In an extraordinary development that will change the global debate about amalgam, the United States government has announced that it supports a “phase down, with the goal of eventual phase out by all Parties, of mercury amalgam.” This statement – a radical reversal of its former position that “any change toward the use of dental amalgam is likely to result in positive public health outcomes” – is part of the U.S. government’s submission for the upcoming third round of negotiations for the world mercury treaty.*
While couched in diplomatic hedging – remember it is still early in the negotiations – this new U.S. position makes three significant breakthroughs for the mercury-free dentistry movement:
1. The U.S. calls for the phase-out of amalgam ultimately and recommends actions to “phase down” its use immediately. Incredibly, the government adopted three actions that the World Alliance for Mercury-Free Dentistry and Consumers for Dental Choice proposed at the negotiating session in Chiba, Japan. Our key ally, The Mercury Policy Project, had laid the groundwork for this success at a World Health Organization meeting in 2009!
2. The U.S. speaks up for protecting children and fetuses from amalgam, recommending that the nations “educat[e] patients and parents in order to protect children and fetuses.”
3. The U.S. stands up for the human right of every patient and parent to make educated decisions about amalgam.
What does this mean? Our position – advocating the phase-out of amalgam – is now the mainstream because the U.S. government supports it. Who is the outlier now? It’s the pro-mercury faction, represented by the World Dental Federation and the American Dental Association. With the U.S. continuing its leadership role in this treaty, we will broadcast the U.S. position to other governments around the world, encouraging them to support amalgam “phase downs” leading to phase-outs not only globally, but within each of their countries.
We applaud the U.S. government. But tough work lies ahead. For example, we must demonstrate to the world that the available alternatives – such as composites and the adhesive materials used in atraumatic restorative treatment (“ART”) – can cost less than amalgam and increase access to dental care particularly in developing countries.
For now though, let’s mark this watershed in the mercury-free dentistry movement: the debate has shifted from “whether to end amalgam” to “how to end amalgam.”
Charles G. Brown
National Counsel, Consumers for Dental Choice
President, World Alliance for Mercury-Free Dentistry
"We are aware that several delegations at INC-2 suggested mercury amalgam should not be included in Annex C, noting a number of difficulties and complexities related to this issue. The United States supports further consideration of dental amalgam by the INC such that the agreement is able to achieve the phase down, with the goal of eventual phase out by all Parties, of mercury amalgam upon the development and availability of affordable, viable alternatives. To the extent that Annex C is not structured to accomplish such a goal, the United States believes that a number of obligations could be considered within an appropriate operative paragraph of the agreement itself. Such a paragraph could commit Parties to phase down the use of mercury amalgam or address mercury releases through conducting and promoting further research on alternatives, mandating the use of separators in dental offices, promoting and incentivizing prevention strategies, educating patients and parents in order to protect children and fetuses, and training of dental professionals on the environmental impacts of mercury in dental amalgams, and to report on their progress in doing so to inform the Conference of the Parties on the progress being made to phase down amalgam use.”
Indeed good news! However, it would be good that also health reasons (not only environmental ones) are cited for the phase down (then phase out) of dental mercury amalgams (let's not use the false word 'silver'). Moreover, it is extremely important that UNEP sets a date for the phase out/ban of dental mercury amalgams, because dental materials are there and because otherwise the 'phase down' could be for ever. More adequate dental materials are available since many years ago (composites, A.R.T., etc.), and these alternative materials, at the end, are extremely cheaper that dental mercury amalgams if we see the whole picture and sum up the avoided costs in labour, illnesses, environmental costs...
(President of MERCURIADOS association and First Vice President of the World Alliance for Mercury-Free Dentistry)