Amalgam has been used in dentistry for over 150 years and remains a durable, safe and cost-effective solution for dental restorations. However, amalgam is a combination of metals including up to 50% liquid mercury and there’s been increasing global concern about the implications caused by mercury being released into the environment resulting in numerous regulations surrounding its use.
In 2017 the European Parliament agreed its Regulation on Mercury, the EU’s method of ratifying the 2013 Minamata Treaty, a global environmental agreement aimed at reducing the release of mercury into the environment. This doesn’t ban the use of amalgam outright as it’s specifically an environmental, not a health regulation. However, its implementation has seen a series of requirements aimed at reducing and phasing out the use of amalgam in dentistry, potentially by 2030.
The Treaty’s impact on UK dentistry began on the 1st July 2018 when dental professionals were no longer able to use amalgam in the treatment of deciduous teeth, children under 15 years and pregnant or breastfeeding women, except when deemed strictly necessary on the grounds of specific medical needs of the patient. This has affected the treatment of over 12 million women and children, a significant amount of the population for whom a safe alternative to amalgam needed to be found.
Finding the alternatives
Mercury-free restorative materials are nothing new and there’s now a variety of alternatives including extremely strong, mercury-free glass ionomer restorative materials offering easy, non-stick handling and excellent adaption to cavity surfaces. riva self cure HV (SDI) is an ideal self-curing conventional glass ionomer restorative for minimally invasive dentistry, bulk fill and radiopacity. With excellent tooth adhesion and fluoride release, it can withstand high penetration of the surface and, because it does not contain resin, eliminates the problem of volumetric shrinkage after curing.
riva light cure HV (SDI) is a high-viscosity, radiopaque, resin-reinforced glass ionomer restorative that chemically bonds to tooth structure while offering the aesthetics of a composite. Designed for easy shaping and contouring without sticking to instruments, it can be manipulated immediately after mixing and resists any threading traditionally found with a light cured glass ionomer composite. With sustained fluoride release, high compressive strength and command set it can be used for a wide range of restorative applications.
The end for mercury
The phasing-down of the use of amalgam is already impacting on UK dentistry, considering how long it has been and continues to be used as a restorative material. With a move towards more patient-centred, minimally invasive and preventative dentistry, based on the use of tooth-coloured restorative systems, finding suitable mercury-free aesthetic alternatives to amalgam that are fast to place, cost-effective and long-lasting, is key.
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