Making mercury history – Dr John Rafelt

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  Posted by: The Probe      7th April 2018

 

 

In 2013, the Minamata Convention on Mercury was set up to globally protect the environment from the adverse effects that mercury causes. Mercury is a naturally occurring substance that has a wide range of uses in everyday objects and it can be released into the atmosphere, water and soil. Major highlights of the Minamata Convention include a ban on new mercury mines, the phase-out of existing mines, the phase-out and phase-down of mercury use in a number of products and processes,control measures on emissions to air and on releases to land and water plus the regulation of artisanal and small-scale gold mining. The Minimata Convention also addressed the interim storage of mercury and its disposal.[1]

 

On 14 March 2017, the European Parliament agreed to the final version of its Regulation on Mercury in agreement with the Minamata Treaty, which mainly aims to reduce the negative effects of mercury on the environment. However, it also prescribed a phase-down of the use of dental amalgam.[2]While this does not prevent dentists from using amalgam, it does restrict its use to certain circumstances, including the following:

 

  • Dental amalgam only to be used in pre-dosed encapsulated form; use of bulk mercury by the practitioner prohibited (from 1 January 2019)
  • Mandatory use of amalgam separators (from 1 January 2019)
  • Service standards from January 2019; mandatory retention of at least 95 per cent of amalgam particles for separators installed from Jan 2018, and for all separators by 1 January 2021
  • Dentists to ensure that their amalgam waste is handled and collected by an authorised waste management establishment
  • Member States to set out a national plan (by 1 July 2019) on the measures they intend to implement to phase-down the use of dental amalgam
  • No use of amalgam in the treatment of deciduous teeth, children under 15 years and pregnant or breastfeeding women, except when strictly deemed necessary by the practitioner on the ground of specific medical needs of the patient (from 1 July 2018)
  • The commission to report (by 30 June 2020), on the outcome of its assessment regarding:
    • The need for the Union to regulate mercury emissions from crematoria;
    • The feasibility of a phase-out of dental amalgam use in the long term, and preferably by 2030, taking into account national plans for measures to phase-down amalgam use, and respecting Member States’ competence for the organisation and delivery of health services and medical care.[3]

 

This restriction therefore leads to a need for alternative materials that can be used in certain patient groups. Indeed, both the Minamata Treaty and the EU Regulation recognise the need for further development and optimisation of alternative materials. Such alternatives include the use of composite resin fillings and glass ionomer cement fillings.[4]Composite resin fillings are made from an acrylic resin reinforced with powdered glass filler whereas glass ionomer cement fillings contain organic acids and bases and may include acrylic resins. Composite resin fillings are the most commonly used alternative[5]and they haveadvantages over amalgam in terms of being tooth-coloured and their reparability.[6]

 

In line with this, a trusted leader in composite filling materials, 3M Oral Care, now provides a range of dental restoratives that offer a unique alternative to mercury. For example, the Filtek One bulk fill restorative from 3M Oral Care incorporates nanotechnology to give you the simplicity of one-step placement with excellent polish retention,[7]easy handling,[8]high strength and wear resistance7without compromising aesthetic results.[9]It is a bulk fill composite that makes posterior restorations faster and easier.

 

Currently, the second largest use of mercury is in dental amalgams and with future regulations coming into force to phase-out dental amalgam in the long term, dentists need to be ready to provide safe and effective alternatives to patients.

 

 

 

 

 

 

 

 

For more information, call 0800 626 578  or visit www.3m.co.uk/dental

 

 

 

 

 

[1]UN Enviroment. Minamata Convention on Mercury. Convention. Available online: http://www.mercuryconvention.org/Convention/tabid/3426/language/en-US/Default.aspx[Accessed 7thDecember 2017].

[2]European Parliament. Legislative train schedule. Regulation on mercury. Available online: http://www.europarl.europa.eu/legislative-train/theme-environment-public-health-and-food-safety/file-regulation-on-mercury[Accessed 7thDecember 2017].

[3]British Dental Association. Dental amalgam. Available online: https://bda.org/amalgam[Accessed 7thDecember 2017].

[4]US Food and Drug Administration. Medical devices: alternatives to dental amalgam. Available online: https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/ucm171108.htm [Accessed 9th January 2018].

[5]US Food and Drug Administration. Medical devices: alternatives to dental amalgam. Available online: https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgam/ucm171108.htm [Accessed 9th January 2018].

[6]Alcaraz M, Veitz-Keenan A, Sahrmann P, Schmidlin P, Davis D, Iheozor-Ejiofor Z. Direct composite resin fillings versus amalgam fillings for permanent or adults posterior teeth. Cohcrane Databse of Systematic Reviews 2014; 3.

[7]3M Oral Care Internal Data. Nanotechnology; durability, polishability and polish retention. Claim 6809, 2016.

[8]3M Oral Care Internal Data. Excellent adaption and ability to sculpt. Claim 6778, 2016.

[9]3M Oral Care Internal Data. Increased opacity for improved aesthetics. Claim 6810, 2016.

 

 


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