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Welcome Our New Mercury-Free Dentists

The International Association of Oral Medicine and Toxicology (IAOMT) in the Philippines would like to welcome three dentists into the fold.

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Dr Dylette David (Oriental Mindoro), Dr Rhea Ong (Dumaguete), and Dr Hope Faner (Cavite City) have recently taken and completed a course on the Fundamentals of Mercury-Free Dentistry, provided by IAOMT-Philippines’ President and Director Dr. Lillian Lasaten-Ebuen.

The two-day lecture included sessions on issues surrounding dental mercury use such as storage and waste management procedures. The highlight however is a demonstration on dental amalgam removal where Dr Ebuen stressed the importance of having the right equipment, gear, and dental office layout to minimize risks during an amalgam removal. She emphasized that mercury fillings is not a simple matter and dentists must have the expertise and the facility to deal with the procedure.

Unfortunately, there are a number of dentists that take out dental amalgam fillings without observing proper protocols thus creating a recipe for disaster. According to the International Academy of Oral Medicine and Toxicology (IAOMT) in the US, when amalgam fillings are taken out with a high speed drill, a cloud of amalgam particulates are generated. 65 % of these particulates are one micron or less in size which get easily absorbed by the lungs.

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In dental amalgam removal cases, it is imperative that all safety protocols from protective gear to an efficient mercury separator must all be in place.

With three new dentists trained to remove dental amalgam fillings safely, IAOMT-Philippines is confident that Dr David, Dr Ong, and Dr Faner will serve as role models and spearhead an advocacy on mercury-free dentistry in their respective regions.


Reference:
https://iaomt.org/safe-removal-amalgam-fillings/

Lason Sa Hangin

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The second part of IAOMT-Philippines' study with BAN Toxics!

This second installment goes in-depth as it analyzes ambient air in dental colleges.

It shouild be noted that while dentists are free to choose between amalgam and modern fillings, dentistry students do not have that luxury as the current dental curriculum requires dentistry students to perform a number of amalgam restorations to pass the course. This study reveals that continued amalgam use releases significant amount of mercury vapour into the air.

Click here to download the full study.

Study Reveals Alarming Rates of Mercury Vapor in Dental Sector

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Advocacy group International Association of Oral Medicine and Toxicology (IAOMT) – Philippines and public health and environmental justice group BAN Toxics (BT) revealed that alarming levels of mercury vapor can be found in dental clinics and schools in a study presented today.

The second phase of a research released in 2014, “Lason sa Hangin: Mercury Vapor Levels in Dental Schools” reveals the high level of mercury vapor in dental schools, with measurements ranging from 183.5 ng/m3 to a high >30,000 ng/m, depending on variables such as the architecture of the facility, the weather, and the number of dental restorative procedures. Overall, each site yielded figures much higher than the recommended Agency for Toxic Substances and Diseases Registry (ATSDR) minimal risk level (MRL) for inhalation exposure at 200 ng/m3 and the action level of 1000 ng/m3, which triggers remediation if exceeded in indoor air.

The study was conducted in the dental restorative areas of four dental colleges around the country through BT’s Lumex Ra-915+ Hg vapor analyser, which measured mercury vapor levels over an eight-hour period, simulating a typical work-day for dental professionals and students.

€œThe results are not surprising,” stated IAOMT-Philippines’ Executive Director, Dr. Lillian Lasaten-Ebuen. “Our previous research has already shown that dental amalgam releases a significant amount of mercury vapor. What’s more troubling is how it is continually being overlooked.”

Dr. Ebuen explained that dental amalgam fillings are valued because it is supposedly durable, inexpensive, and easier to manipulate. However, as the dental restorative material is composed of 50 percent mercury – toxicologists and researchers have warned of its potential effects not only on patients but also on dentists and dental staff as well.

According to the World Health Organization (WHO), short or long-term exposure whether through ingestion or inhalation of mercury fumes can severely affect a person’s nervous, digestive, and immune systems. The WHO further adds that while everyone is exposed to mercury at some point, some sectors of the population are more at risk – and these include those who work closely with mercury or mercury-containing products such as artisanal gold miners and the dental sector.

Indeed, a study by the British Dental Journal in 2004 revealed that mercury vapor from dental amalgam fillings lingers in dental offices thus establishing that dentists, dental personnel, and even dentistry students are at risk of chronic mercury exposure.

