Consensus statement issued on phasing down use of dental amalgam in Hong Kong

     The Department of Health (DH), joined by the Dental Council of Hong Kong, the Faculty of Dentistry of the University of Hong Kong, the College of Dental Surgeons of Hong Kong and the Hong Kong Dental Association, issued the "Consensus Statement on the Minamata Convention on Mercury and Phase Down of Dental Amalgam in Hong Kong" today (October 18). The statement was issued to support the requirement of the Minamata Convention on Mercury to phase down the use of dental amalgam for a better environment, and to reaffirm the safety of dental amalgam as a filling material in dental procedures.
 
     The Convention is an international treaty that aims to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds. It was signed in 2013 by 128 signatory nations and entered into force in 2017. The Convention also applies to Hong Kong.
 
     As required by the Convention, the use of dental amalgam shall be phased down gradually. Under the statement, five recommendations to phase down the use of dental amalgam in Hong Kong are made as follows: 
 
1. Non-mercury containing filling materials should be considered as far as practicable. Amalgam may be considered for conditions which are suboptimal for non-mercury containing restorative materials, such as difficult moisture control;
 
2. Dental amalgam must only be used in pre-dosed encapsulated form;
 
3. Amalgam separators are strongly recommended to be installed to retrieve the amalgam debris and residues;
 
4. Amalgam waste must be properly stored, handled and disposed of in accordance with the provisions of the Waste Disposal (Chemical Waste) (General) Regulation; and
 
5. Dental amalgam restorations should not be removed and replaced with alternative restorative materials without clear clinical indications. In the case of a patient's request based on non-specific or perceived health complaints, the patient should be fully informed of the implications of this decision.
 
     A spokesman for the DH said, "Although dentistry contributes only a very small proportion of mercury to the environment, there are concerns over its potential impact on the environment. The statement represents the collaborative effort by the Government and the profession to take responsibility to improve the environment."
 
     Dental amalgam has been widely used for more than 150 years because of its ease of use, durability, appropriate mechanical properties and cost-effectiveness. A number of evidence-based studies have also confirmed its safety in dentistry.
 
     International authorities (including the World Health Organization and the World Dental Federation), governments, national dental associations and dental professional organisations have supported the safety and effectiveness of dental amalgam as a filling material. As dental amalgam may have better performance than other alternative filling materials in certain situations, they consider that it should remain available as a treatment option for the time being.
 
     For the full statement, please visit the DH Dental Service's website (www.dh.gov.hk/english/main/main_ds/files/consensus_statement.pdf).