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ESSENCE OF AN IAOMT DENTIST

February 19, 2012, Dr. Lillian Ebuen won grand prize in a photo contest in the annual fun run of the Philippines Dental Association in celebration of its 6th National Dental Health Month. She also won the 2nd place and 4th place in the said competition.

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Her piece captures the true essence of being an IAOMT dentist – serving the local community, setting aside personal gain for the health and welfare of the patient, providing holistic dental health care, and promoting toxic-free dentistry.

Photos were taken last January 2012 when International Association of Oral Medicine & Toxicology Philippines (IAOMT Phil.) had a Dental Mission in Zambales – serving the ethnic group of Aetas. IAOMT reached out to the said local community and conducted free dental check-up, provided information on proper dental care, and promoted mercury-free dentistry.

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IOAMT ignored the scorching heat of the sun, the never ending mountain trail, and all the hardships they went through just to serve and help the Aetas and give them holistic dental health care.

A volunteer said, "Everything was worth it. It really is tiring but I don't mind it. Seeing this people melts my heart and I want to help them, I want to serve them. I felt a sense of accomplishment just being with them (Aetas) and seeing their smiles of gratitude."

UNEP – UNITED NATIONS ENVIRONMENT PROGRAMME INTERNEGOTIATING COMMITTEE SESSION 3 IN NAIROBI, KENYA

October 31 – November 4, 2011, Nairobi, Kenya, the third meeting of the Intergovernmental Negotiating Committee to Prepare a Global Legally Binding Instrument on Mercury (INC3) was held. Over 500 participants representing governments, UN agencies, and intergovernmental and non-governmental organizations attended the meeting. Representatives from Philippines government include: Atty. Juan Miguel Cuna – Director of Environmental Management Bureau (EMB) of Department of Environment and Natural Resources (DENR) and Ms. Elvira Fausin also from DENR. Advocates from Non-governmental include Manny Calonzo of Global Alliance for Incinerator Alternatives; Atty. Richard Gutierrez of Bantoxics (ASGM); and Dr. Lillian Ebuen of International Association of Oral Medicine and Toxicology Philippines.

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Prior to the 27th session of the United Nations Environment Programme Governing Council/Global Ministerial Environment Forum (UNEP GC/GMEF) in 2013, five meetings are scheduled to assemble where the negotiations are supposed to be concluded. INC3 was the third of the said five meetings.

 

Intergovernmental Negotiating Committee (INC) Chair Fernando Lugris (Uruguay) opened the session on Monday, 31 October 2011. He noted several intersessional meetings and workshops had been held in the intersessional period since INC2.

 

Executive Director Achim Steiner welcomed the participants to the meeting. He said that the objective of the mercury instrument is to reduce and eliminate the threat of mercury to human lives. He also urged the delegates to work together to produce a formal draft negotiating text, noting that INC3 marks the halfway point of the process to prepare a legally binding instrument on mercury.

 

Negotiations on the new draft text (UNEP(DTIE)/Hg.INC.3/3) were conducted by the delegates. The said text draft, which is compiled by the Secretariat, was based on the view submitted by parties during INC2 and the intersessional period. INC3 completed a comprehensive review of the text using the text as the basis for negotiation. The Secretariat, as requested, compiled a revised draft text based on the plenary negotiations, the reports of the INC3 contact groups and the work of the Legal Group.

 

INC3 was reigned with a spirit of enthusiasm and a good humor. A demanding pace was set by Chair Fernando Lugris (Uruguay), and delegates worked late into the evening throughout the week. Provisions on human health in the new draft, called for phasing out use of thimerosal in vaccines and mercury in dental amalgam, called for restriction of mercury trade and prohibition of dumping mercury waste in developing countries, and emphasized the need for financial and technical assistance for developing countries was introduced.

 

Critical issues regarding the provisions were discussed such as financial and technical assistance to developing countries; legally-binding agreement on mercury; and global action to mercury. Concerns on artisanal and small-scale gold mining (ASGM) and the increasing concentration of mercury in the some parts of the World were also raised.

 

An advocate from the Philippines, Dr. Lillian Ebuen – Executive Director of International Association of Oral Medicine & Toxicology, non-governmental organization, gave a statement regarding Dental Mercury Amalgam. She said,

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“The amalgam era of dentistry must end. Amalgam is a colossal pollutant, as the WHO and about every national environmental agency confirm. Thus it causes major public health and environmental problems for children and the unborn. Amalgam is an inferior filling material and a primitive pollutant from the 19th century; I believe we can all agree that if alternatives are available, this treaty should end the use of amalgam. WHO says A.R.T. is “the perfect solution” for the needs of developing nations and developed parts of developing nations. It has had repeated success in multiple nations on every continent. Alternatives are available, effective, and considerably affordable. We salute the African nations for standing together to call for the phase out of amalgam. We applaud small island developing states, who lack the land to bury dental mercury and who support the phase-out of amalgam.

 

I invite all my fellow dentists to switch to mercury-free dentistry, as thousands and thousands of us have already done. En route to phase out, we can phase down amalgam now; tell consumers and patients amalgam is mainly mercury, not silver fillings; change insurance; as WHO says; and stop amalgam now for children and pregnant women. We support the call for the full phase-out with timelines and deadlines.”