€œGovernment regulators need to be consistent in its policy on mercury. If we are banishing it from use in hospitals and healthcare facilities all over the country, as well as prohibiting its use in small-scale gold mining, the dental sector remains the lone and illogical exception,” explains Ms. Myline Macabuhay, BT Chemicals Management Assistant Coordinator.

However, despite the calls to phase-out dental amalgam, some dentists persist in using dental amalgams and dentistry schools continue to follow a flawed curriculum that require students to practice and hone their skills via dental amalgam restorations.

IAOMT-Philippines and BT recommend steps to be taken by the government and other concerned institutions. The paper cites enacting policies to strategically phase-out dental amalgam use, the immediate revision of the dental curriculum, and a re-examination of the current standards on dental amalgam safety.

€œWe need to review antiquated processes, especially those that pose harm to the environment and health, and move forward with practical and preferably toxic-free options for Filipinos.  Philippine dentists and schools need to re-evaluate their duty of care to patients and students, and phase out dental amalgam use immediately,” Macabuhay added.

The study was made possible through the support of the World Alliance for Mercury Free Dentistry and the Swedish Society for Nature Conservation. 

Dr Munro-Hall and IAOMT-Philippines' Talk on Dental Amalgam Use

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Philippine dentistry is at the crossroads of change. The signing of the Minamata Convention on Mercury and Mercury-Containing Products has put dental amalgam use at the center of discussion among academics, oral health professionals, and health-environment advocates.
On one side of the debate are groups advocating for a mercury-free dental practice and on the other are groups arguing for a phase-down of dental amalgam use instead of a complete phase-out. While government agencies are pushing for a phase-out of dental amalgam use, the academe and a number of dental professionals are opposing the move.


To address this, the International Association of Oral Medicine and Toxicology (IAOMT) – Philippines conducted a couple of lectures on the impact of continued dental amalgam use.  Researcher and British dentist, Dr Graeme Munro-Hall BDS, FIAOMT was invited to speak in the lectures and to present the latest findings on dental amalgam research.
The lectures were held in two dentistry schools, one in Manila and one in Davao. These talks served as IAOMT-Philippines follow up to the first mercury-free dentistry forum held in 2012, this time, focusing on dentistry students, faculty, and others in the dental college community.

The National Capital Region

Over a hundred junior and senior dentistry students and faculty members attended the symposia at the College of Dentistry of the National University (NU).  Together with Dr Munro-Hall, several speakers were invited to discuss issues that are related to dental amalgam use. While the lecture is primarily a dental issue, mercury in dental amalgam fillings crosses borders and sectors, thus affecting not only the dental sector.

The speakers were:

â€Â¢Ã‚ Â   City Councillor Numero Lim of Manila presented city government efforts in addressing environment issues such as unlicensed dental practice and the use and sale of toxic chemicals.

â€Â¢Ã‚ Â   Myline Macabuhay of BAN Toxics! presented figures to illustrate how dental mercury can cross over from the dental sector to the small-scale gold mining sector.

â€Â¢Ã‚ Â   Sonia Mendoza of Mother Earth Foundation presented a brief slideshow on how wanton rubbish disposal and chemical use can destroy the environment.

The main part of the programme however is Dr Munro-Hall’s presentation on the implications of dental amalgam use. Through several graphs, images, illustrations, numerical data, and latest research figures, Dr Munro-Hall underlined that

â€Â¢Ã‚ Â   Mercury has no safety levels.
â€Â¢Ã‚ Â   Dental amalgam can cause further damage to affected tooth.
â€Â¢Ã‚ Â   Mercury impacts the economy as it lowers the population’s IQ and
â€Â¢Ã‚ Â   Prices of mercury-free alternatives are stable whereas dental amalgam fluctuates and continues to rise.

Davao City

The Mindanao Medical Foundation College is one of the two universities with dentistry courses in Davao. Currently, the college is gaining much attention and respect as one of its dentistry school graduates topped the recent dental board exam.

Together with higher-level dentistry students, the audience was composed of government workers, particularly those involved in health and peace and security. Members of the Davao Dental Association were also present and dominated most of the discussions.

Towards Mercury-Free Dentistry

Overall, the lectures were a revelation. Participants were eager to learn and dentists particularly, expressed concern regarding occupational exposure to mercury. Several students meanwhile expressed interest in government action regarding dental amalgam usage.

