Dental amalgam

The Minamata Convention on Mercury

The Minamata Convention on Mercury is a global treaty to protect human health and the environment from the negative effects of mercury. It was adopted in October 2013 and entered into force in August 2017. To date, 89 countries have ratified the Convention. Since its adoption in 2013, FDI has supported the implementation of the Convention.

How does the Convention impact the dental profession?

The Convention has specific provisions for dental amalgam —a metal mixture used for tooth fillings containing 50% mercury that has been used around the world to repair tooth decay for over 150 years.

In the Convention, dental amalgam is the only mercury-added material subject to a phase-down. All other mercury-added materials addressed in the Convention are subject to a ban or phase-out.

Annex A, Part II, of Article 4 on mercury-added products and dental amalgam outlines nine provisions for the phase-down of dental amalgam; ratifying countries must commit to implement two or more of these provisions. FDI has focused advocacy efforts on the provisions relating to: prevention; promoting research and development of quality mercury-free materials for dental restoration; and best management practices for amalgam waste.

Why a phase-down and not a phase-out?

Affordable alternatives to dental amalgam are not available everywhere. In many parts of the world, dental amalgam is often the only available resource to repair tooth decay. Therefore, FDI advocates a phase-down, and not a complete phase-out, of this material. Prohibiting the use of dental amalgam before appropriate alternatives are available would negatively impact oral health from both an individual and population perspective.

To successfully phase-down dental amalgam, there must be a greater emphasis on prevention, increased research on amalgam alternatives, and best management practices for amalgam waste.

FDI, National Dental Associations, partners, and individual dental professionals have a critical role to play in ensuring that the impact of the convention is positive. Dental professionals living in a country that has ratified the Convention need to be aware of the direct impact this will have on their profession.

FDI encourages dental practitioners to:

FDI will continue the dialogue with industries on the manufacture of safe alternatives to dental amalgam and call for affordable access, specifically in low-and middle-income countries (LMICs).

For more information, download Dental restorative materials and the Minamata Convention on Mercury: guidelines for successful implementation. Visit our page on the 2016 World Oral Health Forum, which was dedicated to this topic.

COP1 to the Minamata Convention on Mercury

The Conference of the Parties (COP) to the Minamata Convention on Mercury is the decision-making body of the Convention. At the COP, all countries and regional economic organizations that have agreed to abide by the Convention come together to review compliance with the Convention and promote its effective implementation.

FDI represented the oral health community at the first Conference of the Parties (COP1) held in Geneva, Switzerland, from 24-29 September in 2017. It was important for FDI to attend in order to influence discussion around dental amalgam phase-down, rather than phase-out, and represent the interests of our NDA members.

FDI’s position has always been that amalgam phase-down can only be a reality if access to safe, effective, affordable alternatives, specifically in LMICs, are made a priority together with financial support.

FDI took a leadership role during the negotiation stage of the Convention and together with our members, the World Health Organization (WHO), and the International Association for Dental Research (IADR), successfully lobbied for the phase-down and not phase-out of dental amalgam.

In the lead up to COP1, WHO held a side event themed For Health, Make Mercury History. FDI made a joint statement with IADR to support WHO and Member State efforts in the implementation of Resolution WHA67.11, Public health impacts of exposure to mercury and mercury compounds: the role of WHO and ministries of public health in the implementation of the Minamata Convention, and to emphasize its longstanding position on dental amalgam phase-down. FDI and IADR also called on WHO to update its 2009 publication, WHO Guidelines on Future Use of Materials for Dental Restoration, to help in the phase-down of amalgam in a practical, evidence-based way. In preparation for COP1, FDI also drafted guidance on interim storage of mercury that is not part of the mercury waste category.

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