Toxic Mercury/Mercury Amalgm Use in Dentistry

Toxic Mercury/Mercury Amalgm Use in Dentistry

Publication details

  • Tuesday | 01 Apr, 2014
  • Mahmood A. Khwaja, Sadaf Nawaz
  • Research Reports,Project Publications
  • 20
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Sadaf Nawaz, Mahmood A. Khwaja

Review and Evaluation of Curriculum in Dental Teaching Institutions of Pakistan


The present study was designed follow up to an earlier SDPI study reported last year, in May, 2013, regarding alarmingly high mercury levels in air (indoor as well as outdoor) at 11 of the 34 dental sites (17 dental teaching institutions, 7 general hospitals & 10 dental clinics) in five main cities of Pakistan. 88% of the sites indicated indoor mercury levels in air above the USA EPA reference level of 300ng/m3. These very high levels of mercury vapors in air are thought to be due to more than one reasons, including the use of liquid mercury & non-mechanical mixing for mercury amalgam making and lack of environmentally sound best practices for mercury emissions/releases control. SDPI study also showed general unawareness among dental professionals regarding appropriate handling of mercury/mercury amalgam, management of mercury containing wastes, improper and inadequate ventilation system and lack of awareness about health hazards of mercury exposure to human health and its impact on the environment. Another main reason for the observed elevated levels of mercury vapors in air at operative dentistry wards/halls, adjacent corridors and surrounding air, at some of the visited dental teaching institutions, was the very careless/care free use of mercury/mercury amalgam by the students of these institutions.

UNEP Global assessment report on mercury, assesses mercury as toxic to humans, wildlife and environment. In the list of toxic substances, mercury is ranked at 3rd by ATSDR, the agency of toxic substances and disease registry.

The present SDPI study was undertaken, in view of the hazardousness of mercury, its adverse impacts on environment and health, lack of environmentally sound practices/technologies in dentistry and lack of awareness of the same, among majority of present and future dental professionals in the country. The main objective of the present study was to review the curriculum/syllabus, presently offered by national and professional bodies (including Pakistan medical and dental council-PMDC) to the dental teaching institutions in the country and to assess and evaluate its contents with regard to mercury/mercury amalgam use and the related issues, For comparison and guidance, the curriculum offered by medical and dental council of neighboring countries, Bangladesh and India and some teaching institutions in India and Pakistan were also reviewed.

A survey carried out at 38 dental teaching institutions in the country indicated (42.86% of the respondents) that the present curriculum did not effectively lead outgoing future dental professionals and did not provide information, knowledge and training on the mercury/ mercury amalgam related human health issues. As also expressed by large majority of the respondents (90.48%), it’s time that the current dental curriculum offered to dental teaching institutions in the country be reviewed and revised at the national level, to fulfill the existing serious omissions by including relevant contents regarding the health, safety, environment, non-mercury fillings/alternatives materials, guidelines for mercury contaminated waste management and control measures for mercury emissions/releases. Details of the activities, collected data, findings material/results and recommendations are described and discussed in the foregoing pages.

Key words: amalgam, curriculum, dentistry, health, mercury