How will you adapt to Minamata?

30 June 2016

The topic under discussion at the 2016 World Oral Health Forum at FDI 2016 Poznań will be 'Are you ready for amalgam phase-down? How the Minamata Convention impacts your Dental Practice'.

The 2013 Minamata Convention on Mercury lists nine measures for a phase-down of dental amalgam - a mercury-added product containing 50% mercury - making it highly relevant to the dental profession. At least two of these measures should be included in a national phase-down programme, taking into account "the Party’s domestic circumstances and relevant international guidance".

The Forum will feature five speakers, with subjects directly or indirectly related to six of the nine provisions. It will be chaired by Prof. David Williams, FDI Science Committee Vice-Chair, and Dr Christopher Fox, Executive Director, International Association for Dental Research. The scheduled speakers are: 

Phase-down

  • Dr Christopher Fox will speak on 'Why we need to commit to the phase down of dental amalgam use'.

This indirectly relates to provisions (i) Setting national objectives aiming at dental caries prevention and health promotion, thereby minimizing the need for dental restoration and (ii) Setting national objectives aiming at minimizing its use.

Research

  • Prof. Jocelyne Feine is the editor of JDR Clinical & Translational Research, will address 'Translational research: bringing new technology/treatments to practice'.

This directly relates to provision (iv) Promoting research and development of quality mercury-free materials for dental restoration.

Mercury-free alternatives

  • Prof. Gottfried Schmalz, Head of the Department of Operative Dentistry and Periodontology Dean of Dental School, University of Regensburg, Germany, who will pose the question 'Restorative materials after Minamata: What will be left?'.
  • Dr Jirun Sun, a dedicated polymer scientist, with postdoctoral experiences at the National Institute of Standards and Technology, will talk about 'New materials for a post-Minamata era'.

These indirectly relates to provision (iii) Promoting the use of cost-effective and clinically effective mercury-free alternatives for dental restoration and (iv) Promoting research and development of quality mercury-free materials for dental restoration.

Resource-constrained settings

  • Dr Benoît Varenne, Regional Advisor on Oral Health, World Health Organization (WHO) Regional Office for Africa, who will focus his remarks on 'What does Minamata mean for the oral health community in a resource-constrained setting? The WHO views and perspectives for the Africa region'.

This relates directly and indirectly to provisions (ii) Setting national objectives aiming at minimizing its use; (v) Encouraging representative professional organizations and dental schools to educate and train dental professionals and students on the use of mercury-free dental restoration alternatives and on promoting best management practices; (viii) Restricting the use of dental amalgam to its encapsulated form; and (ix) Promoting the use of best environmental practices in dental facilities to reduce releases of mercury and mercury compounds to water and land.

Convention provisions on dental amalgam

The Minamata Convention on Mercury was approved by 100 signatory countries in 2013 - today 128 signatory countries - and has already been ratified by 28 countries. It enters into force 90 days in ratifying countries after ratification by 50 countries. 

Of the 28 ratifications, 13 are from the African region, i.e. Botswana, Chad, Djibouti, Gabon, Guinea, Lesotho, Madagascar, Mali, Mauritania, Mauritius, Senegal, Seychelles, and Zambia. Eight are from the Americas region, i.e. Bolivia, Guyana, Mexico, Nicaragua, Panama, Peru, the United States of America and Uruguay and three from the Middle-East, i.e.  Jordan, Kuwait and the United Arab Emirates. The remaining ratifying countries are Japan, Monaco, Mongolia and Switzerland.

As FDI pointed out on page 5 of its 2013 'Guidelines for successful implementation', the Minamata Convention should not lead to any changes in the availability of dental amalgam in the immediate future. However, in the longer-term, restrictions in mercury sourcing and trade in Article 3: Mercury supply sources and trade, are likely to have an impact on the availability and cost of the base product mercury and hence, on amalgam.

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