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Review & Evaluation of Curriculum in Dental Teaching Institutions of Pakistan in View of Toxic Mercury/Mercury Amalgam Use and Exposure Resulting in Risk to Public Health
By: SDPI
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Partner:  EEB/ZMWG

Duration: August to November, 2013

Locale: Dental teaching institutions at Rawalpindi, Islamabad, Lahore, Faisalabad, Multan, Peshawar, Abbottabad, Quetta, Karachi, Hyderabad, Jamshoro, Mirpur Khas

Introduction: 

According to the Agency for Toxic Substances and Diseases Registry (ATSDR), mercury was ranked third most toxic element in the priority list of hazardous substances in year 2011. Mercury, in the form of mercury amalgam restorative filling, is widely utilized in the field of operative dentistry. Mercury/Hg vapors are released during the preparation of amalgam filling, which impose toxic effects on human health and environment. A study was designed by SDPI to gauge the gravity of the problem with regard to awareness and expertise in handling of mercury among those who are regularly involved in use of mercury.

Objectives:

To assess the level of experties regarding mercury/mercury amalgam use in operative/restorative dentistry, control of mercury emission/releases, mercury toxicity, occupational health and safety, environmental degradation, mercury waste management, best in-house environmental practices, use of environment-friendly technologies (mechanical mixing, encapsulated amalgam, non-mercury based composites)
To emphasize the need to revise the present curriculum in the light of the above assessment and include the acquired data for better training, knowledge and sensitization of the dental professionals for mercury reduction at source and phasing out of mercury use leading to its elimination in dentistry for the protection of environment and public health

Activities:

In order to extract the information regarding mercury/ Hg-amalgam use in operative/restorative dentistry, background study of different sets of curriculum provided by Higher Education Commission (HEC), Pakistan Medical & Dental Council (PMDC), University of Health Sciences (UHS) and Fatima Jinnah Dental College (FJDC, Karachi) has been carried out.
Curriculum followed at dental teaching institutions in the neighboring countries, specially of SAARC members states have also been studied for comparison and guidance.
Development of an outline on the missing issues in the curriculums with reference to mercury/mercury amalgam use, phasing out leading to elimination, occupational safety and health and alternatives to mercury based restorative fillings
Meetings with stakeholders, including teaching staff/officials at dental colleges/universities/teaching hospitals, officials of higher education commission (HEC), Pakistan medical and Dental Council (PMDC) and Ministry of health.
Publications with findings  from the field and policy recommendations
Advocacy for the need and importance to revise existing curriculum at dental teaching institutions through Letters to Editors of leading daily newspaper in the country, meetings with the members of higher government officials/stakeholders responsible for the curriculum revision
Advocacy for the  implementation of new curriculum thus developed

Findings:

The preliminary findings of the survey suggest:
Out of 38 dental institutions, 35 institutions were accessed. It was found that 40% of institutions follow the curriculum prescribed by Pakistan Medical and Dental Council, 20% University of Health Sciences, 11% Karachi University and 8% Bahria University.
Bachelors of Dental Surgery (BDS) curriculum prescribe amalgam restorative filling but not specifically mercury amalgam restorative dentistry. Course contents lack any relevant information regarding the protective measures in case of mercury spill, technical skills in the handling and storage of mercury amalgam filling, the environmental degradation due to mercury, assuring safe and environmental friendly waste management of mercury and other occupational health and safety issues, best environmental practices, methodologies and technologies.

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For More Information, Contact the Following Person:


Mahmood A. Khwaja
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