Banning amalgam not realistic - WHO

The World Health Organisation has just published a report - Future Use of Materials for Dental Restoration - saying that “dental amalgam remains a dental restorative material of choice, in the absence of an ideal alternative and the lack of evidence of alternatives as a better practice”. The report was of the meeting of WHOs Oral Health Program held in Geneva last November which assessed the scientific evidence available on dental restorative materials alternative to dental amalgam and the implications to countries of using alternatives to amalgam for dental restorative care.
The report continues: “If dental amalgam were to be banned, a better and more long-lasting replacement would be needed than the materials available to date. The choice of materials may depend on the tooth, site and size of cavity, as well as healthcare financing, patient preference, health care provider preference, technology, cost and environmental factors. While the harmful effects of mercury on health and the environment are recognised, the possible adverse effects of alternative materials require further research and monitoring. Providing the best care possible to meet patients’ needs should be of paramount importance. Variations between countries and challenges faced by middle- and low-income countries are critical. Implications for training of dental personnel and costs to society as well as the individual are significant and need to be taken into consideration”.
The meeting concluded that a complete ban may not be realistic, practical and achievable. The report added: “It may be prudent to consider ‘phasing down’ instead of ‘phasing out’ of dental amalgam at this stage. A multi-pronged approach with short-, medium- and long-term strategies should be considered. Elements of strategies can be put in place while waiting for the new materials to be developed. The role of WHO, UNEP (United Nations Environment Program), NGOs (such as IADR and FDI) and the industry is critical. A further meeting must be convened to discuss the way forward and to develop strategies to address issues in both developed and developing countries”.