Local NGO push for use of mercury-free dental fillings

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NEXT time you visit your dentist, make sure you ask for mercury-free dental fillings. This is the message that AGENDA for Environment and Responsible Development is seeking to get across to the public as part of an awareness campaign against the use of mercury in dental care.

The Dar es Salaam-based NGO is one of more than 30 Civil Society Organizations (CSOs) that have signed the Abuja Declaration calling for Africa to be the first continent on the planet to end the use of mercury in dental care. “Amalgam fillings are 50% mercury, a major neurotoxin.

Its continuous use is not justified because alternatives are now affordable, effective, and available in Tanzania and Africa in general,” observes AGENDA Executive Secretary and Senior Programme Officer, Mr Silvan Mng’anya.

His views are seconded by the World Health Organization report Future Use of Materials for Dental Restoration, which states thus: “recent data suggest that RBCs (resin-based composites) perform equally as well as amalgam – and offer additional oral health benefits because adhesive resin materials allow for less tooth destruction and, as a result, a longer survival of the tooth itself.

” On the other hand, a website on health issues, Mercola.Com outlines that a lesser-known alternative is increasingly making mercury- free dentistry possible even in the rural areas of developing countries.

A traumatic restorative treatment (also called alternative restorative treatment or ART) is a mercury-free restorative technique that has been demonstrated a success in a diverse array of countries around the world, including Tanzania, India, Brazil, Zimbabwe, Turkey, South Africa, Thailand and the United States.

ART relies on adhesive materials for the filling (instead of mercury) and uses only hand instruments to place the filling, making it particularly well-suited for rural areas of developing countries.

According to Mr Mng’anya, concerted efforts are needed to check the use of mercury especially now when the heavy metal’s devastating effects on the environment and people’s health is well documented.

He says the fight against mercury use in dental care is just a component of an all out anti mercury use campaign in the country.

AGENDA’s Programme Officer (Implementation), Ms Dorah Swai says the campaign against mercury use is underway, involving various NGOs and stakeholders from the Ministry of Health and Social Welfare.

Ms Swai expresses her concerns that dentists normally do not give their patients options to choose between mercury and non mercury amalgams when treating them.

“By raising awareness of the public on health risks associated with mercury use in dental care, patients would be able to make informed decisions next time they visit their dentists for fillings,” she notes.

She also points out that exposure to mercury also puts dentists’ health at risk, while disposal of the heavy metal if not done professionally may harm the environment around hospitals.

AGENDA and other CSOs’ concern base on the fact that dental mercury accounts for 10 per cent of annual global mercury consumption and 260-340 metric tons of mercury pollution around the world each year.

The dental amalgam mercury enters the environment via various pathways, polluting air via cremation, dental clinic releases, and sewage sludge incineration; water via human waste and dental clinic releases to septic systems and municipal wastewater; and soil via landfills, burials, and fertilizers.

Once dental mercury is in the environment, bacteria in soils and sediments may convert it to methylmercury, “a highly toxic form that builds up in fish, shellfish and animals that eat fish, thereby making fish and shellfish the main sources of methylmercury exposure to humans. In the dental workplace, uncontrolled mercury vapours are a major occupational risk, especially to young women of childbearing age.

Mr Mng’anya says the restriction on mercury use is demanded worldwide in the new Minamata Convention on Mercury, adopted by more than 140 governments and the European Union in 2013, in Kumamoto Japan. 102 nations including Tanzania signed the convention on its first day on October 10 last year.

Currently there are 128 signatories and 6 ratifications. “We are calling on Africa to be the first continent in ending the use of mercurybased dentistry.

In the whole world, amalgam use is lowest in Africa, so we are nearer to the finish line than any continent. “The CSOs say that the toxic trade in dental mercury -- which can be diverted into illegal gold mining uses -- needs to be ended.

The surest route is to have a ban on the use of dental amalgam in all countries of the continent, and have mercury-free dentistry,” reads the CSO’s joint communique.

Mercuryfree dentistry is growing in Africa. Recent studies in Côte d’Ivoire and Tunisia show that, already, almost 30 per cent of dentists are using alternatives to dental amalgam.

As per the joint communiqué, African countries are requested to declare that the children of Africa -- and all the people of Africa -- have a basic human right to mercury-free dental care and a mercury-free environment.

The request follows the existence of sound scientific evidences that mercury can damage children’s developing brains and nervous systems even before they are born.”

In addition to the literature, the Minamata Convention on Mercury, noted that the world recognizes dental amalgam as a major environmental pollutant which requires each participating nation “to phase down the use of dental amalgam.”

The declaration highlights that mercury, which is used in dental amalgam, is a restorative material that is approximately 50 per cent elemental mercury, and is a notorious heavy metal of global concern that is known to be a potent poison of the human nervous system.

The CSOs are also reminding the African countries on their efforts during negotiations of the Minamata Convention, which saw them work very hard to make sure that reduction in dental amalgam use is specifically included in the treaty, strongly arguing for the phase out of amalgam generally and for an end to amalgam in milk teeth specifically.

In the African Regional consultation held in Pretoria two years ago, a plan for dental amalgam was boldly adopted – the phase-down steps – that coupled with subsequent amendments was enshrined into the treaty. The reference is also made to the Libreville Declaration on Health and Environment in Africa.

“The phase down is possible since Mercury-free dental restorative materials are far less expensive than dental amalgam when environmental and societal costs are factored in.

The costs of using mercury- free options (including retreatment) is about half the cost of amalgam without retreatment, making this mercury-free technique significantly more affordable in low-income communities, particularly in areas without electricity or dental clinics,” the Communique further explains.

The CSOs call the African countries to work together and make Africa the first continent with mercury-free dentistry – considering that the current amount of dental amalgam used in Africa is much closer to zero than in any other continent.

In 2010, the Sub-Saharan African Region used just six tonnes of dental mercury. In addition, the CSOs call the countries to adopt effective amalgam phase down strategies that have been proven in nations that have already phased out or significantly reduced dental mercury use by raising awareness about dental mercury to parents, consumers, dental workers, health professionals, and educators, promoting the benefits of non-mercury dental restorative materials, considering government programmes and insurance policies that favour non-mercury dental restorative materials among others.

Furthermore, the CSOs call African countries to reject the double standard mentality which infers that Africans must accept toxic chemicals that the rest of the world rejects.

In the first anniversary after adoption of the Convention, the NGOs that endorsed the Abuja Declaration, launched an African Day of Mercury-Free Dentistry on October 13, this year and requested governments to speed-up ratification and implementation of the Convention.