The end of the road for dental amalgam

What to expect

Amalgam’s days have been numbered since the Minamata Agreement, signed by 143 countries in 2013. It was widely thought that the date for a final phasing out of amalgam would be 2030, but late last year the EU published a draft document, which has since been ratified, which “sets rules that put the EU firmly on the track to becoming the first mercury-free economy” by:

• Introducing a total phase-out of the use of dental amalgam from 1 January 2025 in light of viable mercury-free alternatives, thereby reducing human exposure and environmental burden;
  Prohibiting the manufacture and export of dental amalgam from the EU from 1 January 2025;

As a result, supply chains will be disrupted and cost of amalgam will, almost certainly, rise significantly because it will have to be imported from countries such as India and Mexico. In effect, dentists worldwide will have to find an amalgam replacement.

This webinar will trace the demise of dental amalgam and discuss potential “viable alternatives”. In Trevor’s view, these include various types of resin composite materials suitable for posterior teeth (such as, conventional and bulk fill) plus a novel self-adhesive resin composite (perhaps the first true amalgam replacement) and their associated bonding agents. Glass ionomer materials, on the other hand, do not need an intermediate bonding agent (as resin composites do), and are less time consuming to place as a result. They therefore might be considered a suitable alternative to amalgam, except for the fact that their wear resistance was suboptimal and interproximal box fracture was common. The latest glass ionomer variants, the glass hybrid materials, will therefore be appraised – might they be potential amalgam replacements? Evidence will be presented regarding the clinical success of these materials in loadbearing situations in posterior teeth, alongside with suggestions for their placement.

This is a recording of a webinar that took place on 15 May 2024.

Learning objectives

• Understand why dental amalgam’s days are numbered
• Understand the most recent developments in resin composite materials for loadbearing situations in posterior teeth, their cost comparison with dental amalgam and how to avoid post-operative problems
• Understand how glass ionomer (GIC) materials have developed over fifty years
• Be aware of the clinical performance of most recent GIC materials in loadbearing situations in posterior teeth.

Development outcome

C

Meet the speaker

Trevor Burke graduated at Queens University Belfast. Following appointments in Belfast and Manchester, he worked in general dental practice from 1975 to 1996 in Manchester and part time at the University of Manchester. His first Chair was in Glasgow in 1996, becoming Professor of Primary Dental Care at the University of Birmingham / Hon. Consultant in Restorative Dentistry in 2000, before retiring from there in October 2020. He still sees patients in private practice.

Trevor is co-author of 380 papers published in peer-reviewed journals and three books. His principal research interest is work on restoration survival, using a database of 13 million restorations at 16 years.