Mercury is recognised as a chemical of global concern due to its ability to transport in the atmosphere, bio-accumulate in ecosystems and significant negative effect on human health and the environment.

This is contained in a communiqué issued at the end of a two-day workshop on ‘Phase Down of Amalgam-The Alternatives,’ to mark the 10th annual scientific conference of the Faculty of Dental Sciences, College of Medicine, University of Lagos, recently.

During the meeting, participants observed that the Minamata Convention on Mercury, signed by Nigeria in October 2013, stipulates measures to be taken by parties to phase down the use of dental amalgam in oral health.

They also noted the low level of awareness among Nigerians on the dangers of mercury; the continued and wide usage of dental amalgam in Nigeria; limited number and distribution of dental clinics and centres to provide services for the nation’s teeming population; and the inadequate number of dentists and other auxiliary personnel to provide dental services to patients.

Other observations were that alternative direct restorative materials, such as composite, compomer and ceramics could be used for restoration of carious and posterior teeth based on specific selection criteria and indications.

Also, that most government pediatric dentistry units have long stopped the usage of dental amalgam also due to other associated reasons.
The forum brought together over 140 participants drawn from Government, medical/dental, dental associations, practitioners (doctors, nurses, technicians, therapist etc), academia, finance, pharmaceutical industry, media and civil society groups, among others, and deliberated on phasing down of dental amalgam use in Nigeria.

In his opening words, Dean, Faculty of Dental Sciences, College of Medicine, University of Lagos, Prof. Godwin Arotiba said, the phasing down of dental amalgam is an issue of global importance that requires an urgent national action. He further noted that a road map for dental amalgam phase down for Nigeria Dental institutions; draft action plan for mercury free dentistry implementation are expected as outcomes of the conference’.
The Minister of Education, Mallam Adamu Adamu, represented by Mrs. Stella Olagunju, commended the organisers on a very important topical issue on the phase down of Dental Amalgam and stated the willingness of her ministry to accept the decision on dental curriculum change in Nigeria with emphasis on phasedown from dental amalgam use to Mercury-free alternatives into the National education curriculum. On the other hand, the Vice Chancellor of the University of Lagos, Prof. Salman Bello, represented by Prof. B.O. Sylva, noted that the Faculty of Dental Sciences remains the pioneer Dental Institution in Nigeria and as a centre of excellence in dental practice, it is more strategic to the promotion of Dental amalgam phasedown initiatives for dental practice in Nigeria. He further stated that the University of Lagos currently has facilities for scientific research and analysis to support the phase down programme.
The Federal Ministry of Environment representative (Mr Olubunmi Olusanya) who stood in for Dr Idris Goji noted that mercury emission and releases poses health and environmental concerns and although satisfactory alternatives to dental amalgam are available in Nigeria. He further called for a national road map in line with the national phase down plan which would help to save lives. The Representative of the National Agency for Food and Drug Administration and Control (NAFDAC) Dr. Anthony Hotton noted that NAFDAC regulates the importation, Sales, Use, Manufacturing and Distribution of chemicals which are grouped as General, Controlled or Restricted chemicals. He stated the mercury and its compounds are placed under restriction due to its health impact. Hence, there are calls for the need for a National Action Plan (NAP) and goal setting for monitoring companies and also inter-phasing with dental practitioners to eliminate or phase down amalgam use in Africa.
The keynote speaker, Prof. Adeyemi Oluniyi Olusile, a past President of National Dental Association (NDA) and presently the President of African Regional Organisation of World Dental Federation (FDI), outlined the effect of mercury on the environment and health, especially occupational exposures. He strongly called for the inclusion of dental amalgam alternatives filling materials in the National Health Insurance Scheme in Nigeria. He further stated that curriculum changes into dental amalgam alternatives is already in place in some institutions like LUTH, University College Hospital, Ibadan, Lagos State University Teaching Hospital (LASUTH), Obafemi Awolowo University and other schools.
Olusile said, “The reality is that whether we like it or not, soon and very soon, amalgam will no longer be available for use. We do not manufacture amalgam in Nigeria, we import it and if the countries from where we import no longer export. We have to use the alternatives.”
The confab then recommended that government should discourage and stop amalgam use in children’s primary teeth by December 2017; immediate review and updating dental schools training curriculum to emphasize mercury-free dentistry by mid-2017; government should initiate a coordinated multi-sectoral approach for an effective phase down of dental amalgam use in Nigeria; and raising awareness about dental mercury and promotion of Alternatives/Transition to alternatives.
Others are to initiation of demonstration projects (pilot hospitals) and application of best available technology and environmental practice in the management of dental amalgam; the urgent need for NAFDAC to include phasedown programme in her awareness campaign which includes engaging the media in awareness creation on the health impacts of mercury in dental amalgam; and creation of special fund for dental schools.

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