (UNEP) discussions about a potential phasing out or down of the use of Mercury, heard from senior academics from the UK and Germany, as well as the Chief Dental Officer for England, Dr Barry Cockcroft.

Professor Trevor Burke, of the University of Birmingham Dental School, told attendees that he believes a prudent approach would be a phasing out, rather than down of the use of amalgam. That transition, he argued, needs to happen in parallel with the development of an alternative material with the qualities to make it a practical substitute. That replacement, he said, is still a few years away, and the use of amalgam – particularly in molar fillings – should be retained for the time being.

That conclusion was shared by Professor Gottfried Schmalz of the University of Regensburg, who argued that amalgam must remain available as a treatment for at least a generation. This time, he argued, would allow for the improvement of the quality of alternative materials, would see improved oral health that would reduce the number of complex cases, and would allow for the education of both dentists and patients about alternative materials. Professor Schmalz also stressed the particular role that amalgam fillings play in the treatment of more complex cases and said that composite fillings are between 1.7 and 3.5 times more expensive than amalgam, due to the greater amount of time needed to place them.

Dr Cockcroft said that he doesn’t believe that a ban on the use of dental amalgam is imminent, and that a phase down is the right approach. Dental amalgam, he asserted, has played a significant part in improving oral health and reducing edentulousness over the course of the last 35 years. A new dental contract in England, which is currently being developed by piloting, will mean that the type of restoration provided to patients will depend on patient need, rather than the remuneration system in which it is provided.

The meeting followed a 2011 World Health Organization (WHO) report, which considered the health and environmental factors arising from different filling materials.

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