Amalgam is liquid mercury and metal alloy mixtures used in filling cavities caused by tooth decay especially in children under 16 years, pregnant women and breastfeeding mothers. Research shows that amalgam contains 50 percent elemental mercury. Exposure to mercury can harm the brain, heart, kidneys, lungs, cardiovascular system and immune system, particularly in women, unborn children and infants. As a result of the dangers posed by the use of amalgam, stakeholders now call for the use of alternatives. This call for alternatives heralded the process of phasing out dental amalgam in many nations of the world, including Nigeria.
In Nigeria, Edo State has set the pace via a workshop tagged, “Phasing Down of Dental Amalgam Use in Edo State”, with the aim of heralding the process of phasing out amalgam use in the State in particular and Nigeria in general. The phasing out process was endorsed by the Edo state Commissioner for Health, Dr. David Osifo and his counterpart in the Ministry of Environment, Honourable Reginald Okun. It is of joy to note that the Minamata convention of 2013 has been ratified by the Federal government of Nigeria.
According to United Nations Environment Programmes, dental amalgam constitutes a global mercury consumption of about 313 – 411 tons yearly. It is one of the largest consumer uses of mercury in the world. The demand for dental mercury is higher than for almost any other mercury product – more than lighting (only 120 – 150 tons), measuring devices (only 170 – 210 tons). As other mercury products are phased out, amalgam is fast becoming the largest source of mercury pollution from products.
Dental mercury pollutes the water, air and soil. It pollutes the water through dental clinic releases and human waste; the air through cremation, dental clinic emissions, sludge incineration, and respiration and the soil through landfills, burials.
As a result of phasing out dental amalgam use in Nigeria various awareness campaign and programmes have been organized and a degree of success has been achieved. The West African Summit on phasing out Amalgam was held in Abuja on 20 May 2014, bringing together NGO leaders from the ECOWAS nations of Benin, Cote d’ Ivoire, Ghana, Nigeria, and Senegal, and also from Tanzania. They adopted the Abuja Declaration, then invited NGO leaders from across Africa to Join as signatories.
This is sequel to the adoption of the adoption of the Minamata Convention on Mercury in 2013, where the world recognizes that dental amalgam is a major environmental pollutant and requires each participating nations “to phase down the use of dental amalgam”
The NGO leaders called on African Countries to declare that the children of African and all the people of Africa have a basic human right to mercury – free dental care and mercury – free environment. They also called on African Nations to adopt effective amalgam phase down strategies that have been proven in nations that have already phased out or significantly reduced dental mercury by way of raising awareness about dental mercury to parents, consumers, dental workers, health professional, and educators, promoting the benefits of non mercury dental restorative materials, encouraging government programs and insurance policies that favour non – mercury dental restorative materials, training dental professionals to use non – mercury dental restorative materials and techniques; discouraging amalgam use in milk teeth (Primary teeth); protecting dental workers from mercury vapours in the workplace; etc.
As a way of heralding the phasing out of dental amalgam in Edo State as mentioned earlier, the Sustainable Environmental Development Initiative (SEDI), held a workshop in Benin City, with the theme, “Phasing Down of Dental Amalgam Use in Edo State”. The workshop brought together stakeholders from the medical profession, academia, civil society organizations, student groups, media and representatives from both the state and Federal Governments. The stakeholders frowned at the low level of awareness among Nigerians on the dangers of mercury in dental amalgam which has resulted to its wide use in Nigeria. They recommended full compliance with the provision of the Minamata convention adopted and signed by over 87 nations of the world on 9th October, 2013 at Minamata, Japan. They said that in doing this, the government should initiate a multi-sectoral approach for an effective phase down, which will lead to phase out of dental amalgam in Nigeria. They also called for the updating of dental schools training curriculum to emphasize mercury – free dentistry.
Key players that attended the workshop include: the President of World Alliance for Mercury – Free Dentistry, USA, – Dr. Charlie Brown, Lead Fellow of Sustainable Research and Action for Environmental Development (SRA Dev) – Mr. Leslie Adogame, Executive Director, Sustainable Environmental Development Initiative (SEDI) – Dr. Tom Aneni, Senior Lecturer and former Head, Department of Restorative Dentistry University of Benin – Dr. Mrs. Joan Enabulele, Rep. Federal Ministry of Environment – Mr. Bummi Olusanya, Chairman, Nigeria Dental Association (NDA), Edo State branch, Dr. Anthony Osaguona, and many others.
The workshop by SEDI was a precursor to the 6th Annual Conference/Annual General Meeting with the theme: Amalgam Phase Down: The way forward, held 6th December, 2017 by the Nigerian Dental Association (NDA), Edo State branch. The guest lecturer, Professor Matthew Sede, a former President of the Nigeria Society of Restorative Dentistry, said “Amalgam placement is a primitive procedure; it requires the removal of large amounts of unhealthy tooth matter, which permanently damages tooth structure. Then it gets worse”. He therefore calls for the use of alternatives.
According to the World Alliance for mercury – free Dentistry, “The alternatives to amalgam are now so widely available; amalgam use is rapidly decreasing around the world. For example, amalgam only accounts for less than 4% of restorations in Japan, 10% or less in Mongolia, Russia, the Netherlands, and Switzerland, and 20% in Singapore and Vietnam. Some countries like Sweden and Norway Phased out amalgam.
To SEDI, with the tons of dental mercury threatening our environment, we all must take steps to address it. Now is the time to implement proven steps to phase out dental mercury.
With the pace set by Edo State and the resolution reached at the SEDI workshop on phasing down dental amalgam, which states thus: “Assembled this 31 October, 2017, we the stakeholders of Edo State:
v Call for the end of dental amalgam use in children under 16 and for breastfeeding women as of 1st of July 2018.
v Urge the Federal Government, other states of Nigeria, all nations of Africa to end amalgam use in children under 16 and breastfeeding women as of 1st July 2018.”
Stakeholders are urged to key in and bring to reality the resolution reached in Edo State on 31st October, 2017.