Mercury dispute. An EU step in the right direction

The European Union has decided on dental amalgam: it has banned its use in children, pregnant women and nursing mothers.

Mercury still remains

Unfortunately - the mercury will stay with us for years to come. But there will be much less of it. Much now depends on the individual EU Member States. It remains to be seen whether they care about the health of their citizens. For the time being, the European Union has banned the use of amalgam in those most exposed to toxic heavy metals - children, pregnant women and nursing mothers.Hanna Schudy

Decisions at EU level

European civil society influenced a preliminary agreement between the European Parliament, the European Commission and the Council of the European Union in early December. It was decided to ban the use of dental amalgam for children under 15 years of age, pregnant women and nursing mothers. The ban is due to come into effect on 1 June 2018.

The text of the agreement must now be approved by Parliament and the Council. In addition to this, each member country must now create a national plan outlining how the country will reduce the use of amalgam. The deadline is 1 July 2019. By mid-2020, the European Commission will issue a report on the feasibility of phasing out amalgam from dentistry in the EU. Amalgam would be phased out by 2030. The above actions are part of a package in the ratification and implementation of the Minamata Convention.

Ministry of Health: amalgam is good, we will install separators

The Ministry of Health, specifically the Department of Mother and Child, has given us the position that there is no conclusive evidence at this time that mercury from amalgam fillings has a direct effect on systemic diseases. This is a debatable issue, as there are studies available that conclude that the compound is neutral. The Ministry maintains that it is in favour of the continued use of amalgam. At the same time, however, the Ministry of Health acknowledges that:

We support the European Parliament's (EP) amendment to make it compulsory to install amalgam separators in the drains of dental units (new surgeries - from 2019; current surgeries - from 2021). The date proposed by the EP for equipping surgeries with amalgam separators makes it possible to plan and implement this obligation with a favourable, tailor-made distribution over the years of the financial commitments

If this is all that the Polish side wants to do, it must be admitted that it is very little. The separators will admittedly reduce mercury from dental waste. However, they will by no means reduce further emissions of dental mercury into the environment. The mercury that "comes out" of the surgery in the patient's teeth will enter the environment through, for example, cremation or burials. We should add that mercury in the environment transforms into methylmercury, which is even more toxic than metallic mercury.

Government systematically overlooks environmental costs

The environmental costs of using amalgam were summarised by Paweł Gluszynski of Zero Waste Europe:

It is completely incomprehensible that the government ignores the environmental costs caused by dentistry, which is one of the most profitable medical services. As a result of this attitude, more than 5.6 tonnes of mercury from amalgam fillings are released into the environment in Poland every year. Both the environmental and health costs and the availability of alternative materials clearly indicate that it is high time that Polish dentistry took a holistic approach to the problem and got rid of the toxic ballast.

Gluszynski also commented on Poland's position regarding its willingness to continue using amalgam and our scepticism regarding alternative fillings:

The Ministry of Health uses a number of studies on the negative effects of BPA (Bisphenol A) to justify the need for amalgam fillings, as these are supposed to be safer than alternative materials. Yes, the toxicity of BPA is known and undisputed. Of the studies cited, only one concerns the analysis of composite fillings, where BPA and its metabolites were found to be present. However, this study does not confirm that the amount of BPA is at a level considered hazardous. Furthermore, all the comparative studies carried out by the European Commission (SCENIHR), WHO, FAO, KEMI, etc. conclude that the negative health and environmental effects of amalgam are incomparably greater than those of other materials used in dentistry.

Given the above, we can expect Poland to push for the continued use of amalgam. However, this does not change the fact that the European Union is already, albeit slowly for the time being, on the way to phasing out amalgam.

Children, pregnant women and nursing mothers

Charlie Brown, president of the Global Alliance for Mercury-Free Dentistry, said: 

This is a win-win for Europe's children. The next generation of Europeans will not be exposed to mercury from amalgam fillings.

In turn, Elena Lymberidi-Settimo of the European Environmental Bureau recognised:

This agreement is a milestone for Europe on the way to being a leader in the implementation of the Minamata Convention. This decision is bound to reverberate around the world.

There was also no shortage of voices from dentists. It is worth quoting a dentist from the UK, president of 'Transition and Training' said:

Amalgam is a primitive filling. Technically, it is a step backwards given the alternatives available. The era of mercury in dentistry is coming to an end, which has been enthusiastically welcomed by thousands of European dentists.

Philippe Vandendaele of Health Care Without Harm Europe added:

We accept this agreement with mixed feelings. This decision should rather contribute to the withdrawal of amalgam from the European Union. At the same time, however, it is an acknowledgement that there is no place in Europe for mercury in dentistry in the future. I regret that the move to completely phase out amalgam proposed by the rapporteur, Sfefan Eck, did not pass in the trialogue. We must acknowledge that this is a missed opportunity to phase out one of the most important sources of mercury in the European Union.

The European Union's decision is not very ambitious, but it is nevertheless a sign that the era of amalgam is coming to an end. In Poland, where patients usually visit the dentist for a fee, patients have a choice and opt for composite fillings. However, many patients would like a different reality. Not only accessible, reimbursable dentistry, but above all effective, aesthetic and completely safe, which means mercury-free. Unfortunately, many Poles who receive treatment under the National Health Fund can only count on a black filling containing toxic mercury, because only such fillings are subsidised by this institution. Instead of convincing us, as it does all the time, of how progressive it is, Poland is following the example of those who do not want to. For the time being, therefore, we will continue to bear witness with our teeth to where we come from.

Hanna Schudy for www.eko.org.pl