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WAMFD's Charles Brown and IAOMT-Phils Pushes for Mercury-Free Dentistry

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Atty. Brown with IAOMT-Phils' Dr Ebuen, EMB-DENR's ASec Cuna and Ms. Beng Pausing

Citing the recent move of the European Union to ban the use of mercury fillings (aka dental amalgam), Charles Brown of the World Alliance for Mercury-Free Dentistry (WAMFD) reiterated that the country needs to follow suit and immediately address the continued use of the dental material.

As one of the leading figures in mercury-free dentistry and a staunch advocate of consumer rights, Charles Brown played a key role in highlighting the dangers of dental amalgam. This month, Brown met with IAOMT-Philippines' Dr, Lillian Lasaten-Ebuen and several Philippine government officials to commend them on their efforts. He mentions the Department of Health (DOH) and the Environment Management Bureau (EMB-DENR) for their current push to phase-out the use of dental mercury.

However, Brown also pointed out that the proposed phase-down/phase-out needs to be implemented soon or else the country is at risk of becoming a dumping ground for dental mercury. Dr, Ebuen likewise stated that the continued use of dental amalgam, particularly in dental colleges, exposes dentistry students, faculty, and patients to unnecessary health risks.

"The recent accidental spilling of liquid mercury in a public school in Manila, reminds us again, that the use and presence of neurotoxins such as mercury should never be allowed in the academic setting."€ Dr Ebuen said.


Currently, IAOMT-Philippines is campaigning for a change in the dental curriculum, urging the Commission on Higher Education (CHED) to put focus on mercury-alternatives instead of requiring students to learn dental restoration via dental amalgam application. With the Minamata Convention on Mercury and the support of the DOH and the EMB-DENR, Dr. Ebuen is optimistic that the CHED will heed IAOMT-Philippines' call and eventually overhaul the dental curriculum to suit the country's commitment to the Convention.

Dental colleges in other countries, such as the NYU's College of Dentistry have already adopted policies to limit dental amalgam use. Stressing environment protection more than health concerns, the college's policy is still a significant challenge to dental mercury.

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WAMFD's Charles Brown recognizing OLFU's Dean De Leon's efforts in minimizing dental amalgam use

Fortunately for CHED, the commission does not need to look any further as the Our Lady of Fatima University (OLFU) has adopted a similar policy. Dr. Arturo de Leon, Dean of the College of Dentistry, clarified that the college's policy is in line with the government's environment guidelines and it does not affect the training and education quality that their dentistry students receive.

As such, Dr De Leon stresses that while the college's programme limits dental amalgam use, the college does not contradict the stand of the Philippine Association of Dental Colleges (PDAC) on dental amalgam and still adheres to GV Black's amalgam formula. "There is no question when it comes to mercury's environmental effects but more data is needed when it comes to proving or disproving effects on human health once bound in amalgam fillings."€


Brown recognized that although OLFU's Dental College is not 100 percent mercury-free, its ingenuity in limiting the use of dental amalgam and exposing the environment to its ill effects should be recognized and applauded. As the country is preparing to meet its obligations under the Minamata Convention on Mercury, OLFU's Dental College could serve as a role model for dental colleges.


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Mercury Has No Place In Schools


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The recent chemical spill in Manila Science High School is proof that the use of dangerous chemicals, particularly mercury should be completely removed from the curriculum. According to the latest reports, the spill exposed a number of students and school staff and two of those exposed have already developed skin rashes - one of the many symptoms accompanying mercury exposure and poisoning.


While there were other chemicals spilt, mercury is of chief concern for us. As a neurotoxin, physical contact or the inhalation of its vapors can lead to a number of symptoms including headaches, mood swings, neuromuscular changes, respiratory illnesses, and in severe cases - even death.

In 2006, a similar incident happened in another school in another city and has left one student dealing with the effects of mercury exposure. To avoid further untoward incidents, the DOH and the DENR has initiated a phase-out of mercury and mercury-containing products in health care institutions.

However, mercury is still largely present in the dental health sector, mainly among dental colleges. With a curriculum that puts heavy emphasis on dental amalgam use, dentistry students are required to work with these mercury-laden fillings to pass the course. Often, aside from the lack of info on proper amalgam handling and waste disposal; the students are not informed of the health risks involved and are left to handle dental amalgam fillings without wearing any protective gear.

As a signatory to the Minamata Convention on Mercury, the Philippines has a responsibility to phase-down - if not totally phase-out - the use of mercury and mercury-containing products, and this includes dental amalgam fillings. For the past years, IAOMT-Philippines has been consistently calling for the overhaul of the dental curriculum and to limit the exposure of dentistry students and faculty to mercury vapors.

