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Amalgam ban "not feasible' in short term
1st Feb 2012
International professors and the chief dental officer have agreed it would not be feasible for the use of dental amalgam to be banned in the short term but phasing down was the right approach.
Speaking to a meeting of MPs and senior stakeholders from the industry at the All-Party Parliamentary Group for Dentistry, CDO Barry Cockcroft said there had already been a reduction in the use of amalgam in the past 20 years with a new approach to restorative techniques
and changing patterns of disease.
He said while amalgam still had a place he anticipated the decline would
continue.
Dr Cockcroft also warned the cost to the NHS of composites, not for the materials but the time taken by the dentist.
His comments come as discussions continue into the use of mercury in dental amalgam.
Environmental concerns now mean that its use could be banned by the United Nationals Environment Programme.
Professor Trevor Burke, Professor in Primary Dental Care and Hon Consultant in Restorative Dentistry at the University of Birmingham Dental School, said transition had to happen in conjunction with developing an alternative material.
He said: 'People are working night and day to find an amalgam replacement and the market for this is huge. Amalgam is still safe to use but environmental issues will hasten its demise. Posterior composites may provide performance as good as amalgam. But a true amalgam replacement is
still a few years away.'
He insisted therefore, the use of amalgam, particularly in molar fillings be kept for the time being.
He concluded: 'Introduce posterior composite for premolar teeth. Use for initial caries rather than replacement because that is where the minimally invasive nature of the technique has the best effect.'
Professor Gottfried Schmalz of the University of Regensbury, said amalgam should remain available for a least a generation and that there are alternatives but total replacement is currently not possible.
Professor Schmalz said that this time span would allow continued improvement in oral health, and allow the improvement of the quality of alternative materials. In addition, dentists and patients could learn about alternative materials.
He told the meeting the cost of composite fillings were between 1.7 and 3.5 times more expensive than amalgam, primarily because of the increased time needed to place them.
He concluded: 'Amalgam should stay available as one treatment option at least for the next generation. The dentist and the patient, they must decide in each case what is best.'
Author
Anika Bourley
Parliamentary Correspondent
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