Progress in eradicating amalgam from restorative dentistry

This paper sets out the current position with respect to the replacement of dental amalgam as a restorative material. The environmental impact and the question of possible adverse effects of mercury on human health, including that of dental personnel, are reviewed. The literature has been surveyed using Pub Med with the following key words employed: dental amalgam; environmental; disposal; alternative materials. This identified a large number of papers, and more recent ones were selected for inclusion, particularly where they summarised the earlier literature. The findings of this process are that dental amalgam remains a popular and widely used material which, with appropriate hygiene measures, does not pose a threat to human health. However, environmental concerns with the mining, transport and technical uses of mercury led to the Minamata Convention in 2013, one consequence of which is that mining of mercury will cease from the year 2032. This means that dental amalgam will no longer be available for use. This article considers alternative materials. Results from the literature show that neither of the main possibilities, namely composite resins of glass-ionomer cements, compares with amalgam in terms of strength or durability. The impact of this on the dental profession is discussed briefly.