Immediate ban on dental amalgam in PH pushed
MANILA, Philippines – Environmental activist groups are pressing the government to immediately stop the use of dental amalgam – and to change the dental curriculum accordingly – even before the 2016 deadline for its phaseout.
They have cited a study proving that there are high levels of mercury vapor in dental schools and supply stores because of the amalgam and that this can cause cancer.
Amalgam is a mixture of mercury and other metals that is used in dental fillings.
Dental medicines practitioners – dentists, dental hygienists, dental auxiliaries, dental clinical instructors, dental students, and dental supply traders – are all prone to mercury intoxication through inhalation of mercury vapors from activities and procedures like preparation, drilling, polishing, and storing.
Ban Toxics, an environmental and social justice group, said mercury vapor in 5 Philippine dental institutions and 3 dental stores that they checked exceeded the standard reference levels set by the US Environmental Protection Agency (US EPA), endangering the health and well-being of dental students, dental workers, and patients.
Myline Macabuhay, assistant coordinator for chemicals management of Ban Toxics, said: “The exposure to toxic mercury vapors in the dental institutions is not only dangerous, but unnecessary and preventable. Learning methodologies can be put into place to avoid toxic mercury. This should itself be a strong incentive as well to abandon dental amalgam use in its entirety in the Philippines.”
The study, “What is in the Air: Mercury Vapor Levels in Dental Institutions” was conducted in partnership with the International Association of Oral and Medical Toxicologists-Philippines (IAOMT-Philippines), World Alliance for Mercury-Free Dentistry, and Asia Center for Environmental Health.
It measured mercury vapor concentrations from identified sources – such as equipment and facilities used in amalgam procedures, storage and immediate disposal sites, among others – using Lumex RA-915 Mercury Vapor Analyzer, an instrument that measured mercury levels over five-second and10-second sampling periods.
It was found that mercury concentration values varied from 967 nannogram per cubic meter (ng/m3) to a high 35,617 ng/m3, the majority of which were at levels beyond recommended reference standards such as the Agency for Toxic Substances and Disease Registry (ATDSR) action level of 1,000 ng/m3.
Some areas posted a concentration of more than 10,000 ng/m3, which is considered as the evacuation alert level by the US EPA.
Leading source of mercury poisoning
Macabuhay said the use of dental amalgam or “silver pasta or silver filling,”, is used as a restorative material for teeth that have cavities. “It is still prevalent specifically in dental schools, where it is a requirement for dentistry licensure exams.”
Dental amalgam is an alloy of mercury (50%), silver (22-32%), tin (14%), copper (8%), and other trace materials. Due to amalgam's mercury component, pediatricians and toxicologists acknowledge that it is a potent toxic substance that causes adverse effects on neurologic, gastrointestinal, and renal organ systems of patients.
The International Agency for Research on Cancer (IARC) of the World Health Organization recently confirmed that mercury is a human carcinogen.
Conducted from June to July 2013, the study was supported by the World Alliance for Mercury-Free Dentistry and the Swedish Society for Nature Conservation.
Prior to this study, the United Nations Environment Programme concluded that mercury poses great risks to human health and the environment after conducting a global study in 2002 on the impacts of mercury. In 2005, the UNEP estimated that 362 tons of dental mercury is consumed worldwide annually.
The study said, in the Philippines, the dental industry remains to be one of the main sources of mercury or as a base substance in the creation of dental amalgams or fillings. Depending in tooth characteristics and cavity size, the average mouth filling can contain three to four grams of mercury.
Further, the study said dental amalgams are the leading source of mercury intoxication for people who have them, as the chemical comes out from the filling in vapor form and its amount depends upon factors such as number and amount of fillings and temperature of ingested food and drinking liquid and activities like chewing and grinding of teeth.
Particularly alarming is the huge number of dental amalgam restoration installed to mannequins and actual human patients in dental schools that are training grounds for students to practice their skills in preparation for the counterpart licensure examination of the Philippine Dental Professional Regulations Commission.
Dr Lillian Ebuen, president of IAOMT-Philippines, said that the government phaseout of dental amalgam in 3 years is most welcome, because “mercury-free alternatives are now widely available and are safer and cost-effective as amalgam.”
She stressed, however, that “Philippine dentistry should move beyond amalgam and should prepare the future generation of dentists to embrace better and safer alternatives for their patients.”
Ebuen also said the Philippines agreed with international health authorities that mercury is considered a major environmental pollutant and signed the Minamata Convention of Mercury in 2013.
Ban Toxics called on the leaders of Philippine dentistry to change in the dental curriculum in schools to exclude the required use of dental amalgams. This is in line with the move to phase out mercury use in the health sector by 2016, to be implemented by the Department of Health. – Rappler.com
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