GENEVA, Switzerland: To date, more than 100 countries have ratified the Minamata Convention on Mercury, a global treaty to curb the effects of mercury on the environment and human health. Parties to the convention recently rejected a controversial proposal from the Africa region’s delegation for an all-out ban on dental amalgam and instead approved two new provisions that add limitations to the use of mercury in a phase-down approach.
It was during the second segment of the meeting of the Conference of the Parties to the Minamata Convention on Mercury in late March that limitations were approved on the use of mercury in bulk form by dental practitioners and in patients under the age of 15 as well as in pregnant or breastfeeding women, instead of supporting an overarching ban on dental amalgam.
Although mercury-free alternatives exist, clinically, economically and practically, they are still less than optimal. Therefore, continued investment is needed to accelerate the development of innovative restorative materials, to increase their durability and affordability and to move them from the laboratory to the market. If this is not done, dental practitioners will witness a negative impact on the provision of quality treatment for dental caries and an increase in tooth extractions, threatening to widen oral healthcare inequalities. Evidence on the health and environmental impact of new restorative materials is also needed.
As there is no solution to every situation faced by the parties as they implement a phase-down approach, organisations such as FDI World Dental Federation emphasise the importance of adapting strategies to national contexts and in line with Part II of Annex A of the convention. The section referred to stipulates that any efforts to phase down the use of dental amalgam should consider relevant international guidance and domestic circumstances and that parties must adopt at least two of the nine measures. The measures include promoting insurance policies that favour amalgam alternatives, encouraging research and development of quality mercury-free restorative materials for dentistry and establishing national objectives for oral health promotion.
In order to be well prepared for the next meeting of the parties in Geneva in Switzerland in 2023, it is recommended that parties should work together with their ministries of environment, ministries of health, national dental associations and chief dental officers to understand the challenges and the feasibility of any recommended approaches. The World Health Organization states that setting up a national coordination committee under the leadership of the respective ministry of environment and ministry of health could create an environment conducive to consensus building for the healthcare sector.
More information on the Minamata Convention on Mercury can be found here.
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