Update dental curricula

dental students
Dental students learning about mercury-free dentistry in Bangladesh

The Minamata Convention lists “encouraging representative professional organizations and dental schools to educate and train dental professionals and students on the use of mercury-free dental restoration alternatives” as a measure to phase down amalgam use.  To reach the next generation of dentists, dental curricula must be updated – from classroom lecture…to dental school clinics… to licensing exams.

Why is it effective? 

Updating dental school curricula to promote mercury-free dentistry can help phase down amalgam use. Many dental schools still teach amalgam first and then provide instruction on mercury-free dental restorations later.  Consequently, dentists tend to rely on amalgam, especially in posterior teeth (back teeth).  As a recent study explains, “The risk in providing instruction in amalgam placement techniques before posterior resin-based composite placement techniques is that students base their approach to operative dentistry on outdated principles” (Lynch 2011).

Where has it been effective? 

In many nations where dental schools give preference to mercury-free dental restorations, amalgam use has been phased down or phased out.  For example:

  • Japan: 93% of dental schools in Japan are reported to teach the use of mercury-free dental restorations as preferable to amalgam.
  • Netherlands: Dental schools in the Netherlands are reportedly phasing out instruction on amalgam use.
  • Sweden: By the early 2000s, dental schools in Sweden provided instruction on mercury-free fillings first while amalgam instruction was only a small – and mostly theoretical – part of the training later.

How can it be implemented?

Nations can direct dental schools – especially government-funded dental schools – to update their curricula by instructing them to implement the following steps:

  • Inform students that amalgam is a major source of mercury pollution in the air, water, and land.
  • Explain the benefits of using mercury-free dental restorations, including how they preserve tooth structure consistent with the principles of minimally-invasive dentistry and reduce environmental health impacts.
  • Emphasize training in the use of mercury-free dental restorations and techniques, including atraumatic restorative treatment (ART).
  • Require competency exams only for mercury-free dental restorations.
  • Set a date to end amalgam use in dental school clinics.
  • Establish a date to end amalgam instruction in the classroom.