Mercury poses serious health risks and its continued presence in HS laboratories and dental colleges only puts students, faculty, and the entire school community to unwarranted hazards. The availability of upgraded, aesthetic, and modern dental fillings make mercury fillings redundant.

Again, we are urging the Commission on Higher Education (CHED) to consider the safety and health of our dental college faculty, staff, and dentistry students. We urge these organizations to assess the current dental curriculum and bring an end to a century old restoration material.

Chronic Mercury Exposure from Dental Fillings

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Source: screenshot from the film, "Evidence of Harm"

You cannot argue with hard science. In the 2015 documentary, "Evidence of Harm", Sue Casteel, an Environmental Health Scientist from the Agency for Toxic Substances and Disease Registry (ATSDR) provides an overview of the harm chronic mercury exposure can cause.

Click on this link to jump to the video.

Healthy Teeth. Healthy Body. No Mercury.

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Dental amalgam fillings, also known as silver fillings, is comprised of 45 to 55 percent mercury. Mercury is a naturally occurring element found in air, water and soil. It exists in several forms: elemental or metallic mercury, inorganic mercury compounds, and organic mercury compounds. Elemental (or liquid) mercury is the type of mercury used in dentistry.

Mercury is a neurotoxin and chronic exposure to it affects the nervous, respiratory, cardiovascular, and immune systems. All people are exposed to mercury in some form or another but certain sectors are more frequently exposed. This may be due to diet (certain seafood contain high levels of mercury) and/or occupation.

Mercury is known to bioaccumulate in people and animals that are chronically exposed. Some groups claim that the mercury used in dental amalgam fillings are so small that it poses no risks to health. However, the World Health Organization (WHO) states that even the minutest amount is harmful and can easily penetrate the blood-brain barrier, thus compromising the development of children in utero and putting children, pregnant women, and women of childbearing age at risk.

Several studies conducted by IAOMT revealed that patients with amalgam fillings are constantly exposed to mercury vapor as chewing, drinking hot beverages, and even brushing can cause mercury to leak into the saliva and into the bloodstream. Studies also show that mercury from amalgam fillings can increase the risk for allergies, MS, autism, and Parkinson's Disease.

References:

Arenholt-Bindslev, D., and Harsted-Bindslev, P. (2009) Dental Amalgam In Schmalz, G., & Arenholt-Bindslev, D., (eds) Biocompatibility of Dental Materials. (Pp 59-91) Berlin: Springer-Verlag GmbH Agency for Toxic Substances and Disease Registry (n.d.)Mercury: Quickfacts: Health Effects of Mercury Exposure. Retrieved on 06 April 2014 at http://www.atsdr.cdc.gov/mercury/docs/HealthEffectsMercury.pdf IAOMT-Philippines and

BAN Toxics. (2012).What's Up in the Air? Mercury Vapor Levles in Dental Institutions. Dental Amalgam Mercury Solution. (N.D). Oral Effects of Dental Amalgam. Retrieved on 06 April 2015 at http://amalgam.org/education/dams-fact-sheets/dams-mercury-fact-sheet-6/

Environmental Protection Agency. 1999 (Rev. 2000) Mercury Compounds.

International Academy of Oral Medicine and Toxicology (2011) The Toxic Effects of Mercury in Dental Amalgam Fillings on the Environment and Human Health.

Ritchie, K.A., Burke, f.J.T., Gilmour, W.H., Macdonald, E.B., Dale, I.M., Hamilton, R.M., McGowan, D.A., Binnie, V., Collington, D., & Hammersly, R. (2004) Mercury vapor levels in dental practices and body mercury levels of dentists and controls. British Dental Journal. Volume 197. 625-642

Coalition Formed For Urgent Phase-out of Dental Amalgam

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The campaign for mercury-free dentistry in the Philippines gained ground today as a broad coalition of dental and health professionals, environment workers and social justice advocates joined to call for the urgent phase-out of mercury-laden dental amalgam.

Emphasizing safety and environment concerns, the group, led by BAN Toxics and International Association of Oral Medicine and Toxicology (IAOMT), stressed that with the continued use of dental amalgam fillings, efforts to comply with the Minamata Convention and to control mercury pollution in the country will be compromised.

