Opinion: Uganda should ban use of dental amalgam mercury

ROBERT TUMWESIGYE

Mercury is a highly toxic liquid metal that attacks the central nervous system and remains in the environment for long periods of time.

Communities are exposed to the effects of mercury through air, soil, and water.

Children are more affected by mercury because their brains are still developing where most of them are affected while they are in the womb of their mothers.

Mercury is a neurotoxin which can damage brains and nervous systems of human being, and can harm developing brains of children and lead to reduced intelligence.

Other effects of mercury are tremors, impaired vision and hearing, paralysis, insomnia and emotional instability.

Also, because mercury is classified as CMR (Carcinogenic, Mutagenic and Reproductive) due to its health effects, it has negative reproductive effects: as it can damage sperms to men, birth defects, miscarriages, birth problems and developmental deficits during pregnancy and childhood.

In Uganda; like in many other African countries, mercury exposure also occurs through the numerous consumer products available on the market.

Mercury, which is used in dental amalgam, is a restorative material that is approximately 50% elemental mercury and is a notorious heavy metal of global concern that is known to be a potent poison of the human nervous system.

Dental mercury enters the environment via many release pathways, polluting air via cremation, dental clinic releases, and sewage sludge incineration; water via human waste and dental clinic releases to septic systems and municipal wastewater; and soil via landfills, burials, and fertilizer.

Also, amalgam poses “a risk for secondary poisoning because its mercury enters rivers and lakes, methylates, and contaminates fish that are then eaten by children and pregnant women.

Dental workplace, uncontrolled mercury vapours are a major occupational risk, especially to young women of childbearing age, and the amalgam is not consistent with modern dentistry.

Unlike the less invasive mercury-free filling materials, amalgam placement requires the removal of a substantial amount of healthy tooth matter, which weakens the tooth structure and can lead to more expensive dental care later.

Due to the high costs of dental mercury pollution, amalgam is now recognised as “more expensive than most, possibly all, other fillings when including environmental costs.

Because of the toxicity of mercury, the global community has agreed to phase out mercury by signing a Global Treaty called the Minamata Convention on Mercury which aims at protecting human health and the environment from the adverse effects of mercury.

The Convention draws attention to a global and ubiquitous metal that, while naturally occurring, has broad uses in everyday objects and is released to the atmosphere, soil and water from a variety of sources.

Controlling the anthropogenic releases of mercury throughout its lifecycle has been a key factor in shaping the obligations under the Convention.

In accordance with the Minamata Convention, the proposal foresees that dental amalgam can be used only in an encapsulated form and that dental facilities be equipped with amalgam separators aimed at collecting and retaining amalgam particles with a view to preventing discharge of mercury residues into sewage systems and into the environment.

The Minamata Convention advocates a phase-down of the use of dental amalgam, in line with the domestic circumstances of each country and in tandem with recommendations for prevention programmes and increased research into alternative materials.

Over the next decades, implementation of this international agreement will help reduce mercury pollution from the specific human activities responsible for the most significant mercury releases to the environment.

The ratification of the Minamata Convention is the beginning of eliminating the use of mercury, mercury containing equipments and healthcare items including dental amalgam around the world.

Uganda Government signed the Minamata Convention though it has not yet ratified it.

The Convention is an opportunity for Uganda to address this mounting problem before it gets worse.

Uganda should make a legislation that contains some specific requirements aimed at reducing the use of amalgam.

Uganda should phase down dental amalgam for children and women of the child bearing age, and later to the entire population thus making the use of dental amalgam to be history in our country and the African continent at large.

 

Robert Tumwesigye Baganda works with Pro-biodiversity Conservationists in Uganda and can be reached at: Email: tumwesigyeus@yahoo.com and Tel: +256 (0) 782 393 912