What is the impact of the Minamata Convention on Mercury on dentistry?
Context
In February 2009, the Governing Council of the United Nations Environmental Programme (UNEP) agreed on the need to develop a global legally binding instrument, or treaty, on mercury. It tasked governments to negotiate through an Intergovernmental Negotiating Committee (INC) on Mercury, which met five times beginning in June 2010 and concluding in January 2013.
The resulting international instrument is called the Minamata Convention on Mercury. Opened for signature in October 2013, it provides controls and reductions across a range of products, processes and industries where mercury is used, released or emitted. The Convention’s provisions for dental amalgam—a mercury-added product containing 50% mercury—make it highly relevant to the dental profession. Dental amalgam is a key restorative material in the fight against dental caries, the cause of tooth decay, which afflicts 90 percent of the world’s population, making it a global public health issue.
During negotiations on the Convention, FDI had advocated a reduction (phase-down) in the use of dental amalgam—versus a ban (phase-out)—through:
- A reduction in use based on a reduction in demand through greater focus on dental prevention and health promotion,
- Increased research and development on alternatives, and
- Environmentally sound lifecycle management for mercury and amalgam waste.
Efforts by a team representing the international dental and oral-health sector succeeded in ensuring that dental practitioners would continue to have access to dental amalgam when needed and in the framework defined by the Convention.
Commitment and Responsibilities
During the negotiations, the dental profession demonstrated its commitment and responsibility to:
- Protect and maintain the gains in public health.
- Introduce measures that will continue to improve (oral) health care worldwide.
- Strengthen environmental stewardship through the promotion and adoption of an environmentally sound lifecycle management approach.
Read the report executive summary (PDF)
Impact on the Dental Profession
Dental professionals living in a country that has ratified the Convention need to be aware of the direct impact this will have on their profession. In addition, national dental associations (NDAs), their partners and individual dental professionals have a critical role to play in ensuring that the impact is positive. They should take an active role by helping inform governments about opportunities to improve health and protect the environment within the context of the Convention without diminishing the importance of clinically proven, cost-effective and affordable oral-health care.
The next few years will see the implementation stage (2014 to 2017), to be monitored by what the Convention calls the ‘Conference of the Parties’. The expected result for dental amalgam is a reduction in demand through increased efforts: at prevention, to use alternative materials where clinically indicated and to research improved alternative materials.
Additional Resources
The Minamata Convention on Mercury Website
FDI Policy Statements on Dental Materials
Sixth session of the Intergovernmental negotiating committee on mercury (INC 6)
Tell me this is a joke. As a human race, we are destroying the environment at a pace that is unpresidented. We pollute like crazy. We burn the rainforests. We go wild with fossil fuels. Corporations that lobby governments scoff at any environmental reprecussions of doing their daily business, yet mercury is now the devil?!?! and improvement in public health is the key??? How about banning soft drinks and sugar!?!? the root cause of the problem. That would decrease caries rates so that we wouldn’t have to treat chronic mountain dew addicts with wall-to-wall amalgams. Wait, I should just give better OHI and put resin in their mouths? easy-peasy. Wow, this is a major over-reaction. People are going to make of it what they want – that amalgam is the devil…simple is that. It will add fuel to the propaganda already out there. And this is as far from the truth as it can get. When amalgam is gone, God help us all. People who think dentistry is expensive are about to realize that it’s getting even more expensive. I better start learning how to do implants, as restoring difficult teeth is about to become much, much, much more difficult. The almighty resin just can’t do what ugly amalgam can, no matter how much we want it too…I guess this is what progress looks like.
I agree 100% . Well put!
Resin can do far more than many colleagues give it credit for! Unfortunately, even today’s grads are not taught proper resin techniques. Rather, resin is treated like an addendum to amalgam technique, instead of recognizing that absolutely every step, from the moment the cavity prep is begun until the polish is completed, has significant differences compared to amalgam. Until this thinking changes, dentists will continue to produce mediocre resin restorations, thus perpetuating the myth that “amalgam does it better”.