 

Inc3 closed on a positive note despite the emergence of clear divisions on critical issues and concerns among many delegates about whether compromise can be achieved.

 

In their closing statements, many delegates cited the meeting’s accomplishments, emphasizing the “determination and positive spirit” that characterized the week, and underscored their commitment to constructive participation in the next stage of negotiations.

Running For Mercury-Free Teeth

Advocacy group urges dental group to adapt a “No Mercury” policy

19 February 2012 – Manila, Philippines. Together with a Tooth Fairy, two giant molars and a sign that says, “Lason ang Mercury”, Dr. Lillian Ebuen of the International Association of Oral Medicine and Toxicology (IAOMT) – Philippines joins the annual fun run of the Philippines Dental Association in celebration of its 6th National Dental Health Month.

For the past two years, Dr. Ebuen has been urging the dental association for the gradual phase-out of mercury amalgams fillings in treating patients with caries. “With a high concentration of mercury in dental amalgams, toxic vapours can leach into the mouth and in the long run cause neurotoxic effects on the brain neurons, and some of its toxic effects can be a contributory factor to cause birth defects, mental retardation and a host of other illnesses such as cancer, respiratory and impairs kidney function.”, explains Dr. Ebuen.

The use of dental mercury amalgam was also mentioned by the World Health Organization (WHO) as one of the significant contributors to mercury emissions in the atmosphere. Accounting for 300 to 400 tons of mercury in the market today, these eventually end up in the environment as wastes from dental clinics and as toxic fumes generated by burning mercury-filled teeth via cremation or incineration.

Dental amalgams gained wide acceptability and use primarily because of its durability, lower costs and ease of application. Recent dental innovations however have brought safer alternatives that also offer the traits that made mercury fillings attractive the previous century.

“Options such as resin-based composites and atraumatic restorative treatment (ART) have consistently proven to be more practical, more durable and more affordable than dental amalgams. In fact, developed countries have moved away from using mercury in treating caries.”, adds Dr. Ebuen.

“The irony of it all is that we are concerned with mercury contaminating our air, land, sewerage and water systems; yet we still allow dentists to put mercury fillings in our mouths without having any second thoughts” she further stresses.

With a worldwide effort to ban mercury to stop its ill effects, Dr. Ebuen is hopeful that not only the PDA but even dental schools will soon recognize the dangers of mercury in dental amalgams. Dr. Ebuen explains, “AO 21 already addresses the issue of mercury fillings, what we need now is for dental organizations such as PDA to support its phase-out.”

Methods To Reduce Mercury Vapor Exposure

Methods To Reduce Mercury Vapor Exposure To Both Patient and Operators During Amalgam Removal - IAOMT Approved


 


The Dental Protocol for minimizing mercury exposure to the patient during the filling removal.

1. The teeth are isolated with a rubber dam and /or special suction device (clean-up) to contain the pulverized amalgam and its harmful vapor.

2. The patient (and the dental team) breathes clean air during the removal process. The patient needs to be protected from the mercury vapor, which is generated in high amounts during the drilling. The air around the nose is therefore highly contaminated, so a fresh source of air needs to be imported. A nose mask attached to oxygen or air is used.

3. A high speed suction devise with charcoal filters (Denti-Vac) to filter the mercury vapor is placed in front of the patient’s mouth to direct all the mercury laden vapor from the dental removal procedures away from the patient and the dental team.

3. The filling removal is performed in sections, removing large chunks, and minimizing the pulverization (drilling) of the amalgam and thus reducing the vaporization of the mercury. ¨ Copious water is used to cool the drill and amalgam dust and thus reduce the vaporization to the mercury and remove the mercury in the water.

4. The high-speed suction is placed next to the filling being removed to remove the water and the suction the vapor.

5. The saliva ejector is placed under the rubber dam next to the area where the filling is being removed. This is a protection to suction any vapor that goes through the dam and is now on the inside of the mouth. The saliva ejector and the fact that the patient is instructed to breath only from the nose are some of the precautious we recommend to counter this problem.

6. After the procedure the dam is removed carefully and disposed. The mouth is rinsed with copious amounts of water and all amalgam dust and particles are suctioned out.

7. The high-speed suction that conditions the air is left on during the filling procedures to clean and filter the air.

8. The drills and the air/ water syringe are wiped off to remove any mercury residue.

9. The patient can be covered in a disposable drape to minimize the mercury contamination on their clothes. In addition, protective eyewear is suggested. These disposable barriers are removed and into the hazardous medical wastes.

10. The disposable contaminated suction and saliva ejectors are replaced.

11. After the Dental procedure is finished, or sometimes during the restorative procedures, an IV of Vitamin C, glutathione and other vitamins and minerals can be administered to reduce and eliminate the mercury and aid the chelation process.

(First molar with an amalgam filling)

 

(Section by section removal of the amalgam filling)

 

(first molar, free from amalgam filling)

 

(base material put into the exposed pulp)

 

(Composite materials placed on the cavity)

 

(After the amalgam removal and replaced by composite materials)

Procedures done by Dr. Lillian Lasaten-Ebuen.