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Dental Amalgam Being Phased Out in UK

23 March 2017

Dental Amalgam Being Phased Out in UK

The use of dental amalgam for fillings will be reduced in phases, the European Parliament has agreed.

New legislation aims at phasing out dental amalgam by 2030 as part of plans to reduce mercury pollution.

What is dental amalgam?

Dental amalgam is a mixture of mercury, silver, copper, tin and zinc. Around 50% of the mixture is mercury, which is added to bind the metals together into a workable material to fill tooth cavities.

Most people will recognise dental amalgam as the silver-coloured fillings in people's mouths.

Why is it being phased out?

Mercury is a pollutant that harms the environment and human health.

The European Union wants to reduce the use of mercury to bring it into line with the 2013 United Nations Minamata Convention against mercury pollution.

What will happen to amalgam fillings?

The vote in the European Parliament and the expected ratification by the European Council will bring the EU into line with the Convention's aim at 'phasing down' the use of mercury.

There will also be an EU assessment of whether to phase out dental amalgam entirely by 2030.

The British Dental Association (BDA) says the move has ended months of speculation that dental amalgam might have been banned outright by 2022.

It says dentists in the UK will continue to have the full range of filling materials at their disposal to enable them to address the individual needs of each patient.

But are mercury-based fillings safe?

The BDA says evidence shows that dental amalgam is a safe material for patients undergoing restorative dentistry.

It says that in the mouth, mercury is amalgamated with other metals and is therefore rendered inert.

Chewing can release some mercury vapour but this is very minimal.

However, the Medicines and Healthcare products Regulatory Agency (MHRA) suggests it may be prudent not to place or remove amalgam fillings in pregnant women, although it says there is no evidence to suggest it would be harmful to do so.

Are there alternatives to amalgam for fillings?

Yes. Fillings on the NHS may also be made of a tooth-coloured composite of powdered glass and ceramic added to a resin base.

However, these are not as hard-wearing as amalgam fillings.

Tooth-coloured fillings are more usual for front teeth, whereas they are considered purely cosmetic for back teeth.

All fillings on the NHS are covered by Band 2 charges.


European Parliament News

British Dental Association

NHS Choices


Baby teeth removals 'up 24% in a decade'

Hospitals in England are seeing thousands of very young children each year needing baby teeth removed.

The Faculty of Dental Surgery at the Royal College of Surgeons, which compiled the data, blames tooth decay linked to sugary diets.

Figures show there were 9,206 extractions carried out on children aged four and younger between April 2015 and March 2016.

A decade ago, it was closer to 7,400 extractions.

That is a rise of about 24% in the space of a decade - more than you would expect from population growth alone, says the faculty.

However, the total number of extractions for children aged nine or under fell slightly last year, from 34,788 extractions in 2014/15 to 34,003 in 2015/16.

Lead researcher Prof Nigel Hunt said: "When you see the numbers tallied up like this, it becomes abundantly clear that the sweet habits of our children are having a devastating effect on the state of their teeth.

"That children as young as one or two need to have teeth extracted is shocking.

"What is really distressing about these figures is that 90% of tooth decay is preventable through reducing sugar consumption, regular brushing with fluoride toothpaste and routine dental visits.

"Despite NHS dental treatment being free for under-18s, 42% of children did not see a dentist in 2015-16."

Tooth decay is preventable - largely by limiting sugary food and drink and making sure children visit the dentist regularly, as well as brush their teeth twice a day with fluoride toothpaste.

  • Brush as soon as your baby gets their first tooth
  • Do it twice a day - morning and night - for about two minutes
  • Use only a smear of toothpaste if your child is younger than three. Use a pea-sized blob thereafter
  • Make sure the toothpaste is lower-strength, containing 1,000ppm fluoride

Watch Dr Milad demonstrate how best to brush teeth and sing more tunes on our facebook page

Public Health England is working with the food and drink industry to cut the amount of sugar children consume from common foods such as breakfast cereals, yoghurts, biscuits and cakes.

A spokesman from the Department of Health said: "These are worrying statistics - which is why we are taking action.

"We are introducing a soft drinks levy, as well as a broader sugar reduction programme, to encourage food and drink companies to reduce the amount of sugar that is in popular products in the first place."


Spider venom may offer stroke therapy

A protein in spider venom may help protect the brain from injury after a stroke, according to research.

Scientists found a single dose of the protein Hi1a worked on lab rats.

They said it showed "great promise as a future stroke treatment" but had not yet been tested in human trials.

The Stroke Association said the research was at its early stages but it would "welcome any treatment that has the potential to reduce the damage caused by stroke".

The researchers, from the University of Queensland and Monash University, travelled to Fraser Island in Australia to hunt for and capture three potentially deadly Australian funnel web spiders.

"We regularly collect spiders from Fraser Island off the south coast of Queensland," explained lead researcher Prof Glenn King.

"The reason for this is that funnel-web spiders dig burrows that can be as deep as 20-30 cm. Thus, digging them up from hard clay soils is very difficult. Fraser Island is a sand island which makes it easy for us to extract the spiders from their burrows."

The team then took the spiders back to their laboratory "for milking".

This involved coaxing the spider to release its venom, which could then be sucked up using pipettes.

Next the scientists dissected the venom gland of the spiders and honed in on a protein in the venom to recreate a version of it in their lab.

They then injected this Hi1a into the lab rats.

A stroke is a brain attack that happens when the blood supply to part of the brain is cut off or there is bleeding on the brain

  • Every two seconds, someone in the world will have a stroke
  • Almost 17 million people who had never had a stroke before had one in 2010
  • Stroke is the second most common cause of death, causing about 6.7 million deaths each year, one every five seconds
  • Almost one in every eight deaths is caused by stroke
  • The burden of stroke-related illness, disability and early death is set to double within the next 15 years

Source: Stroke Association

They found that the protein blocked acid-sensing ion channels in the brain - something the researchers say are key drivers of brain damage after stroke.

Prof King said the protein showed "great promise as a future stroke treatment".

"We believe that we have, for the first time, found a way to minimise the effects of brain damage after a stroke.

"Hi1a even provides some protection to the core brain region most affected by oxygen deprivation, which is generally considered unrecoverable due to the rapid cell death caused by stroke."

The research was published in Proceedings of the National Academy of Sciences.

Why look to spider venom in the first place? Prof King explains:

"My lab is interested in developing drugs for human nervous system disorders. Many of these disorders involve either dysfunctional ion channels (e.g. epilepsy) or over-active ion channels (chronic pain and stroke).

Thus, we are typically looking for molecules that modulate the activity of ion channels. The venoms of small venomous invertebrates such as spiders, centipedes and scorpions have evolved to target the nervous system of insects, and consequently they are absolutely full of ion channel modulators.

Because the human nervous system is more complex and wired differently to insects, ion channel modulators that kill or paralyse insects can actually be beneficial to humans. Thus, looking in venoms for ion channel drugs is not as weird as it seems."

Dr Kate Holmes, deputy director for Research at the Stroke Association, said: "We do not have an accurate picture of what happens in human brains from this research, therefore, it is currently unknown if this could be a successful treatment option for humans in the future.

"We welcome any treatment that has the potential to reduce the damage caused by stroke, particularly if this can benefit people who are unable to arrive at hospital quickly.

"Current treatments must be given in half this time period, and it is too early for us to know if this research can offer an alternative for stroke patients.

"We urge for stroke to be treated as an emergency - the sooner a person can get to hospital after a stroke, the sooner the right treatment can be received, which can improve survival and help recovery."

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