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Dental amalgam is a combination of metals (50 per cent mercury, 35 per cent silver, plus tin, copper and other trace metals) and has been used as a filling material for dental cavities for about 150 years. (DTI/Photo courtesy of Kacso Sandor/Shutterstock)
2 Comments Jul 31, 2012 | News Europe

European Commission study recommends ban of dental amalgam

Post a comment by Dental Tribune International

BRUSSELS, Belgium: A new study, conducted on behalf of the European Commission, recommends phasing out dental amalgam use over the next few years owing to mercury’s negative impact on the environment. According to the recently published study results, the ban should be combined with improved enforcement of the EU waste legislation regarding dental amalgam.

The report explains that mercury-free alternatives are still not used widely in many EU member states. The reasons are that alternative fillings are often believed to be more expensive than amalgam fillings, that many dentists are simply not trained to apply new methods and that many dentists think that composite materials have a lower durability than amalgam fillings. Some dentists are also “reluctant to change their current practice and invest in new equipment to handle mercury-free fillings,” according to the report. Additionally, many patients are not even aware that amalgam fillings contain mercury.

In 2007, mercury was used in more than 60 different applications in the EU, dental amalgam being the second largest mercury use (24 per cent) after chlor-alkali production (41 per cent). Once the use of mercury in chlor-alkali production has been phased out (target year 2020), according to the Euro Chlor’s voluntary agreement, dental mercury will become the main use of mercury. The EU consumption of dental amalgam is estimated to be between 55 and 95 tonnes of mercury (figures from 2010).

The study analysed the baseline scenario and three policy options to reduce the environmental impact of dental amalgam. The researchers stressed that there is currently no scientific consensus on the direct health effects of dental amalgam (except allergies) and that future policy actions concerning dental amalgam addressed in the study focus on the environmental aspect of the problem and indirect health effects.

The options suggested included improving enforcement of the EU waste legislation regarding dental amalgam, encouraging member states to take national measures to reduce dental amalgam use while promoting the use of mercury-free filling materials, and banning the use of mercury in dentistry entirely.

The researchers concluded that a combination of a ban and the improved enforcement of the EU waste legislation would be the most effective policy option. The European Commission would “ask member states to report on measures taken to manage dental amalgam waste in compliance with EU waste legislation and to provide evidence of the effectiveness of the measures in place. Usual steps taken to comply with these requirements are the presence of amalgam separators in dental practices, adequate maintenance of these separators in order to ensure a minimum 95 per cent efficiency and to have amalgam waste collected and treated by companies with the adequate authorisation to handle this type of hazardous waste”.

The ban of mercury could be implemented by adding the use of mercury in dentistry to Annex XVII of the REACH Regulation. REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the EU regulatory framework for chemicals that aims to enhance the protection of human health and the environment. REACH establishes European-wide uniform legal standards.

The report suggests the possibility of defining limited exemptions for medical conditions for which there is no substitute for dental amalgam at present. The study suggests that a decision to submit a REACH Restriction Dossier and effect a ban would probably be made in 2013, and become applicable five years later.

The researchers consider the combination of both policies necessary, as without the ban, mercury released from natural deterioration of amalgam fillings in people’s mouths, from cremation and burial, and from residual emissions into urban wastewater treatment plants would not be addressed. While the ban would eliminate the environmental impact in the longer term, the cessation of mercury would only be significant after about 15 years; therefore, both policies need to be employed to reduce mercury releases in the short term as well.

Amalgam’s environmental effects have been much discussed. Sweden has already phased out dental mercury, while Denmark, Finland, the Netherlands and Italy have all reduced amalgam use significantly. Other countries, including Germany, Spain, Italy and Austria, either have restrictions or guidelines on amalgam in place.

The complete “Study on the potential for reducing mercury pollution from dental amalgam and batteries”, conducted by BIO Intelligence Service, a Paris-based environment and sustainable development consultancy, can be downloaded at http://ec.europa.eu/environment/chemicals/mercury/pdf/Final_report_11.07.12.pdf

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  • John Bayne, Patea 4520, South Taranaki, New Zealand Nov 25, 2012 | 9:25:34 AM

    I think those opposed to anything toxic, but most particularly mercury amalgam and flouridated municipal water supplies, should look at the cunningly devised laws which have no doubt been drafted after much expense on the part of those who benefit most from these two unacceptable practices. For example, knowing that most people would not dream of anyone paying at all let alone a lot of money to purchase a certain highly toxic waste which would otherwise be a terrible bother to those responsible for creating this toxic waste (in the case of flouridation, the fertiliser manufacturers and the aluminium smelting industry). The chemical description of this toxic waste is: "hexafluorosilicic acid (H2SiF6). This stuff is as bad or worse than the gases it is formed from through the wet scrubber which has been put into the top of the industrial chimneys to stop the devastation which the fertiliser industry had caused through the two gases which had been traditionally emitted hydrogen flouride gas (HF) and Silicon tetrafluoride (SiF4). Apparently these two gases almost wiped out the Florida citrus industry they are so toxic. So how is it that the companies may not dump this hesafluorosilicic acid (H2SIF6) which is also mixed with traces of arsenic and lead, anywhere but in our municipal water supplies. Easy! A very wicked law has been written which defines anything purchased as a 'product' and under this technical term, provided that teh council pays for this toxic waste, it may be dumped into the water supplies. Does this mean that, being legal, it is any better than if it were not paid for? Not at all, for if the council's dumped even a small amount of this toxic waste into our waterways which it had not purchased, or if, by accident, twice the amount that what was paid for was accidentally sent and all dumped into the water supplies? If it became known adn could be proved, they would get into exactly the same kind of trouble which the fertilisers companies would get into if they had dumped it into the sea, not having paid for it. Someone should look into the legal definitions concerning mercury amalgams to see if any similar legal twisting is going down, concerning mercury amalgams. Regards John Bayne

  • Samantha-S. Malekides-Kruse Nov 1, 2012 | 12:33:10 PM

    What about the mercury in the "so called" energy-saving bulbs? They should be banned as well. Here in Cyprus we do not have special collection places for old and destroyed bulbs. They are wasted with the normal garbage.

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