Stakeholders brainstorm impact of mercury in dental amalgam

The Ecological Restorations in collaboration with the World Alliance for Mercury-Free Dentistry and the Global Environment Facility - Small Grants Programme (GEF/SGP), has initiated moves to assess the impact of mercury in dental amalgam.

The stakeholders also used the platform to gather information and other alternatives ways forward towards the Phase-down or phase -out of dental amalgam.

The workshop was attended by representatives from the Ghana Health Service, civil society organisations, media practitioners and cross section of the public in Accra.

Speaking at the workshop, the Executive Director for the Ecological Restorations, Mr Emmanuel Odjam-Akumatey called for more education on the effects of mercury, the ratification of the government of the Minamata Convention, a global agreement to protect human health and the environment from the adverse effects of mercury.

He noted the need to raise awareness among stakeholders and find strategies to help reduce, find alternatives to or eliminate mercury use.

Mr Odjam-Akumatey said where there is a possibility there should be the elimination or Phase-Down/Out mercury in dental practice and mercury products.

Dr Emmanuel K-Amoah of the Occupational and Environmental Health Unit of the Ghana Health Service (GHS) noted that dental amalgam is the combination of about 50 per cent (mercury in elemental form) and 50 per cent (other metals silver, tin, copper, trace metals).

He said it has been used in the last 150 years for dental restoration and it was introduced to the western world in France in the 1830s.

He cited the health effects of dental amalgam: tremors, impaired vision and hearing; paralysis, insomnia, emotional instability; developmental deficits during foetal development; attention deficit and developmental delays during childhood. do not occur.

He identified alternatives to dental amalgam as the use of composite resins fillings and the glass ionomer cement fillings.

Dr K-Amoah however said the problem is that they are more expensive and as such cheaper alternatives had to be sourced.

Dr Eva Evelyn Opoku, Dentist from the Department Of Restorative Dentistry, School of Medicine And Dentistry, Korle Bu added that, research on monkeys had shown that mercury released from amalgam restorations is absorbed and accumulated in various organs such as the kidney, brain, lung, liver, gastro-intestinal tract and the exocrine glands.

She noted that the current use of amalgam has not posed a health risk apart from allergic reactions in few patients.

She said clinical justifications have not been available for removing clinically satisfactory amalgam restorations, except in patients allergic to amalgam constituents.

She said mercury hypersensitivity is an immune response to very low levels of mercury.

“There is no evidence that mercury released from amalgams results in adverse health effects in the general population.

“If the recommended mercury hygiene procedures are followed, the risks of adverse health effects in the dental office could be minimised.

“Amalgam is safe and effective restorative material and its replacement by non-amalgam restorations is not indicated,” she noted.

Dr Opoku noted that a recent review by the American Dental Association Council on Scientific Affairs states that: “Studies continue to support the position that dental amalgam is a safe restorative option for both children and adults. When responding to safety concerns it is important to make the distinction between known and hypothetical risks.”

Mr George Ortsin, National Coordinator of GEF/SGP, who chaired the workshop called for research and legislation into the proper use and disposal of mercury in Ghana.

Dr Chloris Adadevoh, Retired Dentist, called on the government to include at least 30 per cent of dental amalgam in the National Health Insurance Scheme, so that people could pay the remaining 70 per cent in other to switch from using dental amalgam to either of composite resins fillings or the glass ionomer cement fillings.