In India, Toxics Link, a non-government organisation working on chemical pollution, has written to Dental Council of India (DCI) seeking ban on its use. “Children lose their milk tooth, hence filling cavities with mercury amalgam only generates more mercury bearing waste and also exposes the child to further risks of mercury toxicity,” claimed Satish Sinha, associate director of Toxics Link.
He added that use of this mixture for pregnant women and lactating mothers also has the risk of exposing the fetus and the child to the effects of mercury toxicity, which is totally avoidable. Dr Ajoy Roychoudhury, professor and head of oral and maxillofacial surgery at AIIMS, said the premier institute had already switched to composite filling instead of dental amalgams.
“The harmful effects of dental amalgams that contain mercury outweigh its benefits such as lower cost and durability. It must be phased out,” he said, adding that DCI and the central government should come up with an advisory to completely ban them.
Around 50-55% of the Indians suffer from caries or tooth decay. Around 30% of them require dental filling at some point of life, Dr VikrantMohanty, associate professor and head of the department of public health dentistry at Maulana Azad Institute of Dental Sciences (MAIDS), told TOI. Phasing out use of amalgams is a must, he added.
MAIDS, Dr Mohanty said, uses amalgam fillings mainly for academic requirements and not to treat patients. In 2013, countries taking part in an UN-led conference held in Kumamoto in Japan adopted Minamata Convention against mercury pollution.
Experts say being a signatory to it, India should take steps to cut down on usage of the chemical pollutant.
They, however, raise concerns about available substitutes as well. For example, composite restorations, some studies have shown, do not last as long as dental amalgams. There are also reports of clinical limitations and toxicological hazards of alternative materials that need to be addressed, experts point out.
“Most people ask for composite fillings even in smaller set ups these days as it is more aesthetic compared to the dental amalgam. However, caries involving proximal surfaces of premolars and molars sometimes dental amalgam filling because they last longer compared to the substitutes,” Dr Pradeep Yadav, a South Delhi based dentist. Besides healthcare products, mercury is also used in paints, cosmetics, electrical switches and fertilisers.