The colleges were also very receptive and stayed true to education’s promise of sharing or pursuing information and knowledge when it is needed. The students, dental professionals, and all others involved may have furthered their knowledge regarding dental mercury and as Dr Graeme Munro-Hall is eager to stress, “The burden of proof is on amalgam supporters, not us. Next time they argue about the safety of dental amalgam fillings, tell them to show us the data.”

What You Need to Know About Dental Amalgam Fillings

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In a forum hosted by the International Association of Oral Medicine and Toxicology (IAOMT-Philippines) and the College of Dentistry of the National University, speakers and experts have unanimously asserted that dental amalgam is toxic and a danger to the environment and people’s health.

Approximately composed of 50 percent mercury and other metals, the safety of dental amalgam fillings have been a point of debate among dental professionals since the 19th century. The split in the profession reached its peak in the 1850’s but support for dental amalgam gained grounds with the formation of the American Dental Association in 1859 and its eventual statement of support on the safety and reliability of the dental material.

Today, the debate is rekindled with the signing of the Minamata Convention on Mercury and Mercury-containing Products. While there are groups calling for a phase-down on dental mercury use, there are groups urging the government to adopt a more effective stand by phasing-out its use. Foremost among these groups is IAOMT-Philippines, the Philippine chapter of an international research organization that seeks to eliminate the use of toxic products out of dentistry.

IAOMT-Philippines’ Executive Director Dr Lillian Lasaten-Ebuen argued that the continuous use of dental amalgam fillings would only continue to harm the environment and affect the health and safety of patients and dental personnel.

Echoing a report by the World Health Organization (WHO)  Dr Ebuen explains, “Mercury from amalgam fillings enters the environment via different pathways: as wastes from dental clinics and as vapor released during placement and removal or through incineration or cremation.” She further adds, “Looking at the dental profession on a larger scale, this sums up to over 50 metric tonnes of mercury released into the environment annually.” Studies indicate that mercury vapors released during amalgam application and removal can linger in the environment, thereby compromising the occupational safety of dental personnel or contaminate its surrounding areas.

The forum’s keynote speaker, Dr Graeme Munro-Hall, a distinguished British researcher and oral health practitioner, is no stranger to dental mercury’s detrimental effects. In the mid-80’s, Dr Hall was diagnosed with a serious heart ailment prompting him to conduct research on his ailment. He later concluded that his exposure to dental mercury exacerbated his genetic predisposition to heart disease.   Symptoms can vary, according to Dr Munro-Hall, and it depends on an individual’s genetic predisposition. For others, symptoms may manifest as tremors or behavioural changes.

Now cleared of the illness, Dr Munro-Hall is actively campaigning to halt the use of dental amalgam in the dental profession. He asserts that with such a high toxic content, dental amalgam continuously emits mercury vapours that can cause health problems to patients and dental health practitioners.   

In 2014, IAOMT-Philippines together with environment group BAN Toxics! presented the results of their study on ambient air in dental universities and dental supply stores. The groups’ assumptions were confirmed as the testing sites posted mercury level values from 967ng/m3 to a high of 35,617ng/m3—the majority of which are beyond recommended reference standards such as the ATSDR Action level of >1,000 ng/m3. Some areas posted Mercury concentration of >10,000 ng/m3, which is considered as the evacuation alert level by the US EPA.  

Amalgam supporters however remain resolute, stating that amalgam fillings are cost-effective and a reliable treatment for a developing economy burdened with oral health problems.   Health experts, researchers, and environmentalists are also quick to point that promoting dental amalgam for treating lower income groups is a form of social injustice as only higher income groups are provided with a choice.

Dr Ebuen then adds that the cost of implementing, monitoring, evaluating, and putting up a mercury waste storage facility would be more of a financial burden on the government and individual dentists. “The cost of amalgam separators – an equipment approved by European and American agencies for trapping mercury waste - is too costly for the average Filipino dentist. Research also revealed that separators are not highly effective in controlling mercury pollution as it only addresses one pathway.”

Concluding the event, Dr Lillian Ebuen again called for a shift towards mercury-free dentistry and challenged future dentists to champion people’s rights to information and favourable treatment and to pursue a progressive approach to dentistry.

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