“Scientific evidence-based research shows that mercury vapors can be emitted by amalgam fillings,” said Dr Lillian Ebuen, DMD, of IAOMT. “The phase out of dental amalgam in the Philippines is inevitable. A short timeline will enable a quicker shift away from a centuries-old toxic technology and will open more doors for greater progress on safe and healthy dental fillings, helping advance the field of dentistry.”

“Mercury pollution is a problem that needs a comprehensive solution,” said Teddy Monroy, Policy Development and Research Manager. “By banning the use of mercury in small-scale mining as well proposing a 2020 phase-out timeline for other sectors, the Philippines is making steady progress in mercury reduction. But its use by the dental profession also needs to be phased out under the same 2020 timeline to close all windows for illegal mercury trade within the country and to prevent the country from becoming a dumping ground of mercury we have no capacity to deal with.

“It is also crucial that the Philippines ratify the Minamata Convention soonest. Once it enters into force, the global flow of mercury will follow the path of least resistance. The entry of mercury as dental amalgam is a big hole that needs to be plugged,” he added.

The Philippines is one of the countries taking a leading role in ensuring protection of the environment from mercury emissions. After signing the Minamata Convention in 2013, the government is in the process of updating the existing Chemical Control Order (CCO) for Mercury and Mercury Compounds. The proposed new CCO for mercury will include a provision on a timeline for the phase out of dental amalgam which is exempted from regulation under the 1997 CCO.

Dental amalgam fillings, erroneously known as “silver fillings”, is composed of 50 percent mercury and has been the dominant dental restorative material for the past century. With neurotoxic mercury as a main ingredient, concerns regarding its safety have been raised. Mercury vapors are also emitted during preparation of the amalgam, endangering the health of dental professionals and students, as well as patients. After application on the tooth, excess amalgam is frequently disposed in wastewater, contaminating water systems with mercury. Dental fillings use more mercury each year than lighting electrical devices or measuring devices[1] and is a major source of mercury pollution in waterways.[2]

A 2013 report by the United Nations Environment Program (UNEP) cites that dental amalgam, through cremation and solid wastes, contributes significantly to global and local mercury pollution.[3] Likewise, a report by IAOMT-Philippines and BAN Toxics[4] shows significant mercury vapor emissions coming from dental clinics, schools and dental supply shops, thus posing a risk to both patients and dental health practitioners.

According to the latest dental health survey by the Department of Health (DOH), 87.4 percent of the Filipino population suffer from dental caries. Another recent study places caries rate at 98%, and estimates that 7 million Filipinos have never seen a dentist. Opponents of a dental amalgam phase-out cite the country’s caries rate as basis to continue using amalgam due to its low cost. But to propose dental amalgam as an “affordable solution” for the poor despite its toxicity runs counter to the principles of human rights. And proposing to treat the millions of cases of cavities with dental amalgam will mean corresponding massive mercury vapor emissions and mercury contamination of waterways.

Reflecting on these factors, the group found that issues such as poverty, the lack of access to basic dental health care, and the inaccessibility of mercury-free dental treatments as crucial aspects in developing a comprehensive plan on dental mercury. The group is calling for the phase-out of dental amalgam with a 2020 end date and for government programs that will allow an easy transition to mercury-free dentistry.

The group is calling on the government to protect the rights of the Filipino people and dental workers to safe, environment-friendly, and mercury-free dental procedures. Among these is the provision of basic dental health care and education to low-income groups, training support for current dental practitioners on mercury-free restoratives through continuing program education by the government and other key experts, training of Filipino dental health workers on amalgam safety protocols, and to overhaul the current dental curriculum to remove dental amalgam laboratory and clinical training as a requirement for dentistry students.

“Health is a trade union issue and health care is at the heart of quality public service, which is consistently pushed by public sector unions,” said Erma Montebon of Public Services Labor Independent Confederation (PSLINK). “Ang usapin sa phase out of dental amalgam ay kaakibat ng usapin sa dentalwork, a primary campaign of PSLINK; at sa usapin sa decent work hindi lamang natin concern at isinusulong ang equitable pay at social benefits kundi ang lalo lalo na occupational safety and healthy working conditions and circumstances.”

“Promoting best practices in achieving a caries-free nation and avoiding mercury dental fillings would promote a nationwide oral awareness campaign. Alternatives to mercury fillings are available, affordable and safe for the community and the environment,” said Dr Ebuen.

The solidarity group to achieve mercury-free dentistry in the Philippines is composed of the following: The International Association of Oral Medicine and Toxicology (IAOMT) – Philippines, BAN Toxics, Public Services Labor Independent Confederation (PSLINK), and the Philippine Society of Clinical and Occupational Toxicology (PSCOT).

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